HCQ has 90% chance of helping COVID-19 patients: US doctors' body

A team of US doctors has claimed that hydroxychloroquine, an anti-malarial drug termed potential "game-changer" for COVID-19 by President Donald Trump, has improved the survival and recovery odds for about 90 per cent of patients infected with the virus.

In a letter to Arizona Governor Doug Ducey, the Association of American Physicians and Surgeons (AAPS) presented a frequently updated table of studies that report results of treating COVID-19 with the chloroquine and hydroxychloroquine drugs.

They presented data on 2,333 patients treated with hydroxychloroquine in China, France, South Korea, Algeria, and the US.

It shows 91.6 per cent of those who got the drug fared better after treatment.

The antiviral properties of these drugs have been studied since 2003. Particularly when combined with zinc, they hinder viral entry into cells and inhibit replication. They may also prevent overreaction by the immune system, which causes the cytokine storm responsible for much of the damage in severe cases, the AAPS explained.

In a letter, the AAPS team urged that doctors should not wait for results of gold standard tests of the drug to start using it for coronavirus patients and should instead base their use of it on reasonable interpretations of limited available data.

Peer-reviewed studies published from January through April 20, this year, provide clear and convincing evidence that hydroxychloroquine may be beneficial in COVID-19, especially when used early, they stated.

AAPS's endorsement of the drug comes after the study from Veterans Health Administration medical centres showed that hydroxychloroquine has no benefit in treating patients with the disease.

Meanwhile, on April 24, the US Food and Drug Administration (FDA) issued fresh guidelines, cautioning people against over-the-counter use of hydroxychloroquine or chloroquine for Covid-19 outside of the hospital setting or a clinical trial due to the risk of heart rhythm problems.

The FDA said it is aware of reports of serious heart rhythm problems in patients with Covid-19 treated with hydroxychloroquine or chloroquine, often in combination with azithromycin and other QT-prolonging medicines.

"We are also aware of the increased use of these medicines through outpatient prescriptions. Therefore, we would like to remind healthcare professionals and patients of the known risks associated with both hydroxychloroquine and chloroquine," the agency said in a statement.

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Coronavirus--Drug for sepsis to be tested for COVID-19

It will be administered to 50 patients at AIIMS, PGIMER

Can a drug used to treat severe sepsis be deployed for critically ill coronavirus (COVID-19) patients?

Sepsivac, a drug jointly developed by the Ahmedabad-based Cadilla Pharmaceuticals and the Council for Scientific and Industrial Research (CSIR), will be tested in 50 COVID-19 patients at the All-India Institute of Medical Sciences in Delhi and Bhopal, and Post Graduate Institute of Medical Education and Research, Chandigarh.

Results from a human trial are expected in the next two months, Ram Vishwakarma, Director, Indian Institute of Integrative Medicine, Jammu, told The Hindu. IIIM is a CSIR laboratory and was involved in the early development of Sepsivac.

Sepsivac was originally developed for treating sepsis by a class of pathogens called gram negative bacteria, that are known to cause life-threatening infections. Given the similarities in the immune-system response in critically ill COVID-19 patients, it is theorised, the therapy could stimulate a benign response.

A large quantity of cytokines, chemicals signalling the presence of an infection, are produced in the early stages of the body’s response against an infection to stimulate the production of antibodies. However, cytokines also cause inflammation of organs and can be counter-productive in protecting the body. Keeping them in check is the goal of so called immuno-modulators, or medicines like Sepsivac.

“The advantage is that we have a ready made product and can be put into trials. We already have an approval for phase-3 [large trials] and can be scaled up if it shows promise,” Dr. Vishwakarma added.

The drug uses the Mycobacterium w (formally known as mycobacterium indicus pranii) as it produces a different immune-system response.

Previous randomised trials in sepsis patients showed 11% absolute reduction and 55.5% relative reduction in mortality. Sepsivac reduces the days on ventilator, in ICU and hospital and incidence of secondary infection, Cadilla Pharmaceuticals have claimed on their website.

The United States and Australia are also going to start testing the efficacy of the BCG, or tuberculosis vaccine, that also employs a different strain of mycobacterium, in health care workers at the frontline of treating COVID-19 patients.

What is hydroxychloroquine

Statistics suggest that of India’s nearly 19,000 COVID-19 cases as on Tuesday, 3,800 had a clinical outcome — that is, they had either recovered/been discharged or had died. The death rate in those with an outcome was 16%.

CSIR has also planned to evaluate Mw for faster recovery of hospitalised COVID-19 infected patients and minimise the spread of disease through them as well for providing preventive treatment (prophylaxis) to persons coming in contact with COVID-19 infected patients like family members and health care workers, it said in a statement.

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Amidst coronavirus outbreak, IMCR recommends medicines to prevent infection in high-risk cases

Amid increasing cases of coronavirus outbreak in India which has claimed 8 lives and over 400 confirmed cases till today, the National Task Force COVID-19 constituted by Indian Council of Medical Research (ICMR) on Monday recommended the use of hydroxy-chloroquine for the treatment of COVID-19 for high-risk cases.

In an advisory issued by the department, asymptomatic healthcare workers involved in the care of suspected or confirmed cases of COVID-19, and asymptomatic household contacts of laboratory-confirmed cases have been advised to be placed under chemoprophylaxis with hydroxychloroquine.

“Hydroxychloroquine is recommended only for a healthcare worker who is treating a #COVID patient. Secondly, it’s recommended only for persons staying and caring for a household positive patient. They can take that only for prophylaxis, only for prevention,” said ICMR Director-General Balram Bhargava.

The Drug Controller General of India (DCGI) has also approved the protocol recommended by the ICMR National Task Force for restricted use in an emergency situation.

The key considerations to administer the medication are:

    The drug has to be given only on the prescription of a registered medical practitioner.

    If anyone becomes symptomatic while on prophylaxis, he or she should immediately contact the health facility, get tested as per national guidelines and follow the standard treatment protocol.

    The intake of hydroxychloroquine should be coupled with a proper lookout for adverse drug reactions through self-reporting using the Pharmacovigilance Program of India app or helpline.

    The asymptomatic contacts of confirmed COVID-19 cases should maintain home quarantine as per the guidelines even if they are taking hydroxychloroquine.

    The drug is not recommended for prophylaxis in children under 15 years of age.

    It is contraindicated in persons with a known case of retinopathy, known hypersensitivity to hydroxychloroquine and 4-aminoquinoline compounds.

As for the dosage it has been recommended that the asymptomatic healthcare workers who have been involved in the care of suspected or confirmed COVID-19 cases can be given 400mg of hydroxychloroquine twice a day on Day 1 and then 400mg once in a week for the next seven weeks.  The drug has to be taken with meals.

The task force also warned the health workers that placing them under chemoprophylaxis should not instil a sense of false security in them and asked the health-workers to follow all prescribed public health measures such as frequent washing of hands, respiratory etiquettes, keeping a safe distance of minimum 1 metre and use of personal protective equipment.

Bhargava also announced that the process of Covid-19 test kit manufacturing has been fast-tracked at ICMR-NIV Pune and two manufacturers are already approved.

The ICMR director furthered that he would like to clarify that FDA/CE approval isn’t mandatory. ICMR-NIV approved tests which will be done there on a fast-track basis will also be acceptable for COVID-19 testing, ANI reported.

This is only for your information, kindly take the advice of your doctor for medicines, exercises and so on.     

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