Quick question about hydroxychloroquine

As I recall, hydroxychloroquine seemed early on to help people who had COVID and were on respirators. I also recall that the FDA did not recommend its use because it could kill the patient. So I think I remember that hydroxychloroquine was useful in emergencies, but it was not good for the majority of patients.

Do I remember that correctly? It’s on my mind now, since Trump indicated he had taken it prophylactically.

Further studies have shown that it has no benefit. Here’s one:

Here’s the conclusion:

CONCLUSIONS

Among patients hospitalized with mild-to-moderate Covid-19, the use of hydroxychloroquine, alone or with azithromycin, did not improve clinical status at 15 days as compared with standard care. (Funded by the Coalition Covid-19 Brazil and EMS Pharma; ClinicalTrials.gov number, NCT04322123. opens in new tab.)

I thought it was just used as a prophylactic measure, is that not true either?

No evidence it’s useful prophylactically:

The results reported by Boulware et al. are more provocative than definitive, suggesting that the potential prevention benefits of hydroxychloroquine remain to be determined.

One of the effects of hydroxychloroquine found by some doctors are it anti-inflammatory properties and inhibiting platelet clumping and blood clots. There have been several studies that have found in severe cases of COVID-19, that the protein von Willebrands factor is increased in the bloodstream which promotes clotting. It is this clotting in the lungs which is one of the fatal factors of COVID19. It is a standard protocol now to give patients in the ICU with COVID19 blood thinners to fight off this increased clotting brought on by the virus.

I think they also give them steroids to combat inflammation. No one should be giving these patients HQ at this point.

We’re getting better and better at treating the disease (using blood thinners, steroids, Remvirdir (sp?), and that’s helping to bring the fatality rate down.

I got to wondering how it was going in Brazil…

Some studies seem to indicate it has some small value in advanced cases as a treatment for the symptoms. Maybe. As Omar Little posted.

By no means does that indicate it is a cure, nor a preventative.

Aspirin can help treat some symptoms too, but it aint a cure or a preventative.

nevermind

Cite?

Respectfully, I’d like to see those studies.

Severe viral respiratory illnesses are not new, even though COVID-19 is. Hydroxychloroquine has been proposed as a treatment for respiratory viruses for 50, 60 years now but it has never panned out as an effective treatment against any of them. I spent a lot of time in April looking at old trials that failed to prove any effectiveness against other viruses - like flu - and I never found anything like that.

Since hospitalized COVID patients seem to have around an 80% survival rate, there’s going to be a lot of perceived treatment successes that aren’t real. This is true of any disease with a high survival rate.

Then there’s this, which just showed up on my Facebook, touting it. Newsweek?

https://www.newsweek.com/key-defeating-covid-19-already-exists-we-need-start-using-it-opinion-1519535?fbclid=IwAR1LYHfdoM8tHRV9E1FJIiM47H87bz_hTGJ2fBpuwSfxjUJETCKOokYr7Kg

Yeah, that one. I spent too much time today reading it and trying to reason with people citing it that the HQ combo, used early on, effectively treats COVID. It’s utter rubbish, and Risch should be ashamed of himself. Here’s one commentary that explains why more coherently than I can:

Risch is on the board of the journal in which his paper was published. He blows his own horn, then cites studies that have been discredited.

I have a question about his expertise. He’s an epidemiology professor – I think that would mean he’s good about how to mitigate the spread of disease, how to track epidemics, and things like that. Would he have any particular expertise in actually treating a specific disease? I would think that would be a different specialty, but I’m happy to learn otherwise.

I would think an infectious disease specialist or a pulmonologist or virus doctor (whatever they’re called) would know more about treating COVID-19, but would not be particularly useful if you’re trying to come up with a proposal to track the disease spread.

https://www.pharmacytimes.com/news/von-willebrand-factor-may-hold-key-to-covid-19-severity

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7156948/

https://www.thelancet.com/journals/lanhae/article/PIIS2352-3026(20)30216-7/fulltext

Your cites make a good case that VFW factors may play a role in the pathology of COVID-19. They make almost ZERO case for the use of Hydroxychloroquine as a COVID cure, in fact neither of your cites even mention Hydroxychloroquine.

Your first cite mentions chloroquine in one paragraph. The second cite does not mention either drug and I don’t know why it was included. The premise of both articles is that it may fight VFW factors by slowing or stopping a process called autophagy.

In plain language, autophagy is one of the processes by which the body cleans out damaged cells in order to generate newer, healthier cells. It’s a buzzword that gets thrown out a lot as a pseudoscientific explanation for the benefit of fasting and it is one of the reasons turmeric and curcumin are touted as beneficial.

An agent that boosts autophagy could be beneficial in the treatment of conditions and it may play a factor in cancer, autoimmune disorders, liver disease, CNS disorders , inflammatory disorders and even mental illness. Cancer was at the top of that list, pre-COVID, and there was a theory that it could make standard chemotherapy more effective.

While some preliminary in vitro studies showed promise, it failed to pan out in actual clinical studies. This paper indicates that one of the reasons might have been the inability of patients to tolerate a dosage that allowed for an clinically effective serum concentration.

And here is a plain language article addressing the clinical history of Hydroxychloroquine as an anti-cancer agent. It calls the results underwhelming.

So, while Hydroxychloroquine has been studied extensively as an autophagic agent in many other disorders, there haven’t been any clinical successes. These studies mirror what I found when looking into other HCQ studies - while it may be an effective agent in a test tube, there’s a dosing problem. You can’t reach the serum concentrations that proved effective in vivo without a dangerously high dose.

Maybe COVID will be different, that’s the refrain. I think the fact that no one has ever made it work clinically as an autophagic agent against any condition ever means that it’s highly highly unlikely to work as one against COVID-19. This does not change my mind.

My apologies, I messed up the second link and I can’t find the article now, I’ll post if if I find it. For now, please disregard

Here’s the link, the first page is the relevant one,
https://cancercommun.biomedcentral.com/articles/10.1186/s40880-019-0418-0

There are a number of rebuttals to Dr. Risch’s paper; they are linked on the right hand side of the page under the heading “More On This Topic”


The first two cite mathematical errors made by Dr. Risch which they say invalidate his reasoning before he even gets started.

ETA: His Newsweek column is a straight-up appeal to authority; the first sentence is

I wonder if Newsweek will issue a retraction.

I’m still curious about whether this guy’s background give him any special expertise about treating a particular sickness.

I haven’t reviewed the critical comments yet, but his assertion that it hasn’t been studied as a preventative are wrong.

https://covidpep.umn.edu/