Despite multiple studies that show that hydroxychloroquine reduces mortality by up to 50% when administered in low doses, 200-400 mg daily, preferably in an early stage of infection, there are many medical "experts", particularly those advising politicians, who refuse to consider the evidence. Many base their opinion on the Recovery trial posted July 15, 2020.
where patients were given up to 2400 mg of HCQ, which although not lethal in itself is 6 to 10x more than multiple successful trials and could explain the reported adverse effects.
Many believe that HCQ was rejected because President Trump promoted it.
Another reason is that it was not possible to find any positive reports through a search on Google. Try searching on Google using "hydroxychloroquine
" or "HCQ Covid studies" to see that it only shows negative studies, mostly relatively old. The only positive study listed out of the top 50 results referred to a critical article on the study, apparently not an accident.
Google might be liable for massive damages and misrepresentation in not stating that the search has been edited on their search page.
29 July 2020. When President Trump tweeted a link to a group called Medicine and Censors link which advocated using hydroxychloroquine as a treatment for COVID-19, where it received 17 million hits, it was removed by Facebook almost immediately. The video can be seen here. I do not know if their argument has merit, but it sounded plausible, even though the doctors were accused of being Tea Party supporters, and its leader Dr Gold has since been charged for participating in the invasion of the Capitol on 6 January 2021.
Dr. Didier Raoult
prematurely reported success using hydroxychloroquine with azithromycin, but in his eagerness to share his results, did not observe accepted protocols for proof and has been accused of allowing his pride and arrogance to distort his early results, possibly true or as an attempt to discredit him and his results.
Hydroxychloroquine as a cure for Covid-19 patients.
January 2021 - Well, well, well, will you look at that. The American Journal of Medicine just published an article about "early outpatient treatment of SARS-CoV-2" which INCLUDES hydroxychloroquine. Yes, you read that correctly. "The absolute state of the medical field validating HCQ!
Hydroxychloroquine (HCQ) is an antimalarial/anti-inflammatory drug that impairs the endosomal transfer of virions within human cells. HCQ is also a zinc ionophore that conveys zinc intracellularly to block the SARS-CoV-2 RNA-dependent RNA polymerase, the virus replication's core enzyme.
The currently completed retrospective studies and randomized trials have generally shown these findings:
1) when started late in the hospital course, and for short durations of time, antimalarials appear to be ineffective,
2) when started earlier in the hospital course, for progressively longer durations and in outpatients, antimalarials may reduce the progression of the disease, prevent hospitalization, and are associated with reduced mortality.
Here is a link to a Database of all known HCQ COVID-19 studies. 254 studies, 184 peer-reviewed, 208 comparing treatment and control groups.
HCQ is not effective when used very late with high dosages over a long period (RECOVERY/SOLIDARITY); effectiveness improves with earlier usage and improved dosing. Early treatment consistently shows positive effects. Negative evaluations typically ignore treatment time, often focusing on a subset of late stage studies. In Vitro evidence made some believe that therapeutic levels would not be attained, however that was incorrect.
A highly recommended peer-reviewed study by Henry Ford Health Systems published 2 July 2020 in the International Journal of Infectious Diseases found that Treatment with Hydroxychloroquine Cut Death Rate Significantly in COVID-19 Patients, with 13% of hospitalized patients treated with hydroxychloroquine alone died of COVID-19, compared to 26.4% who died who were NOT treated with the drug.
Washington Times link also here. Hydroxychloroquine is effective, 'helped save lives.
Also not found using any Google search is this YouTube video by Dr John Campbell who has 742,000 subscribers.
Dr John Campbell explains that the failed Hydroxychloroquine studies gave unexplained high dosages of up to 10 x the guidelines of 200 to 400 mg based on weight. He discusses a Belgium study "Low-dose Hydroxychloroquine Therapy and Mortality in Hospitalized Patients with COVID-19: A Nationwide Observational Study of 8075 Participants (International Journal of Antimicrobial Agents, 24 August)".
Hydroxychloroquine is not a panacea for severe cases of Covid-19. Apparently given early, it helps reduce mortality by about half, compared to those not given the drug. Indian Experts Explain: The case for using hydroxychloroquine (HCQ) to treat Covid-19.
Here are references to chloroquine dating back to August 2005 as a cure for SARS."Chloroquine, a relatively safe, effective and cheap drug used for treating many human diseases, including malaria, amoebiosis and human immunodeficiency virus, is effective in inhibiting the infection and spread of SARS CoV in cell culture. The fact that the drug has a significant inhibitory antiviral effect when the susceptible cells were treated either prior to or after infection suggests a possible prophylactic and therapeutic use.".
Pharmacology of Chloroquine and Hydroxychloroquine
Chloroquine (CQ) and HCQ are produced and administered orally in tablet form
(Pastick et al., 2020). CQ tablet consists of 500 mg of CQ phosphate. HCQ tablet is composed of 200 mg of HCQ sulfate. The required dosage varies according to the treated disease. For malarial prophylaxis, a weekly dosage of 6.5 mg/kg is prescribed to adult and pediatric patients. However, a single dose should not exceed 400 mg. Patients are instructed to take two doses before travelling to endemic countries and continue the same dose until 1 month after return. A higher dosage of 2000 mg is used to treat acute malaria. On the contrary, a daily dosage of 200-600 mg is used to treat rheumatoid arthritis and systemic lupus erythematous.
For the treatment of COVID-19, the used daily dosages of HCQ have ranged between 800 and 1,600 mg. However, in one study, they defined the effective and safe dose of HCQ based on data reported by in vitro studies and clinical trials (Garcia-Cremades et al., 2020). They examined the relationship between viral load reduction and the dosing of HCQ in treated COVID-19 patients. In this study, it was concluded that a daily dose of HCQ should not exceed 800 mg. Higher dosages may lead to a quicker reduction in viral load and clinical improvement. However, they may induce undesired side effects such as QT interval prolongation. For the therapy duration, the above-mentioned regimen should be given over 7 days.
Refer to the article
about bioavailability, Anti-inflammatory and Anti-infectious Activity of Chloroquine and Hydroxychloroquine. Their elimination half-lives are estimated at 40-50 days
. The medical use of quinine dates back to 1630 A.D. when the quinine powder, extracted from the tree of Cinchona, was employed to treat malaria. CQ and HCQ were approved by the U.S. Food and Drug Administration (FDA), not only as treatment and prophylaxis for malaria but also as a treatment for rheumatic diseases. Quinine derivatives are currently considered safe and well-tolerated medicines that effectively treat a wide range of chronic autoimmune and rheumatic diseases such as anti-phospholipid syndrome, discoid or systemic lupus erythematosus, Sjogren disease, juvenile idiopathic arthritis, psoriatic arthritis and rheumatoid arthritis, among others. CQ and HCQ are similarly effective in treating skin diseases such as dermatomyositis, cutaneous sarcoidosis, eosinophilic fasciitis, lichen planus and porphyria cutanea tarda. Additional distinguishing effects have also been reported in the literature. They include anti-thrombotic, anti-neoplastic, and anti-microbial effects. In addition, the use of HCQ in systemic lupus erythematosus and rheumatoid arthritis patients has been associated with diminished rates of cardiovascular morbidities and diabetes mellitus, shedding light on added favorable properties that need to be further investigated. Similarly, HCQ was associated with improved glycemic and lipid profiles in these patients and improved overall survival and life quality.
Other uses for HCQ have also been reported. For instance, when co-administered with doxycycline, HCQ can be effective in treating Q fever endocarditis. This regimen results in quicker recovery rates and infrequent relapses when compared to the originally adopted regimen. Similarly, HCQ appears to be adequate for the management of Whipple disease and Tropheryma whipplei endocarditis. Moreover, HCQ is effective against a multitude of other microbial agents such as giardia, Ebola virus, hepatitis C, HIV and chikungunya
Many advantages make HCQ an attractive candidate. Not only it is safe, but it is also an effective medication with a broad spectrum of action covering various microbial and autoimmune diseases, likely by virtue of its ability to modulate the immune system. Additionally, HCQ is a cheap medication with a good safety profile that has been garnered over hundreds of years of its use. Importantly, it can be safely used in pregnant women.
The undesired side effects of this drug are also mild.
The UK called Randomised Evaluation of Covid-19 Therapy, or "Recovery" trial.
July 15,2020. Conclusions
In patients hospitalized with COVID-19, hydroxychloroquine was not associated with reductions in 28-day mortality but was associated with an increased length of hospital stay and increased risk of progressing to invasive mechanical ventilation or death.
This trial has been questioned due to the high dosage of HCQ. "Patients allocated to hydroxychloroquine sulfate (200 mg tablet containing 155 mg base equivalent) received a loading dose of 4 tablets (800 mg) at zero and 6 hours, followed by 2 tablets (400 mg) starting at 12 hours after the initial dose and then every 12 hours for the next 9 days or until discharge (whichever occurred earlier)".
That's 2400 mg in the first 24 hours (including the second 400 mg dose at the 24 hour mark, 2000 mg if you don't count the dose at the 24 hour mark), 9600 mg in the first 10 days. Either way, 2000 or 2400 mg in 24 hours is three to six times higher than the FDA recommended daily dose. That could easily be considered a toxic dose. Why did this study use such a high dose? And why did they not include zinc? And why did they think it would be useful to test this treatment on severely ill Covid patients?
Trials and Conclusion - continued
Evidence on the effectiveness and safety of HCQ in treating COVID-19
infection is still controversial. Most of the available studies are non-randomized with preliminary results. We argue that multi-center placebo-controlled randomized clinical trials are urgently needed to assess the efficacy, safety and determining the best dosing regimen of HCQ. It is also essential to assess longer-term effects, and thus a thorough examination of upcoming results reported by high-quality ongoing trials is much needed. Additionally, it should be noted that reports indicate that both the RECOVERY and SOLIDARITY trials used heavy dosages, and both were not aimed at early intervention, which seems to have shown the best results.
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