13 ms·

Hydroxychloroquine causes viral load reduction in Covid-19 patients

104 points by ronreiter 7y ago

fullshark 7y ago
This is the first promising bit of news I've seen in days.
robertpelloni 7y ago
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 7y ago
  Trump already gave a press conference about it today about the FDA investigating it quickly
pen2l 7y ago
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?
kian 7y ago
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 7y ago
  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 7y ago
    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?
    - LinuxBender 7y ago
      It is know to be a zinc ionophore so I would not call it random. That said, it is known to have some side effects. [1] My concern around its use is that it requires a prescription. People won't likely be using this until a doctor prescribes it. By the time a person has gone to a doctor, the virus has likely already replicated quite extensively. Zinc ionophores would be most beneficial if taken very early on after initial infection. [1] - https://medlineplus.gov/druginfo/meds/a682318.html https://medlineplus.gov/druginfo/meds/a682318.html
    - mrep 7y ago
      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_pneumonia_has_short_term_curative_effect_on_the_treatment_of_new_crown_pneumonia.html https://www.jqknews.com/news/388543-The_novel_coronavirus_pn...
jonaphin 7y ago
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 7y ago
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 7y ago
  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 7y ago
salmon30salmon 7y ago
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.
pdkl95 7y ago
~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
- pfundstein 7y ago
  Is it not a prescription-only medication (as it is in Australia)? That might be a potential solution to her predicament.
- _bxg1 7y ago
  Just one tragedy-of-the-commons after another.
mbank 7y ago
Study from Marseille seems well founded, although (of course) based on a small sample. Why isn't this higher up?
- kylehotchkiss 7y ago
  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-launches-university-minnesota https://med.umn.edu/news-events/covid-19-clinical-trial-laun... 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.
- sunir 7y ago
  Don’t worry. The people who matter are on it. Chloroquine and Hydroxychloroquine in particular have been the leading therapeutic interventions in the clinical research publications for... quite some time (honestly every week feels like a month so I am losing track). Trump also said yesterday I believe he ordered FDA to fast track both versions plus another antiviral remdesivir that is also showing effects.
burfog 7y ago
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 7y ago
Why are herbs never included in any clinical trials. Are they totally worthless although used extensively
- atomi 7y ago
  I don't think you're on the right website.
- redsymbol 7y ago
  There are several reasons, but a big one is that they cannot be mass produced with consistent quality as easily as synthesized chemicals.
- sunir 7y ago
  The Chinese treatment guides include evidence-based traditional Chinese medicine that has shown impact on this disease. https://www.reddit.com/r/COVID19/comments/fjj8yb/chinese_guideline_for_corona_virus_treatment_and/ https://www.reddit.com/r/COVID19/comments/fjj8yb/chinese_gui...
warmfuzzykitten 7y ago
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"?
hackeerTwo 7y ago
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 7y ago
  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.
lisk1 7y ago
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

104 points by ronreiter 7y ago

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

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 7y ago
Trump already gave a press conference about it today about the FDA investigating it quickly

pen2l 7y ago

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?

kian 7y ago

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 7y ago
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 7y ago
  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?
  - LinuxBender 7y ago
    It is know to be a zinc ionophore so I would not call it random. That said, it is known to have some side effects. [1] My concern around its use is that it requires a prescription. People won't likely be using this until a doctor prescribes it. By the time a person has gone to a doctor, the virus has likely already replicated quite extensively. Zinc ionophores would be most beneficial if taken very early on after initial infection. [1] - https://medlineplus.gov/druginfo/meds/a682318.html https://medlineplus.gov/druginfo/meds/a682318.html
  - mrep 7y ago
    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_pneumonia_has_short_term_curative_effect_on_the_treatment_of_new_crown_pneumonia.html https://www.jqknews.com/news/388543-The_novel_coronavirus_pn...

jonaphin 7y ago

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 7y ago

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 7y ago
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 7y ago

salmon30salmon 7y ago

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.

pdkl95 7y ago

~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

pfundstein 7y ago
Is it not a prescription-only medication (as it is in Australia)? That might be a potential solution to her predicament.
_bxg1 7y ago
Just one tragedy-of-the-commons after another.

mbank 7y ago

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

kylehotchkiss 7y ago
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-launches-university-minnesota https://med.umn.edu/news-events/covid-19-clinical-trial-laun... 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.
sunir 7y ago
Don’t worry. The people who matter are on it. Chloroquine and Hydroxychloroquine in particular have been the leading therapeutic interventions in the clinical research publications for... quite some time (honestly every week feels like a month so I am losing track). Trump also said yesterday I believe he ordered FDA to fast track both versions plus another antiviral remdesivir that is also showing effects.

burfog 7y ago

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 7y ago

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

atomi 7y ago
I don't think you're on the right website.
redsymbol 7y ago
There are several reasons, but a big one is that they cannot be mass produced with consistent quality as easily as synthesized chemicals.
sunir 7y ago
The Chinese treatment guides include evidence-based traditional Chinese medicine that has shown impact on this disease. https://www.reddit.com/r/COVID19/comments/fjj8yb/chinese_guideline_for_corona_virus_treatment_and/ https://www.reddit.com/r/COVID19/comments/fjj8yb/chinese_gui...

warmfuzzykitten 7y ago

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"?

hackeerTwo 7y ago

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 7y ago
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.

lisk1 7y ago

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