With the onslaught by COVID and its coinciding onslaught of self-proclaimed experts with every opinion under the sun, I choose to respond with a series of research study reports so you can choose for yourself. Each edition will bring a few studies describing possible therapies for COVID under investigation or reported in past research. As my recent Facebook Live video noted, we do not know enough about this virus to be definite at this time. I am not claiming any of these are the preventive or curative answer for you or your family’s safety. I just want you to be aware of these studies and have knowledge so that you can grow in wisdom rather than stumble about in panic.
(See appendix paragraph for further thoughts on finding effective COVID therapies)
Whether or not you like President Trump, the producers of hydroxychloroquine love him as his praise for this potential COVID therapy has sent demand through the roof. However, even being President does not make him an MD so let’s examine the evidence to see if his hopes are well placed.
Two related drugs deserve mention together, chloroquine and hydroxychloroquine. Chloroquine and its derivatives have served for years as anti-malarial therapies with good success against this killer of thousands yearly. A variety of studies (listed below) show some hope that chloroquine could lower mortality in the severe cases of COVID. Chloroquine however carries some nasty side effects especially prolonging something called the QT interval in our hearts. In some cases this kills by causing a heart arrhythmia.
Gao J, Tian Z, Yang X. Breakthrough: Chloroquine phosphate has shown apparent efficacy in treatment of COVID-19 associated pneumonia in clinical studies. Biosci Trends. 2020. [PMID:32074550]
An early report in Chinese trials.
Wang M, Cao R, Zhang L, et al. Remdesivir and chloroquine effectively inhibit the recently emerged novel coronavirus (2019-nCoV) in vitro. Cell Res. 2020. [PMID:32020029]
An in-vitro study suggesting chloroquine efficacy.
Devaux, Christian A et al. “New insights on the antiviral effects of chloroquine against coronavirus: what to expect for COVID-19?.” International journal of antimicrobial agents, 105938. 11 Mar. 2020, doi:10.1016/j.ijantimicag.2020.105938
A review and discussion of potential mechanisms of action of chloroquine against COVID 19.
FDA lists chloroquine as drug under investigation for COVID 19 therapy.
Vincent MJ, Bergeron E, Benjannet S, Erickson BR, Rollin PE, Ksiazek TG, et al. Chloroquine is a potent inhibitor of SARS coronavirus infection and spread. Virol J. 2005;2:69. doi: 10.1186/1743-422X-2-69.
Chloroquine was a potent inhibitor in SARS coronavirus therapy from that outbreak in years past.
Medical researchers and clinicians are hoping that a cousin of chloroquine called hydroxychloroquine may be a less risky, yet equally effective therapy. This antibiotic serves many average patients with autoimmune condition already. Therefore, it has a known safety profile. While it may still cause the prolonged QT issue like chloroquine, at appropriate doses it has potential in COVID.
Colson P, Rolain JM, Lagier JC, Brouqui P, Raoult D. 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]
Yao X, Ye F, Zhang M, Cui C, Huang B, Niu P, Liu X, Zhao L, Dong E, Song C, Zhan S, Lu R, Li H, Tan W, Liu D. 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). Clin Infect Dis. 2020 Mar 9. pii: ciaa237. doi: 10.1093/cid/ciaa237. [Epub ahead of print]
This study looked at in vitro cells infected with COVID 19 and found hydroxychloroquine to be more potent than chloroquine. They also speculate that its effects on modulating the cytokine storm may help in actual patients.
Gautret P, Lagier J, Parola P, Hoang V, Meddeb L, Mailhe M, et al. Hydroxychloroquine and azithromycin as a treatment of COVID-19: results of an open-label non-randomized clinical trial. International Journal of Antimicrobial Agents. In Press.
While we wait for peer review confirmation of this study, we can be encouraged that this combination of azithromycin and hydroxychloroquine shows promise.
Besides the studies above, news reports trickle in as uncontrolled use of hydroxychloroquine appears successful in the hospitals. We look forward to more data from the front lines and pray for greater success so we can turn this virus back. In the meantime, unless you are using this medication and need it, do not ask your doctor for your personal stash. The drug should remain available for those who are the sickest, not for everyone with a sniffly nose from an average virus. A shortage caused by hoarding could put the sickest at risk.
One huge challenge in identifying effective therapies for COVID lies in the novelty of it all. Research requires time, something of which we have little in an emerging pandemic. We don’t have the luxury of studying 100 years of research or 10,000 past experiments. This battle requires a great deal of extrapolation. Extrapolation means that we take the little information we do have and attempt to use it in predicting what we don’t know. This process takes place every time an experiment proceeds in science, but the urgency in this case makes it more frustrating than usual. As we walk through a different possible therapy each post, keep this paragraph in mind.
Sanctuary Functional Medicine, under the direction of Dr Eric Potter, IFMCP MD, provides functional medicine services to Nashville, Middle Tennessee and beyond. We frequently treat patients from Kentucky, Alabama, Mississippi, Georgia, Ohio, Indiana, and more... offering the hope of healthier more abundant lives to those with chronic illness.