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HYDROXYCHLOROQUINE SAVES LIVES

https://bit.ly/38t2ZKl

Lawrenceville, NJ (Charles Simone, M.MS., M.D.) – The Henry Ford COVID-19 Task Force clinicians at the Henry Ford Health System in Detroit, Michigan did an observational study from a single institution involving 2,541 patients and published their findings in the International Journal of Infectious Diseases (accepted date June 29, 2020) entitled, Treatment with Hydroxychloroquine, Azithromycin, and Combination in Patients Hospitalized with COVID-19.  https://www.ijidonline.com/action/showPdf?pii=S1201-9712%2820%2930534-8 (journal pre-proof). The Henry Ford Health System is composed of six large hospitals, the largest is an 802-bed quaternary academic teaching hospital in urban Detroit.  Consecutive patients hospitalized with a COVID-related admission in the health system from March 10, 2020 to May 2, 2020 were included.

Their Conclusion: “According to a protocol-based treatment algorithm, among hospitalized patients, use of hydroxychloroquine alone and in combination with azithromycin was associated with a significant reduction in-hospital mortality compared to not receiving hydroxychloroquine.”  Steroids were also used.

Hydroxychloroquine – 400 mg twice daily for 2 doses on day 1, followed by 200 mg twice daily on days 2-5.

Azithromycin – 500 mg once daily on day 1 followed by 250 mg once daily for the next 4 days. The combination of hydroxychloroquine+azithromycin was reserved for selected patients with severe COVID-19 and with minimal cardiac risk factors.

An electrocardiogram QTc>500ms constituted an elevated cardiac risk and consequently hydroxychloroquine was reserved for patients with severe disease with telemetry monitoring and serial QTc checks. 

Observational Versus Randomized Clinical Studies

Compared to randomized studies, observational studies are less costly, can be done more quickly, and have a broader range of patients. Observational studies provide valid information and virtually the same results as randomized studies, a finding that differs from previous conclusions.  Furthermore, “Observational studies do not overestimate the magnitude of the effects of treatment compared with those in randomized trials on the same topic.” (Simone, CB et al. ANTIOXIDANTS AND OTHER NUTRIENTS DO NOT INTERFERE WITH CHEMOTHERAPY OR RADIATION THERAPY AND CAN INCREASE KILL AND INCREASE SURVIVAL, PART 1)  

https://pubmed.ncbi.nlm.nih.gov/17405678/

Hydroxychloroquine is inexpensive and has been used for decades as an antimalarial and immunomodulatory agent and is safer than chloroquine.

On August 22, 2005 the Centers for Disease Control and Prevention published “Chloroquine is a potent inhibitor of SARS coronavirus infection and spread.” Virol J. 2005 Aug 22;2:69. The CDC postulated that chloroquine works by blocking the virus from attaching to the human cell’s receptor, and other researchers have shown hydroxychloroquine can increase intracellular pH that results in decreased ability of the virus to invade the cell.  Hydroxychloroquine has anti-thrombotic effects, and also decreases production of cytokines especially IL-1 and IL-6.  Azithromycin, an antibiotic, can decrease viral replication and block the virus from attaching to the human cell’s receptor.

A small French trial reported promising results with six days of treatment with hydroxychloroquine alone or hydroxychloroquine in combination with azithromycin versus untreated control group (70% vs 12.5%; P < 0.001). However, the Henry Ford COVID-19 Task Force clinicians cite ten early studies of hydroxychloroquine with conflicting results but their own study shows that hydroxychloroquine saves lives.

The US FDA as of June 15, 2020 has revoked the prior emergency use authorization (EUA) to use hydroxychloroquine and chloroquine to treat COVID-19 in certain hospitalized patients when clinical trial data is unavailable or participation is not feasible.  https://www.fda.gov/drugs/drug-safety-and-availability/fda-cautions-against-usehydroxychloroquine-or-chloroquine-covid-19-outside-hospital-setting-or 

Now there are clinical trial data for all physicians and the FDA: “use of hydroxychloroquine alone and in combination with azithromycin was associated with a significant reduction in-hospital mortality compared to not receiving hydroxychloroquine.”

© 2020 Charles B. Simone, M.MS., M.D.