
Hydroxychloroquine causes viral load reduction in Covid-19 patients - ronreiter
https://www.covidtrial.io/
======
pdkl95
_~sigh~_ just got this note from my mother, who has taken hydroxychloroquine
ever since she was diagnosed with lupus over 30 years ago:

> just spent a nightmaremorning trying to get my Lupus meds. [after this
> hydroxychloroquine/covid-19 announcement], no pharmacy has any!

> I spoke directly to the pharmacist. she said that she has no control. this
> wil be first come first serve, she cannot give preferential treatment even
> though I have been diagnosed for 33 years and buying this med from her for a
> long time.

> she has reordered. shes gets many requests an hour today for MY lupus
> medication. im on a list

~~~
_bxg1
Just one tragedy-of-the-commons after another.

------
jonaphin
The immunology department of Marseille, France reported 3 days ago that taking
hydroxy-chloroquine and azithromycin together led to 90% of pilot program
patients testing negative after 6 days.

There are also several publications under review at the NIH. Glad to see the
US Gov. stepping up to the plate so fast on the subject.

------
DyslexicAtheist
[https://en.wikipedia.org/wiki/Hydroxychloroquine#Research](https://en.wikipedia.org/wiki/Hydroxychloroquine#Research)

...

 _> Hydroxychloroquine and chloroquine have been recommended by Chinese and
South Korean health authorities for the treatment COVID-19.[31] [32] In vitro
studies have demonstrated that hydroxychloroquine is more potent than
chloroquine against SARS-CoV-2 with a more tolerable safety profile.[33]

> On 16 March 2020, advisor to the French Government on COVID-19, Professor
> Didier Raoult, announced that a non-randomized unblinded trial[34] involving
> 24 patients from the south east of France supported the claim that
> hydroxychloroquine was an effective treatment for COVID-19.[35] The trial is
> yet to be peer-reviewed.[34] An amount of 600 mg of hydroxychloroquine
> (brand name Plaquenil) was administered to these patients every day for 10
> days. They reported "a significant decrease in viral load".[34] The drug
> appeared to be responsible for a "rapid and effective speeding up of their
> healing process, and a sharp decrease in the amount of time they remained
> contagious".[36] 70% of patients were "considered cured", compared with
> 12.5% of those who did not receive hydroxychloroquine and azithromycin
> combination.[34] The antibiotic azithromycin - which is known to be
> effective against secondary infections from bacterial lung disease - led to
> even better outcomes. Professor Raoult said the results showed there was "a
> spectacular reduction in the number of positive cases" with the combination
> therapy. At 6 days, among patients given combination therapy, the percentage
> of cases still carrying SARS-CoV-2 was no more than 5%.[37][38]

> On March 17 after testing in several hospitals around Italy the Italian
> Pharmaceutical Agency has included hydroxychloroquine in the list of drugs
> with positive preliminary results for treatment of coronavirus disease
> 2019.[39]_

\----

What is strange is that azithromycin - leads to better outcomes. It is used
for bacterial infections but Covid is a virus. How can this be?

~~~
kian
I would guess that opportunistic bacterial co-infections are being suppressed
by the azithromycin, which leaves more room for the immune system to respond
directly to SARS-CoV-2. Viral Pneuomonia can easily lead to Bacterial
Pneumonia. Combined with an attack directly on SARS-CoV-2, and you get a
combination therapy that hopefully works.

~~~
didgeoridoo
While your explanation seems the most likely, macrolide compounds like
Azithromycin may actually have direct antiviral effects of their own:
[https://erj.ersjournals.com/content/45/2/428](https://erj.ersjournals.com/content/45/2/428)

~~~
masonic
That's against rhinovirus, not coronavirus.

~~~
didgeoridoo
The study focused on rhinoviruses because they are the dominant source of
viral morbidity in CF patients. If their proposed MoA (interferon agonist in
epithelial cells) is correct, there’s a good reason to believe the antiviral
effect is nonspecific to rhinovirus.

------
kian
To any scientists - an anti-malarial is found to be effective against
coronavirus. At the same time, initial reports are suggesting that people with
type O blood have a reduced risk of infection and lower infection severity
than those with other blood types. The same pattern also holds true for
malaria, with type O blood having a protective and suppressive effect. If the
coronavirus is getting into cells via the ACE2 receptor, why would we expect
any of this other stuff to be effective? Why is an anti-parasitic working to
reduce viral load? Why is the same blood type protective of both? What common
mechanism of action or attack (perhaps hitching a ride on blood cells to
spread through the body?) are we missing?

~~~
LinuxBender
I am not a scientist, but I have been following the scientists that are
studying this. Chloroquine is a zinc ionophore much like the supplement
Quercetin [1][2][3]. Both allow zinc to be transported into the cell,
preventing or slowing the RNA transcoding process that hijacks your replicator
functions. This vastly slows down the replication, allowing your adaptive
immune system to get ahead of and destroy the virus faster than it can
replicate.

I am not familiar with the observations around type-O blood, but I have been
following the discussions on ACE2 and ACE/ACE2 inhibitors (blood pressure
meds) which is interesting. The jury is still out on that one, but the theory
for ARB's is forcing a binding that blocks nCoV from attaching to the
receptor. [4]

[1] -
[https://examine.com/supplements/quercetin/](https://examine.com/supplements/quercetin/)

[2] -
[https://www.ncbi.nlm.nih.gov/pubmed/25050823](https://www.ncbi.nlm.nih.gov/pubmed/25050823)

[3] -
[https://www.youtube.com/watch?v=vE4_LsftNKM](https://www.youtube.com/watch?v=vE4_LsftNKM)
Chloroquin, Quecertin 6 mins in

[4] -
[https://www.youtube.com/watch?v=1vZDVbqRhyM](https://www.youtube.com/watch?v=1vZDVbqRhyM)

~~~
has2k1
Given that Chroloquine has been around for a long time and that it is well
studied, is there any merit to assume that using it was not a random idea and
that it works against some other known RNA viruses?

~~~
mrep
Apparently the possible utility of chloroquine was discovered because SLE
patients on it in China weren't getting Covid-19 during the outbreak [0].

[0]:
[https://www.jqknews.com/news/388543-The_novel_coronavirus_pn...](https://www.jqknews.com/news/388543-The_novel_coronavirus_pneumonia_has_short_term_curative_effect_on_the_treatment_of_new_crown_pneumonia.html)

------
warmfuzzykitten
The report is from a small trial that was not blind or randomized.
Encouraging, but hardly worthy of the headline. How about "Hydroxychloroquine
associated with viral load reduction in a small number of Covid-19 patients"?

------
mbank
Study from Marseille seems well founded, although (of course) based on a small
sample. Why isn't this higher up?

~~~
kylehotchkiss
Thankfully it seems like US and French governments have seen the study and
immediately decided to remove red tape for larger sample sizes.

[https://med.umn.edu/news-events/covid-19-clinical-trial-
laun...](https://med.umn.edu/news-events/covid-19-clinical-trial-launches-
university-minnesota)

I just hope they don't wait "weeks" if they see in 10 days significant
results. They can wait weeks for the formal, 100 page study, but hope we see
some tweets saying go/no go in 10 days after rolling this out.

------
robertpelloni
I hope this makes it on the front page. This might be a real solution to a
large portion of the problem given that it is readily available, easy to
manufacture, and prevents infection with less side effects than regular
chloroquine. Large amounts of the population could be prescribed this as a
prophylactic and prevent much of the spread from occurring even in high risk
occupations. I would love to see the telehealth system used to send
prescriptions for this to pharmacies everywhere for at risk workers.

~~~
jdxcode
Trump already gave a press conference about it today about the FDA
investigating it quickly

------
salmon30salmon
This is exactly the kind of response we need. A well known, well understood
medicine with a low risk profile that we can deploy as soon as possible.

If the CDC believes that destroying the economy to stop this disease is worth
it, then I can't doubt that the FDA would agree that deploying this medication
immediately is worth the risk.

------
lisk1
Due to the outbreak global supplies will be disrupted also there are people
that take it as prescription medicine for arthritis, its relevant people to
have access to the synthesis of it. Here is a paper describing cost effective
way to synthesis it [1].Its not trivial task but good information to have
access to. Had a quick look at the precursor chemicals used in this synthesis
they are sold from global chemical suppliers and doesn't seem to have any
specific restriction for sell.

[1] [https://www.beilstein-
journals.org/bjoc/articles/14/45](https://www.beilstein-
journals.org/bjoc/articles/14/45)

------
hackeerTwo
Anyone care to explain the risks of using this drug?

\- I know one must get tested for G6PD deficiency or it may lead to a
hemolytic crisis. But I'm unsure how probable one is to have it or how long
until this potential problem arises.

\- I heard this drug can cause heart attacks in some people, Can this be
predicted by a test? Some users on r/covid19 were advising against taking it
without doctor supervision in a hospital for this reason but didn't explain
nor gave statistics, as usual. The problem was related to prolonged qt
intervals

~~~
th3o6a1d
For one, hydroxychloroquine, and especially when used in combination with
azithromycin, can cause prolongation of an electrocardiogram interval called
QT. The degree of QT prolongation is associated with a risk of sudden cardiac
death. QT prolongation is an issue in patients with underlying heart disease
or electrolyte abnormalities. QT > 500 is associated w/ increased risk of
sudden death.

------
pen2l
For those who are infected with Covid-19, but observe low severity in
symptoms, is there a correlation to how they'll fare through the disease?

I.e., perhaps they need not even take this medication?

------
fullshark
This is the first promising bit of news I've seen in days.

------
burfog
This looks like a vaccine to me.

We sometimes use weakened live viruses as vaccines. For example, we did it for
polio.

Hydroxychloroquine weakens the virus. No, it isn't genetically weakened, but
that doesn't make a difference. Start the person on hydroxychloroquine, then
give them the virus.

------
fb1994
Why are herbs never included in any clinical trials. Are they totally
worthless although used extensively

~~~
redsymbol
There are several reasons, but a big one is that they cannot be mass produced
with consistent quality as easily as synthesized chemicals.

