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How to (Not) Hydroxychloroquine COVID-19

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The medical journal The Lancet published a study Friday which showed anti-malarial drug hydroxychloroquine (HCQ) — the same drug repeatedly pushed by Trump — does not work as intended against the virus which causes COVID-19.

Hydroxychloroquine’s precursor drug, chloroquine, has shown mild antiviral action in vitro against the Borna disease virus (an orthobornavirus), the minute virus of mice MVMp (a parvovirus), and the avian leukosis virus (a retrovirus) as well as the coronavirus which causes SARS. It has also shown promise against Hepatitis A (a hepatovirus).

But both hydroxychloroquine and chloroquine posed inherent risks to patients as they increased the risk of heart arrhythmia.

Ideally, HCQ’s antiviral effect would prevent the coronavirus SARS-CoV-2 from replicating, allowing the body to attack and remove the virus before it could attack human cells and spread through the body, resulting in earlier recovery from the infection.

Patients who received both HCQ, or its precursor chloroquine, with or without an additional antibiotic, did not recover faster than the cohort which didn’t receive chloroquine.

Further, the patients receiving the drug therapies were more likely to die than those who didn’t.

This study is the latest showing HCQ or chloroquine both didn’t work and increased patient mortality. Previous negative studies included:

Effect of High vs Low Doses of Chloroquine Diphosphate as Adjunctive Therapy for Patients Hospitalized With Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Infection – A Randomized Clinical Trial
Mayla Gabriela Silva Borba, MD; Fernando Fonseca Almeida Val, PhD; Vanderson Souza Sampaio, PhD; et al
JAMA Network Open. 2020;3(4):e208857. doi:10.1001/jamanetworkopen.2020.8857
https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2765499

Of particular note:

Findings In this phase IIb randomized clinical trial of 81 patients with COVID-19, an unplanned interim analysis recommended by an independent data safety and monitoring board found that a higher dosage of chloroquine diphosphate for 10 days was associated with more toxic effects and lethality, particularly affecting QTc interval prolongation. The limited sample size did not allow the study to show any benefit overall regarding treatment efficacy.

Outcomes of hydroxychloroquine usage in United States veterans hospitalized with Covid-19
Joseph Magagnoli, Siddharth Narendran, et al
Pre-print; posted April 23, 2020. medRxiv 2020.04.16.20065920; doi: https://doi.org/10.1101/2020.04.16.20065920
https://www.medrxiv.org/content/10.1101/2020.04.16.20065920v2

Of particular note:

CONCLUSIONS: In this study, we found no evidence that use of hydroxychloroquine, either with or without azithromycin, reduced the risk of mechanical ventilation in patients hospitalized with Covid-19. An association of increased overall mortality was identified in patients treated with hydroxychloroquine alone. These findings highlight the importance of awaiting the results of ongoing prospective, randomized, controlled studies before widespread adoption of these drugs.

We still don’t know why Trump is pushing this drug. It’s no longer under a patent and now a generic medication; it’s cheap to produce. If there’s money to be made by promotion of this medication it’s not clear how Trump profits.

We still can’t be certain he’s taking it himself though he claims he is; the letter from his doctor does not clearly state that Trump has been prescribed HCQ and at what dosage for what period of time nor has there been any information provided with regard to the nature of monitoring Trump receives while taking HCQ.

We don’t know why Trump would claim to take HCQ on the advice of some unknown person alleging to be a doctor. We’ve no further information about the letter, the letter’s author, whether a letter even existed since Trump has a proven propensity for making up shit.

All we can be sure of at this point is that more patients with COVID-19 may have died, potentially because of HCQ’s promotion by Trump, than may have died had he refrained from practicing medicine without a license by pushing HCQ.

In the case of the study of HCQ at Veterans Health Administration medical centers, former service persons who’ve already paid a price for our freedoms have been used in human experimentation in what might have been an attempt to validate Trump’s claims about HCQ — and some of them died for it.

It seems odd VA doctors used it out of the clear blue when the Food and Drug Administration hadn’t formally approved this drug for COVID-19 patients. (It’s probably just a coincidence the Center for Disease Control lifted its guidance on off-label use of HCQ two weeks before the VA study was published, right?)

It’d be nice to know if Trump’s three golf buddies at Mar-a-Lago — one of then a doctor — had anything to do with the use of HCQ and chloroquine at VA hospitals on COVID-19 patients.

There’s simply no good reason for Trump’s plugging this particular drug therapy except to harm and kill Americans.