Review of chloroquine and hydroxychloroquine and COVID-19.

Here is an abstract to a review (first link below) of the use of chloroquine and hydroxychloroquine as a repurposed drug against COVID-19. I'll just quote the abstract and then comment on parts of it.

The skinny is to overall be skeptical of news reports citing health experts. They get expertise from scientific evidence, and even today the evidence on the use of these drugs against COVID-19 is sparse and conflicting. This means their expertise is potentially inapplicable to many aspects of the virus, and should be considered opinion, not expertise.

Also, news reports about science or medicine are rarely spot on. They almost always are spun to sell the news and involves misunderstanding and misinterpretation (because journalists are not usually scientists). It is especially important to realize you should engage a higher level of skepticism as the media has already demonstrated politicization of these drugs, and has already adversely influenced medical opinion.

Abstract: "The predicament arising from the coronavirus disease 2019 (COVID-19) pandemic has become one of the most significant modern public health challenges. Despite uncertainties in the viral determinants and pathogenesis, it is crucial to accurately inspect all available evidence to construct accurate clinical guidelines for optimised patient care. This study aims to discuss the available evidence for the use of chloroquine (CQ) and hydroxychloroquine (HCQ) against COVID-19. Early in vitro studies of CQ/HCQ against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are convincing. But contradictory evidence exists on the clinical use of CQ/HCQ, either alone or in combination with azithromycin. As of now, there is no compelling clinical evidence on CQ, HCQ, and azithromycin in COVID-19 and the available evidence is limited to methodologically inferior non-randomised studies. Studies have also shown detrimental drug reactions to CQ and ‘HCQ plus azithromycin’, mainly cardiac side effects in hospitalised patients with coexisting cardiovascular comorbidities. Therefore, we recommend that physicians avoid high doses and exercise extreme caution in the compassionate use of CQ/HCQ, either alone or in combination with other antiviral drugs."

Key takeaways:

  • Uncertainty still remains in how the virus works.
  • It is critical to accurately inspect all available evidence.
  • The available evidence is limited to methodologically inferior non-randomised studies.
  • Recommend exercise extreme caution in compassionate use.

Sidebar:

  • Chloroquine was already shown to interfere with SARS viral effectiveness via ACE2.
  • Azithromycin is an antibiotic only to help prevent bacterial infections during pneumonia.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7404096/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1232869/?fbclid=IwAR1hj6C2LsxBwxPGuykYu6K5sPTQuIS4MOMSWejq8Hp16XRC4Ba2aTyeidI

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