Malaria drug Hydroxychloroquine fails to prevent COVID-19 in a rigorous study

News Network
June 4, 2020

Jun 4: A malaria drug President Donald Trump took to try to prevent COVID-19 proved ineffective for that in the first large, high-quality study to test it in people in close contact with someone with the disease.

Results published Wednesday by the New England Journal of Medicine show that hydroxychloroquine was no better than placebo pills at preventing illness from the coronavirus.

The drug did not seem to cause serious harm, though -- about 40% on it had side effects, mostly mild stomach problems.

 “We were disappointed. We would have liked for this to work,” said the study leader, Dr. David Boulware, an infectious disease specialist at the University of Minnesota.

“But our objective was to answer the question and to conduct a high-quality study,” because the evidence on the drug so far has been inconclusive, he said.

Hydroxychloroquine and a similar drug, chloroquine, have been the subject of much debate since Trump started promoting them in March.

Hydroxychloroquine has long been used for malaria, lupus, and rheumatoid arthritis, but no large studies have shown it or chloroquine to be safe or effective for much sicker patients with coronavirus, and some studies have suggested the drugs may do harm.

Trump took a two-week course of hydroxychloroquine, along with zinc and Vitamin D, after two staffers tested positive for COVID-19, and had no ill effects, according to results of his latest physical released by his doctor Wednesday.

Federal regulators have warned against hydroxychloroquine's use except in hospitals and formal studies because of the risk of side effects, especially heart rhythm problems.

Boulware's study involved 821 people in the United States and Canada living with someone diagnosed with COVID-19 or at high risk of getting it because of their job -- doctors, nurses, ambulance workers who had significant exposure to a sick patient while not wearing full protective gear.

They were randomly assigned to get either the nutrient folate as a placebo or hydroxychloroquine for five days, starting within four days of their exposure. Neither they nor others involved in the research knew who was getting which pills.

After 14 days in the study, 12 per cent on the drug developed COVID-19 symptoms versus 14 per cent in the placebo group, but the difference is so small it could have occurred by chance, Boulware said.

“There's basically no effect. It does not prevent infection,” he said of the drug. Even if it were to give some slim advantage, “we'd want a much larger effect” to justify its use and risk of side effects for preventing illness, he said.

Results were no different among a subgroup of participants who were taking zinc or vitamin C, which some people believe might help make hydroxychloroquine more effective or fight the coronavirus.

There are some big caveats: The study enrolled people through the Internet and social media, relying on them to report their own symptoms rather than having them tracked in a formal way by doctors.

Participants were not all tested for the coronavirus but were diagnosed as COVID-19 cases based on symptoms in many cases. And not all took their medicines as directed.

The results “are more provocative than definitive,” and the drug may yet have prevention benefits if tried sooner or in a different way, Dr. Myron Cohen of the University of North Carolina at Chapel Hill wrote in a commentary in the journal.

Others were glad to see a study that had a comparison group and good scientific methods after so many weaker reports on hydroxychloroquine.

“This fits with everything else we've seen so far which suggests that it's not beneficial," said Dr. Peter Bach, director of a health policy center at Memorial Sloan Kettering Cancer Center in New York.

This study was in younger relatively healthy people, but the results “would make me very discouraged about trying to use this in older people” who are most vulnerable to serious illness from the coronavirus, Bach said.

“If it does work, it doesn't work very well.” Dr. Dan Culver, a lung specialist at the Cleveland Clinic, said there's still a chance that giving the drug sooner than four days after someone's exposure to the virus may help prevent illness.

But the study “takes 'home run' off the table” as far as hopes for the drug, he said.

The study was mostly funded by David Baszucki, founder of Roblox, a California-based game software company, and other private donors and the Minnesota university.

Boulware also is leading a study testing hydroxychloroquine for treating COVID-19. The study is finished and results are being analyzed now.

On Tuesday, the journal Lancet posted an “expression of concern” about a study it published earlier this month of nearly 15,000 COVID-19 patients on the malaria drugs that tied their use to a higher risk of dying in the hospital or developing a heartbeat problem.

Scientists have raised serious questions about the database used for that study, and its authors have launched an independent audit.

That work had a big impact: the World Health Organization suspended use of hydroxychloroquine in a study it is leading, and French officials stopped the drug's use in hospitals. On Wednesday, the WHO said experts who reviewed safety information decided that its study could resume.

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News Network
February 18,2020

Beijing, Feb 18: A hospital director at the epicentre of China's virus epidemic died on Tuesday, state media said, the latest medical worker to fall victim to the new coronavirus spreading across the country.

The COVID-19 virus, which is believed to have originated in Wuhan late last year, has infected more than 72,000 people and killed nearly 1,900.

Liu Zhiming, the director of Wuchang Hospital in Wuhan, died Tuesday morning after "all-out rescue efforts failed," state broadcaster CCTV reported.

China said last week that six medical workers had died from the virus, while 1,716 have been infected.

Liu's death was initially reported by Chinese media and bloggers shortly after midnight on Tuesday -- but the stories were later deleted and replaced with reports that doctors were still trying to save him.

After initial reports of his death were denied, the hospital told AFP on Tuesday morning that doctors were giving him life-saving treatment.

Liu's death has echoes of that of Wuhan ophthalmologist Li Wenliang, who had been punished by authorities for sounding the alarm about the virus in late December.

Li's death prompted a national outpouring of grief as well as anger against the authorities, who were accused of mishandling the crisis.

People took to social media to mourn Liu on Tuesday, with many users on the Twitter-like Weibo platform drawing critical comparisons between Liu's death and Li's.

In both cases their deaths were initially reported in state media posts -- later deleted -- and their deaths denied, before being finally confirmed again.

"Has everyone forgotten what happened to Li Wenliang? They forcefully attempted resuscitation after he died," one Weibo commenter wrote.

Another commenter said, Liu "already died last night, (but) some people are addicted to torturing corpses".

A hashtag about Liu's death had 29 million views by Tuesday afternoon.

Doctors in Wuhan face shortages of masks and protective bodysuits, with some even wearing makeshift hazmat suits and continuing to work despite showing respiratory symptoms, health workers have told AFP.

Hubei province and its capital Wuhan have been the hardest hit by the virus, accounting for nearly 1,800 of the deaths from the virus so far.

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News Network
March 6,2020

Mar 6: UK stocks fell again on Friday as growing economic risks from the coronavirus outbreak shattered investor confidence, with Britain recording its first death from the pathogen.

A 1.5% fall for the FTSE 100 erased the blue-chip index's gains from earlier this week. Export-heavy companies have now lost over $230 billion in value since the epidemic sparked a worldwide rout last week.

The domestically focussed mid-cap index was down 1.9%.

Cruise operator Carnival dropped 4.2% to its lowest level since 2012, a day after its Grand Princess ocean liner was barred from returning to its home port of San Francisco on virus fears.

Britain said an older person with underlying health problems had succumbed to the flu-like virus on Thursday, while the number of infections jumped to 115.

In company news, drug maker AstraZeneca fell 1% after it said its treatment for a form of bladder cancer failed to meet the main goal of improving overall survival in patients in a late-stage study.

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News Network
April 12,2020

Washington, Apr 12: The US has overtaken Italy as the country with the highest number of deaths due to COVID-19 pandemic with the fatalities crossing 20,000, according to Johns Hopkins University data, as the novel coronavirus continues to wreak havoc across the globe.

The deadly coronavirus, that originated in China in December last year, has so far killed more than one lakh people across the globe. The United States on Saturday became the country with the highest number of deaths at 20,597, surpassing Italy's 19,468 fatalities.

More than 5.3 lakh Americans have tested positive for coronavirus, which is about the same for the next four countries put together: Spain (163,027), Italy (152,271), Germany (125,452) and France (93,790). In terms of fatalities, the US and Italy are followed by Spain (16,606), France (13832) and United Kingdom (9,875), the varsity data showed.

New York City, the financial capital of the world, has emerged as the epicenter of coronavirus in the world. A city of 8.3 million, which is one of the most densely populated cities in the US, by Saturday night had as many as 8,627 deaths and more than 180,000 people had tested positive for COVID-19.

President Donald Trump has declared a national emergency and all the 50 States have been notified with major disaster declaration. More than 95 per cent of the country's 330 million population are under stay-at-home order. Trump has deployed more than 50,000 personnel from the armed forces in fight against COVID-19.

After an initial two-week social mitigation measures, that includes social distancing, the measures have been extended till April 30. Initially, members of the White House Task Force on Coronavirus had projected between one and two lakhs deaths. Now, they have dropped the projection to 60,000 deaths, mainly due to the successful implementation of these measures.

"The people of our country have gone through a lot. But we did it the right way. And we look like we'll be coming in on the very, very low side, really below the lowest, the lowest side of the curve of death," Trump told Fox News on Saturday night.

Trump asserted that situation was improving in places like New York, where there is a drop in new patients. Responding to a question, he said he wanted the country to open up as soon as possible.

However, he has not taken a decision so far, even as some media reports said that he the President was looking for early May.

"I think it's going to be the toughest decision that I've ever made. I really, hopefully that I ever will have to make. But it's certainly the toughest decision that I've ever made. I hope that I'm going to make the right decision," Trump said, adding that he will be making a decision reasonably soon.

"We're setting up a council now of some of the most distinguished leaders in virtually every field including politics and business and medical. We'll be making that decision fairly soon," Trump said.

Meanwhile, The New York Times reported that its investigations have revealed that the president was warned about a potential pandemic but that internal divisions, lack of planning and his faith in his own instincts led to a halting response.

According to The Washington Post, coronavirus is killing about one in 10 hospitalised middle-aged patients and four in 10 older than 85 in the United States. It is particularly lethal to men even when taking into account common chronic diseases that exacerbate risk.

Globally, the novel coronavirus has killed 108,862 people and infected over 1.7 million people globally. The US has the highest number of infections at 529,887, according to Johns Hopkins University data.

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