COVID-19 is the disease that has brought the whole world to a stop, with worldwide lockdowns, quarantines, and social distancing. It has affected the world’s economy drastically, leading to many opinions circulating regarding its treatment. It is caused by SARS-Cov-2, a novel virus first originating in the Wuhan province of China. For a long time, doctors struggled to treat patients with Coronavirus due to a lack of understanding of how the disease progresses and the exact pathophysiology of the infection by SARS-Cov-2. However, doctors soon found that hydroxychloroquine could prove beneficial in the treatment of COVID-19.
What is Hydroxychloroquine?
Hydroxychloroquine is a drug used mainly for malaria treatment. It is also used for rheumatoid arthritis, lupus, and porphyria cutanea tarda. And when the world was crumbling due to COVID-19, Dr. Risch and many others found that it can also treat patients with COVID-19. The exact mechanism isn’t known, but many doctors have published papers and case reports validating its use in this particular scenario. It is being used currently, along with other antivirals in almost all hospitals. Along with that, studies are still being performed to understand it’s benefits and harms. In many retrospective studies and the work of Dr. Risch, it has been proven that it can prevent death in SARS-Cov-2 infected patients, however, there are limitations to its effect.
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Just like any other anti-viral medication, it only works efficiently in the early phases of the disease. That is, if an early diagnosis is made and the medication is given before the virus has replicated and reached the bloodstream, it can help treat and prevent death. However, it is difficult to treat COVID-19 or any virus for that matter once it has reached your bloodstream and already caused damage to the organs.
Politicization of Hydroxychloroquine
The media and some parts of the medical community have heavily politicized this medication which has led to mass hysteria and panic. This panic adds to the uncertainty that the general population has when it comes to the discussion of the treatment of COVID-19. This has also created problems for doctors and nurses who have been criticized and have had their reputations ruined for using this medication, some are even facing legal charges.
On top of that, some countries like Switzerland banned the use of hydroxychloroquine, and that caused many deaths. After seeing an increase in the death rate, they revoked this ban but the damage was already done. The United States has also heavily politicized the use of this drug.
Why is the use of hydroxychloroquine so controversial?
There is an entire saga of hydroxychloroquine transforming from a drug for the treatment of malaria to a heavily politicized drug. There are many reasons why parts of the medical community and many governments feel uncomfortable with the use of hydroxychloroquine for SARS-Cov-2 infected patients.
Some of the doctors and the general population are concerned with the side effects seen with the use of this drug, however, skipping over the fact that these side effects are associated with long-term use of the drug in patients with diseases mentioned above. The risks in short term use have yet to be found or proven with certainty.
Another reason for not accepting this drug for universal treatment is the bias found in the Henry Ford Study conducted in the US. Doctors who conducted this study concluded that hydroxychloroquine was the answer to COVID-19 treatment but the study shows bias. They chose to give some patients the drug and not give it to the rest without there being an actual distinction for group selection. Not just that, they also failed to take into account the lack of comorbidities in the young patients, hence indicating that these patients got better with the drug because they weren’t as severely sick, to begin with.
Dr. Fauci, an infectious disease expert who has been the frontline doctor against COVID-19, has also called the Henry Ford study ‘flawed’ and he went on to say, ‘The Henry Ford Hospital study that was published was a non-controlled retrospective cohort study that was confounded by a number of issues, including the fact that many people who were receiving hydroxychloroquine were also using corticosteroids, which we know from another study gives a clear benefit in reducing deaths with advanced disease’.
Benefits of Hydroxychloroquine in COVID-19 infected patients
Although many controversies exist around this anti-malarial drug especially due to its heavy politicization, its benefit in many patients cannot be ignored. It has shown to be extremely useful in many case reports and case studies published. As mentioned above, no drug can work efficiently after severe damage is done. But as of now, with the very little understanding that exists for the COVID-19, this drug may not be the gold standard but it surely is worth considering.
Hydroxychloroquine, when used along with other antivirals and corticosteroids, is very beneficial in treating the disease and decreasing the very high death rate. It is a matter of timely diagnosis and initiation of treatment, rather than the efficacy of the drug itself. Data collected from many hospitals in an ethical, unbiased manner, shows that although hydroxychloroquine on its own isn’t enough, it is extremely efficient when given with other drugs in treating these patients.
In simple words, till a better solution is found, hydroxychloroquine and corticosteroids should be given to the patients infected with SARS-Cov-2, as the main aim of government and hospitals right now should be treating patients and controlling the pandemic. The choice of treatment drugs should be left to the doctors and scientists, and the politicization of a drug should be avoided because it can lead to regression in the control over this pandemic that has left thousands dead. More randomized and controlled, unbiased studies need to be done on the use of hydroxychloroquine for COVID-19.