Can you use Hydroxychloroquine to combat Covid-19?
Since the end of last week there has been a lot of mention about using hydroxychloroquine in the use of combating Covid-19. The question that is being asked is, why is a drug initially used for the treatment of malaria and Lupus effective against a virus? The answer all comes down to inflammation.
Apparently, the inflammatory response due to Covid-19 is significant. Of course, this can vary with certain patient populations, especially the elderly, and those with other medical problems and especially those that have immunocompromised states.
The inflammatory response to Covid-19
During time of infection, immune responses, trauma, sepsis and cancers, there is a release of proteins known as cytokines, which work in conjunction with our immune system to deal with the insult. It appears that with Covid-19 the inflammatory response can be quite robust, causing what has become to be known as a cytokine storm. If there is a cytokine storm due to Covid-19, one organ that is usually affected is the lungs. A high amount of inflammation in the lungs affects the patient’s ability to transport oxygen from the lungs to the blood stream. If the response is severe enough, a patient may wind up on a ventilator and potential death increases.
Hydroxychloroquine acts as an immunomodulator. It has the ability to minimize these cytokine storms. By minimizing the inflammatory response, it minimizes the tissue damage caused by the virus. Another important aspect to hydroxychloroquine is that it appears to inhibit binding of the virus to healthy cells, again minimizing the inflammatory response.
Azithromycin and Covid-19
Azithromycin has also been suggested to help in combating Covid-19. The question is why would you use an antibiotic which is used for bacteria on a virus? The answer is two-fold. One is, secondary bacterial infections have been associated with Covid-19, but this is not the only benefit to using azithromycin in conjunction with Covid-19. The second is that azithromycin also has anti-inflammatory properties to it which are not well understood, but appear to work.
Several small recent studies have shown that hydroxychloroquine can work in treating Covid-19. In addition, it appears that hydroxychloroquine can be used prophylactically. Prophylactic therapy should be reserved for those that are dealing with the public on a daily basis through this health crisis. Azithromycin should only be taken if you are infected.
These are trying times we’re living in and people are looking for answers as this pandemic unfolds before us. It would be great if we could do more elaborate clinical trials with hydroxychloroquine for both treatment and prophylaxis, but we’re living in the here and now. As this crisis unfolds, we will try and keep you updated.