Sequential

CQ / HCQ Research Papers and Reports

January

to April 20, 2020

Executive

Summary Interpretation of the Data In This Report

The HCQ-AZ combination, when started immediately after
diagnosis, appears to be a safe and efficient treatment for COVID-19,
with a mortality rate of 0.5%, in elderly patients. It avoids worsening
and clears virus persistence and contagious infectivity in most cases.

Sequential

CQ / HCQ Research Papers and Reports

        January to April 12 2020

22 August 2005

CDC

Special Pathogens Branch 

MJ

VIncet, E.Bergon, S. Benjannet, BR Erickson, Pierre Rollin, T.G.

Ksiazek, NG Seidah, 

ST

Nichole. Chloroquine

is a potent inhibitor of SARS coronavirus infection and spread.

Virology Journal. (2005) 2: 69

Chloroquine

has strong antiviral effects on SARS CoV infection of primate cells in

tissue culture. These

inhibitory effects are observed when cells are treated with the drug

either before or after exposure to the virus, suggesting both

prophylactic preventative and treatment use.



The paper describes three mechanisms by which the drug might work and

suggest it may have both a prophylactic and therapeutic role in

Coronavirus infections.

28 January 2020

M. Wang, R. Cao, L. Zhang, X. Yang, J. Liu, M. Xu, Z. Shi, Z. Hu, W.

Zhong, G. Xiao

LETTER

TO THE EDITOR  Cell Research Remdesivir

and chloroquine effectively inhibit the recently emerged novel

coronavirus (2019-nCoV) in vitro.

Cell Research (2020) 0:1–3; https://doi.org/10.1038/s41422-020-0282-0

Tested

Remdesivir and Chloroquine in addition to five other drugs were tested

in tissue culture against a clinical sample of virus from a COVID-19

patient,  Remdesivir

and Chloroquine are highly effective in the control of 2019-nCoV

infection in vitro. Since

these compounds have been used in human patients with a safety track

record and shown to be effective against various ailments, we suggest

that they should be assessed in human patients suffering from the novel

coronavirus disease.

February 13, 2020

 

Physicians work out treatment guidelines for coronavirus,
Korea
Biomedical Review    http://www.koreabiomed.com/news/articleView.html?idxno=7428

The
Korean  COVID-19 Central Clinical Task Force, held the sixth video
conference and agreed on treatment principles for patients with
COVID-19.

• Young with mild symptoms without underlying conditions, doctors can observe
  

  them without antiviral treatment.

  
  

• If 10 days have passed since the onset of the illness and the symptoms are
  

  mild, physicians do not have to start an antiviral medication.

  
  
• If patients are old or have underlying conditions with serious symptoms,
  
   physicians should consider an antiviral treatment as soon as possible.

  lopinavir 400mg/ritonavir 100mg (Kaletra two tablets, twice a day) or
  
  chloroquine 500mg orally per day. Alternate is hydroxychloroquine 400mg orally per day.

  
  

February 18, 2020.

Jianjun

Gao, Zhenxue Tian, Xu Yang  Breakthrough:

Chloroquine phosphate has shown apparent efficacy in treatment of

COVID-19 associated pneumonia in clinical studies.

BioScience Trends Advance Publication, DOI: 10.5582/bst.2020.0104

Thus

far, results from more than 100 patients have demonstrated that chloroquine phosphate is superior to

the control treatment in inhibiting the exacerbation of pneumonia,

improving lung imaging findings, promoting a virus negative conversion,

and shortening the disease course.

 

Severe adverse reactions to chloroquine phosphate were not noted in the

aforementioned patients. Given these findings, a conference was held on

February 15, 2020; participants including experts from government and

regulatory authorities and organizers of clinical trials

reached an agreement that chloroquine phosphate has potent activity

against COVID-19.

27 February 2020

Philippe

Colson , Jean-Marc Rolain , Jean-Christophe Lagier , Philippe Brouqui ,

Didier Raoult , Chloroquine

and hydroxychloroquine as available weapons to fight COVID-19,

International Journal of Antimicrobial Agents  Feb (2020), doi:

https://doi.org/10.1016/j.ijantimicag.

2020.105932

following the very recent publication of results showing the in vitro activity of

chloroquine against SARS-CoV-2, data have been reported on the efficacy

of this drug in patients with SARS-CoV-2-related pneumonia (named

COVID-19) at different levels of severity. 

Following the in vitro results, 20 clinical studies were launched in several

Chinese hospitals.

The first results obtained from more than 100 patients showed

 the superiority of chloroquine compared with treatment

of the control group in terms of reduction of exacerbation of

pneumonia, duration of symptoms and delay of viral clearance, all in

the absence of severe side effects.

This has led in China to include chloroquine in the recommendations

regarding the prevention and treatment of COVID-19 pneumonia. 

Chinese

teams showed that Chloroquine

could reduce the length of hospital stay and improve the evolution of

COVID-19 pneumonia,

leading to recommend the administration of 500 mg of chloroquine twice

a day in patients with mild, moderate and severe forms of COVID-19

pneumonia. 

4 March 2020

Philippe

Colson,a,b

Jean-Marc

Rolain,a,b

Jean-Christophe

Lagier,a,b

Philippe

Brouqui,a,b

and Didier

Raoult,

Chloroquine

and hydroxychloroquine as available weapons to fight COVID-19.

Int

J Antimicrob Agents.

2020 Mar 4 : 105932. doi: 10.1016/j.ijantimicag.2020.105932

[Epub ahead of print]  PMCID: PMC7135139   IPMID: 32145363

A

review of the safety and efficiency of CQ and HCQ reviewing more than 20

clinical studies in several Chinese hospitals. 

Although only available in letter form, this data caused China to 

recommend Chloroquine in the National Guidelines for the Treatment of

COVID-19.

9 March 2020

X.Yao,

F/ Ye2, M. Zhang, C.Cui, R. Lu, H. Li, W. Tan, D. Liu. In

Vitro Antiviral Activity and Projection of Optimized Dosing Design of

Hydroxychloroquine for the Treatment of Severe Acute Respiratory

Syndrome Coronavirus 2 (SARS-CoV-2).

2020..

Clin

Infect Dis. 2020

Mar 9. pii: ciaa237. doi: 10.1093/cid/ciaa237.

Hydroxychloroquine

was found to be more potent than chloroquine at inhibiting SARS-CoV-2

in vitro. Hydroxychloroquine

sulfate 400 mg given twice daily for 1 day, followed by 200 mg twice

daily for 4 more days is recommended to treat SARS-CoV-2 infection.

9 March 2020

Expert Chinese consensus on Chloroquine Phosphate for New Coronavirus

Pneumonia. Diagnosis and Treatment Plan.

Chinese Journal of Tuberculosis and Respiratory Diseases. 2020, 43:

A

Multicenter Collaboration Group was formed to guide

and standardize the use of Chloroquine in Coronavirus pneumonia,

standardizing Chloroquine treatment at 500mg 2x day for 10 days.

Use

of azithromycin was contraindicated.

20 March 2020

Gautret

P, Lagier

JC, Parola

P, Hoang

VT, Meddeb

L, Mailhe

M, Doudier

B, Giordanengo

V, Vieira

VE, 

La

Scola B, Rolain

JM, Brouqui

P, Raoult

D.

Hydroxychloroquine and azithromycin as a treatment of COVID-19: results

of an open-label non-randomized clinical trial.

Int

J Antimicrob Agents. 2020

Mar 20:105949. doi: 10.1016/j.ijantimicag.2020.105949. 

Confirmed

COVID-19 patients were included in a protocol from early March to March

16th, to receive  600mg of hydroxychloroquine daily and their

viral load in nasopharyngeal swabs was tested daily in a hospital

setting. 

Untreated

patients from another center were included as negative controls. 

20

cases were treated in this study and showed a significant reduction of

the viral levels at D6-post inclusion compared to controls,

and much lower average carrying duration than reported of untreated

patients in the literature. Azithromycin added to hydroxychloroquine

was significantly more efficient for virus elimination.

Despite

its small

sample size our survey shows that hydroxychloroquine treatment is 

significantly

associated with viral load reduction/disappearance in

COVID-19 patients and its effect is reinforced by azithromycin,

20 March 2020

Mount Sinai health system treatment guidelines for SARS-CoV-2 infection

(COVID-19)

 https://www.mountsinai.org/health-library/diseases-conditions/2019-novel-coronavirus-2019-ncov

Last accessed on 20th March 2020.

Mount

Sinai Heath System establishes protocols for dosing and treatment of

COVID-19 patients using Chloroquine and Hydroxychloroquine.

27 March 2020

P.

Gautret, J.C. Lagier, P. Parola, V.T. Hoang, T. Dupont, S. Honoré, A.

Stein, M. Million, B. La Scola, P. Brouqui, Didier Raoul. Hydroxychloroquine-Azithromycin

Treatment for COVID-19 Shown to be Effective in an 80-Patient Study


IHU-Méditerranée

Infection, Marseille, France

 March 27, 2020 

In

80 patients

receiving

hydroxychloroquine and azithromycin we

noted a clinical improvement in

all but one 86 year-old patient who died, and one 74 year still in ICU.

A rapid fall of nasopharyngeal viral load tested by qPCR was noted,

with Virus

cultures from patient respiratory samples turning negative in 97.5%

patients at Day 5. 

This

allowed patients to rapidly be discharged from highly contagious wards

with a

mean length of stay of five days.

10 March 2020

Cortegiani

A., Ingoglia G., Ippolito M., Giarratano A., Einav S. A systematic

review on the efficacy and safety of chloroquine for the treatment of

COVID-19.

J Crit Care. 2020 Mar 10;(20):30390–30397.

A

review was made of six articles (one narrative letter, one in-vitro

study, one editorial, expert consensus paper, two national guideline

documents) and these clinical trials done in China. 

ChiCTR2000030417   

COVID-19

pneumonia                

      (n = 30)   

 

              Chloroquine phosphate   

ChiCTR2000030054

    COVID-19 pneumonia          

            (n = 100)     

            HCQ  0.2 g BID × 14 days

ChiCTR2000030031   

COVID-19

pneumonia                

      (n = 120)   



              400 CQ BID   2

tablets placebo BID   

ChiCTR2000029992   

Severe

COVID pneumonia               

(n = 100)   

 

              CQ 1.0 g × 2 days,

then 0.5 g × 12

day                                             

    ;HCQ

0.2 g BID x 14 days   

ChiCTR2000029988 

  Severe COVID-19 pneumonia         

  (n = 80)   



                CQ Standard Rx

-Clinical Recovery

ChiCTR2000029975 

  COVID-19 pneumonia            

            (n = 10)   



                CQ inhalation

aerosol 

ChiCTR2000029939 

  COVID-19 pneumonia            

            (n = 100)     

            CQ Standard treatment   

ChiCTR2000029935   

Single-arm

clinical trial                

      (n = 100)   



                CQ No

comparison 

ChiCTR2000029899   

Mild

COVID-19 pneumonia             

  (n = 100)              

  HCQ:  6 tablets (0.2 g/ 6 tablets/day 

ChiCTR2000029898   

Severe

COVID pneumonia               

  (n = 100)              

  HCQ Hydroxychloroquine 2 tablets/day 

ChiCTR2000029868   

COVID-19

pneumonia                

        (n = 200)        

        HCQ Standard Rx Viral test

ChiCTR2000029837   

Mild

COVID-19 pneumonia             

  (n = 120)              

  HCQ tablets and placebo BID   

ChiCTR2000029826   

Critically

ill COVID-19 pneumonia     (n = 45)      

            2 tablets CQ BID- placebo BID

ChiCTR2000029803   

Close

contacts with confirmed          (n = 320)

                HCQ- high

dose 

ChiCTR2000029762   

COVID-19

pneumonia                 

        (n = 60)   

 

                HCQ Standard

treatment   

ChiCTR2000029761   

COVID-19

pneumonia                 

        (n = 240)        

        HCQ Medium-dose group: 

ChiCTR2000029741   

Mild

COVID-19 pneumonia              

  (n = 112)              

  CQ oxygen index during treatment; 

ChiCTR2000029740   

COVID-19

pneumonia                

          (n = 78)        

          HCQ 0.2 g BID Lab testing   

ChiCTR2000029609   

Non-randomized

controlled trial        (n = 205)    

            Mild-moderate CQ group: 

CQ plus Lopinavir/ritonavir; Severe

CQ                 

  ; group;

Severe Lopinavir/Ritonavir group: 

ChiCTR2000029559   

COVID-19

pneumonia                

          (n = 300)      

          Group 1: Hydroxychloroquine 0.1 g

oral BID; Group 2: 

     Hydroxychloroquine

0.2 g oral BID   Placebo control group: Starch

ChiCTR2000029542   

COVID-19

pneumonia                 

          (n = 20)   

Oral

chloroquine 0.5 g BID for 10 days 30-day specific mortality

NCT04286503   

Critically

ill COVID-19               

            (n = 520)   

Carrimycin,

lopinavir/ritonavir or Arbidol or CQ

• 
  

  Chloroquine
  
  seems to be effective in limiting the replication of SARS-CoV-2 in
  
  vitro.

  
  

• 
  

  There
  
  is rationale, evidence of effectiveness and evidence of safety from
  
  long-time clinical use for other indications to justify clinical
  
  research on chloroquine in patients with COVID-19. 

  
  

• 
  

  Safety
  
  data and data from high-quality clinical trials are urgently needed.

  
  

21

March 2020

Duan

YJ, Liu

Q, Zhao

SQ, Huang

F, Ren

L, Liu

L, Zhou

YW.

The Trial of Chloroquine in the Treatment of COVID-19 and Its Research

Progress in Forensic Toxicology.

2020 Mar 25;36(2). doi: 10.12116/j.issn.1004-5619.2020.02.001. [Epub

ahead of print]

Chloroquine

is a long-established prescription drug that is often used clinically

to treat malaria and connective tissue diseases. The

antimalarial drug Chloroquine phosphate which has already been approved

is confirmed

to have an anti-SARS-CoV-2 effect and has been included in diagnostic

and therapeutic guidelines.

However,

awareness of the risk of chloroquine phosphate causing acute poisoning

or even death should be strengthened. The

dosage used according to current clinical recommended dosage and course

of treatment are larger than that of previous treatment of malaria.

Many

provinces have required close clinical monitoring of adverse reactions.

This paper reviews the pharmacological effects, poisoning and

toxicological mechanisms, in vivo metabolism and distribution, and

forensic issues of chloroquine drugs, in order to provide help to

forensic practice and clinical work

21

March 2020

Chloroquine

US prescribing information. https://www.accessdata.fda.gov/drugsatfda_docs/label/2017/009768s037s045s047lbl.pdf

(Last accessed March 21, 2020)

23

March 2020

Yueping

Li, Zhiwei Xie, Weiyin Lin, Weiping Cai, et.al, An

exploratory randomized, controlled study on the efficacy and safety of

lopinavir/ritonavir or arbidol treating adult patients hospitalized

with mild/moderate COVID-19 

doi:

https://doi.org/10.1101/2020.03.19.20038984

According

to investigators, adding

hydroxychloroquine (HCQ), on top of conventional therapy didn’t shorten

the time to SARS-CoV-2 clearance in a 30-patient trial.

No

significant differences were observed across the two arms in terms of

the time it took to bring body temperature to normal or the number

of patients with disease progression as shown in CT scans.

However,

a careful examination of the study reveals a more complicated

situation.

Most

patients in the study's control group were actually treated with

other antiviral drugs at

the same time, including the HIV combo med Kaletra and the Russian flu

drug Arbidol. Most,

but not all, patients in the hydroxychloroquine group were also treated

with Arbidol. All patients also received interferon-alpha, thereby

completely invalidating any assessment of Chloroquine effects.

24

March 2020

Pagliano

P, Piazza

O, De

Caro F, Ascione

T, Filippelli

A.

Is Hydroxychloroquine a possible post-exposure prophylaxis

drug to limit the transmission to health care workers exposed to

COVID19?

Clin

Infect Dis.

2020 Mar 24.

https://www.ncbi.nlm.nih.gov/pubmed/32211764

PMID:

32211764    DOI: 10.1093/cid/ciaa320 

Chloroquine

and Hydroxychloroquine are able to inhibit replication at early stages

of viral


infection.

No

similar effect on early phases of Coronavirus infection has been

reported for other drugs proposed for SARS-CoV-2 treatment, which are

able to interfere only after cell infection.


We

believe that hydroxychloroquine can be effective in preventing

respiratory tract invasion in HCW and that hydroxychloroquine

administration as prophylactic agent could be particularly useful for

HCW attending to high risk procedures on respiratory tract in

COVID-19 patients. 

Hydroxychloroquine effectiveness

profile, its ability to inhibit lung viral replication for a 10-day

period after only a 5- day cycle of therapy, and the large

amounts of knowledge in term of safety deriving from its use

for malaria prophylaxis and rheumatologic diseases permit to

recommend its pre-exposure or post-exposure use for those performing

procedures at high risk of viral diffusion in patients

with COVID-19 pneumonia. 

26

March 2020

A.K.

Singh,, A.

Singh, A.

Shaikh, R.

Singh, and A.

Misra.

Chloroquine

and hydroxychloroquine in the treatment of COVID-19 with or without

diabetes: A systematic search and a narrative review with a special

reference to India and other developing countries. 

Diabetes

Metab Syndr.

Published online 2020 Mar26. doi: 10.1016/j.dsx.2020.03.011

PMCID: PMC7102587

  PMID: 32247211

A

systematic review of Hydroxychloroquine and COVID-19

7

April 2020

Belgium

Task Force Interim clinical guidelines for patients suspected of /

confirmed with COVID-19 infection. 

https://epidemio.wivisp.be/ID/Documents/Covid19/COVID19_InterimGuidelines_Treatment_ENG.pdf

Based

on pharmacokinetic simulations, the recommended dosing of

hydroxychloroquine sulphate is 400mg BID on day 1, followed by 200mg

BID on day 2-5. 

Because

of the long elimination half-life of the drug (32–50 days), the

duration of treatment should not exceed 5 days to avoid accumulation of

hydroxychloroquine concentrations in plasma and tissues, and associated

increased risk of toxicity, and because there is no in vitro evidence

that longer courses improve drug activity on SARS-CoV-2.

10

April 2020Zhaowei

Chen, VJijia

Hu, Zongwei Zhang, Shan Jiang, Shoumeng Han, Dandan Yan, Ruhong Zhuang,

Ben Hu, Zhan Zhang

Efficacy of hydroxychloroquine in patients with COVID-19: results of a

randomized clinical trial doi:https://doi.org/10.1101/2020.03.22.20040758 

Evidence

regarding the in-vivo use of Hydroxychloroquine is limited. In COVID-19

infection. This study evaluated the efficacy of hydroxychloroquine

(HCQ) in the treatment of patients with COVID-19. From February 4 to

February 28, 2020, 62 patients suffering from COVID-19 were diagnosed

and admitted to Renmin Hospital of Wuhan University. All participants

were randomized in a parallel-group trial, 31 patients were assigned to

receive an additional 5-day HCQ (400 mg/d) treatment, Time

to clinical recovery (TTCR), clinical characteristics, and radiological

results were assessed at baseline and 5 days after treatment to

evaluate the effect of HCQ. 

For

the 62 COVID-19 patients, 46.8% (29 of 62) were male and 53.2% (33 of

62) were female, the mean age was 44.7 (15.3) years. No difference in

the age and sex distribution between the control group and the HCQ

group. But for TTCR,

the body temperature recovery time and the cough remission time were

significantly shortened in the HCQ treatment group.

Besides,

a larger proportion of patients with improved pneumonia in the HCQ

treatment group (80.6%, 25 of 31) compared with the control group

(54.8%, 17 of 31).

Notably,

all 4 patients progressed to severe illness that occurred in the

control group. However, there were 2 patients with mild adverse

reactions in the HCQ treatment group. Significance: Among

patients with COVID-19, the use of HCQ could significantly shorten TTCR

and promote the absorption of pneumonia.

Clinical

Trial   ChiCTR2000029559

10

April 2020

This

data is supportive of preliminary evidence suggesting a significant

reduction in the average length of hospital stay (ALOS)  in

COVID-19 patients administered hydroxychloroquine (HCQ) alone.

This

crude data was generated by a multi-center data collection effort

conducted by Agilum

Healthcare Intelligence Inc.

based

in Brentwood, Tennessee and analyzed with respect to the COVID length

of hospital stay under various investigational treatments.

The

unpublished data was generated from a bell-curve of patient severities

encompassing all levels of severity. Hence, it only provides a gross

estimation of a Hydroxychloroquine effect in COVID-19 patients. However

it is supportive of the French Data released on 12 April 2020 as an

Abstract.

12

April 2020

Raoult,

D.

Cohort of 1061 COVID-18 cases treated with HCQ-AZ Combination with 9

day follow-up. IHU

Méditerranée Infection, Marseille.

http://covexit.com/professor-didier-raoult-releases-the-results-of-a-new-hydroxychloroquine-treatment-study-on-1061-patients/

A

cohort of 1061 COVID-19 patients, treated for at least 3 days with the

HCQ-AZ combination and a follow-up of at least 9 days was investigated.

Endpoints were death, worsening and viral shedding persistence.

From

March 3rd to April 9th, 2020, 59,655 specimens from 38,617 patients

were tested for COVID-19 by PCR. Of the 3,165 positive patients placed

in the care of our institute, 1061

previously unpublished patients met the inclusion criteria for a

Hydroxychloroquine –Azithromycin trial.

Mean

age was 43.6 years old and 492 were male (46.4%), As

in other studies, no cardiac toxicity was observed in this study. 

• 
  

  A
  
  good clinical outcome and virological cure was obtained in 973 patients
  
  out of a total pf 1061 patients within 10 days (91.7%). 

  
  

• 
  

  Mortality
  
  was significantly lower in patients who had received > 3 days of
  
  HCQ-AZ than in patients treated with other regimens both at IHU and in
  
  all Marseille public hospitals (p< 10-2).

  
  

A

poor outcome was observed for 46 patients (4.3%); -10

were transferred to intensive care units,

5

patients died (0.47%) (74-95 years old), 31 required 10 days of

hospitalization or more. 

Among

this group, 25 patients are now cured and 16 are still hospitalized

(98% of patients cured so far). 

Table

1.

Baseline characteristics according to clinical and virological outcome

of 1061 patients treated with HCQ + AZ ≥ 3 days at IHU Méditerranée

infection Marseille, France with Day 0 between March 3 and March 31,

2020 

Prolonged

viral carriage at completion of treatment was observed in 47 patients

(4.4%) and was associated with a higher viral load and more advanced

disease at diagnosis (p < 10-2) but viral culture was negative at

day 10 and all but one were PCR-cleared at day 15. 

Poor

clinical outcome was significantly associated to older age (OR 1.11),

initial higher severity (OR 10.05) and low Hydroxychloroquine serum

concentration. 

In

addition, both poor clinical and virological outcomes were associated

with patients taking selective beta-blocking agents and angiotensin II

receptor blockers (P<0.05) for Hypertension.

13

April 2020

J.

Gao, Hu, S., Update on use of Hydroxychloroquine to TREAT coronavirus

disease 2019 (COVID-19). 

Increasing

evidence from completed clinical studies indicates the prospects for

the treatment of COVID-19 by Chloroquine and Hydroxychloroquine

(indications Hydroxychloroquine is more effective).

• 
  

  Chloroquine
  
  has indicated its efficacy in mild and moderate COVID-19 cases. 

  
  
• 
  

  Chloroquine
  
  is superior to Lopinavir/ritonavir in improving COVID-19 lung lesions.

  
  
• 
  

  Chloroquine
  
  has demonstrated significant efficacy in returning body temperature to
  
  normal.

  
  
• 
  

  Hydroxychloroquine
  
  seems more effective than Chloroquine in a French study on reducing the
  
  amount of virus in the body.

  
  
• 
  

  Hydroxychloroquine
  
  helps reduce the duration of cough, reduce the amount of virus in the
  
  body and improve negative lung lesions on X-ray.

  
  
• 
  

  We
  
  have already commented on the single paper involving 15 patients
  
  subjected simultaneously to Interferon-Alpha, arbidol, and
  
  lopinavir/ritonavir in the control group.

  
  

In

general, completed clinical studies have yielded promising results

regarding the safety and effectiveness of Chloroquine and

Hydroxychloroquine in the TREATMENT of COVID-19

Summary

of Bibliography Review

Dependent

upon a successful peer review of the data presented in 1,061 COVID-19

patients, treated for at least 3 days with the HCQ-AZ combination in

the French Abstract released 12 April 2020, by D. Raoult of the

IHU Méditerranée Infection and a successful review of the

10 April 2020 paper by Zhaowei Chen et.al, ……

………….the

use of HCQ-AZ combination when

started immediately after diagnosis,

appears to be a safe an efficient treatment for COVID-19. It appears to

halt respiratory disease progression and length of hospital stay in

many cases.

Within

the context of an expanding COVID-19 pandemic, it is reasonable to

propose the EARLY

use of Hydroxychloroquine in attempt to reduce the number of COVID

patient hospitalization days, and hence provide an increased rate of

patient turnover and a more efficient use of limited hospital

ventilators. 

The

finding in the gross data study done on 10 April 2020

showing a slightly prolonged Average Length of Hospital Stay (ALOS) in

the population group given HCQ/CQ/Azithromycin, requires further

investigation. Azithromycin

can show the same cardiac conduction effects as Chloroquine in humans,

but there has not been a widespread aversion to its being prescribed.

Some 4,000 individuals have now been given what are considered to be

COVID doses of Hydroxychloroquine, and not one cardiac conduction

problem has been noted. 

Opinion

Historical

controls are used in many previous studies in medicine. In this

respect, the safety of Hydroxychloroquine is well

documented.

When the safe use of this drug is projected against its apparent effect

of decreasing the progression of early cases to ventilator use, it is

difficult to understand the reluctance of the authorities in charge of

U.S. pandemic management to recommend its use in early COVID-19

cases.



The effects of the chloroquines were first outlined 15 years ago by the

CDC’s own Special Pathogens Unit.