A number of randomized controlled trials are currently underway investigating various antiviral therapies for the treatment of COVID-19. Findings from a very small open-label study recently published in the Journal of Antimicrobial Agents found that hydroxychloroquine decreased viral nasopharyngeal levels of SARS-CoV-2 virus in COVID-19 patients in only three to six days in most patients.
Hydroxychloroquine is a common antimalarial drug that is also used to treat rheumatoid arthritis and lupus. In 2017, it was the 128th most prescribed medication in the United States with more than five million prescriptions. It is relatively safe with a few side effects. This Wikipedia article provides an overview of hydroxychloroquine.
In vitro studies in 2004 and 2005 showed that hydroxychloroquine is a potent inhibitor of SARS-CoV, the virus that causes severe acute respiratory syndrome, or SARS. A later study found that hydroxychloroquine improved survival rates in newborn mice infected with a related coronavirus.
The current study involved 32 confirmed COVID-19 patients who were administered 600 milligrams of hydroxychloroquine daily for six days. Some patients also received the antibiotic azithromycin. Nasopharyngeal samples taken on day six of treatment indicated that 70 percent of the hydroxychloroquine-treated patients had cleared the virus compared with 12.5 percent in the group receiving standard of care. All of the patients who received both the antibiotic azithromycin and the hydroxychloroquine cleared the virus from nasopharyngeal samples.
Azithromycin is an antibiotic that has been shown to have antiviral activity against some viruses like Ebola in animal studies. The safety profile of taking both hydroxychloroquine and azithromycin needs to be determined.
In addition, randomized-controlled trials need to confirm whether these therapeutics are effective for the treatment of COVID-19. Large randomized-controlled trials are underway in China and the US. You can read more about those trials here.
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