New Hydroxychloroquine study suggests an increase in mortality of COVID-19 patients

No other potential COVID-19 drug has caught as much public interest as hydroxychloroquine (HCQ). The antimalaria drug has been called a lot of things, from a game-changer to somewhat useful. Some even claim it has no effect on SARS-CoV-2, the virus strain that causes COVID-19. A recent study done in the USA suggests that hydroxychloroquine can be dangerous and potentially fatal when given as the only treatment to COVID-19 patients. [caption id=“attachment_7794651” align=“alignleft” width=“380”]  Representational image. Image source: Getty Images.[/caption] For the study, a group of scientists analyzed COVID-19 patients treated at the United States Veterans Health Administration medical centres. All the patients were either given HCQ alone, HCQ with azithromycin or no HCQ. The study is not peer-reviewed yet and is still in the pre-print phase. It is also not a controlled trial and was conducted on a small scale. The research is being funded by NIH, DuPont Guerry, III, Professorship, and University of Virginia Strategic Investment Fund. However, the NIH or any organisation mentioned here has nothing to do with the study design and may not have the same official views as the author of the study.

The latest developments

The study done in the USA included 368 COVID-19 patients admitted to various Veterans Health Administration medical centres in the country. Out of all the patients, 97 were given only HCQ, 113 were given a combination of HCQ and azithromycin and 158 patients were not given HCQ. The mortality rate was more than 27% in the HCQ group, about 22% in the HCQ azithromycin group and 11.4% in no HCQ group. There was a much higher risk of death from any cause in the HCQ group than in the non-HCQ group. Also, more people in the HCQ group required ventilation than the HCQ azithromycin group. However, the need for ventilation is highest in no HCQ group (although not by much). The study concluded that there was no proof of the use of HCQ alone or with azithromycin being effective against COVID-19. The authors of the study say that the findings highlight the need for more research before HCQ is adopted as a treatment for COVID-19. Last week, ICMR revealed in a press briefing that they have been observing healthcare practitioners in India who had already started taking HCQ as prophylaxis (taken to prevent the disease). Some of them were noted to experience various side effects ranging from abdominal pain and vomiting. Some also observed low blood sugar levels (hypoglycemia). However, about 22% of all the healthcare practitioners in the group had chronic conditions like diabetes or high blood pressure and some of them had not done ECG before starting the drug since such patients may get arrhythmia with the high dose prophylactic dose that is currently being prescribed.

Previous research

HCQ is originally an antimalaria drug and a DMARD (disease-modifying anti-rheumatic drug). Apart from malaria, it is used to treat conditions like rheumatoid arthritis and lupus. HCQ reduces inflammation and is shown to stimulate our innate immunity (the one we are born with) against viruses. Lab studies have shown that HCQ can reduce the transmission of SARS-COV-2. Some of the early clinical studies done on COVID-19 patients in China suggested that HCQ may be effective in reducing the severity of COVID-19 symptoms and help promote recovery. The Indian Council of Medical Research (ICMR) released an advisory in March about the prophylactic use of 400 mg HCQ by health practitioners and caregivers of COVID-19 patients. Various studies have since been done all over the world to test the efficiency of HCQ in the treatment of COVID-19 but with controversial results. Two separate studies done in France had two different and opposite findings. While one said that HCQ is highly beneficial in reducing viral load in COVID-19 patients the other one said that it is not useful at all. NIH in USA and AIIMS in India are currently studying the effects of the drug on COVID-19 patients. AIIMS is also set to study the prophylactic effect of HCQ. For more information, read our article on Is hydroxychloroquine really effective against COVID-19. Health articles in Firstpost are written by myUpchar.com, India’s first and biggest resource for verified medical information. At myUpchar, researchers and journalists work with doctors to bring you information on all things health.