What do we know about Chloroquine use against COVID-19?

Chloroquine (and hydroxycloroquine) are related drugs that have been used for over 70 years to treat and prevent malaria. They have both antiviral and anti-inflammatory properties. French studies Professor Didier Raoult, who has a laboratory and hospital beds in Marseille, France, has been promoting chloroquine as an effective treatment for COVID-19 Coronavirus. From 16 March 2020 he trialed treatment of 24 COVID-19 patients with 600 mg of Chloroquine daily for 10 days. He reported that six days later only 25% of these patients still carried the virus, whereas without chloroquine one would expect 90% to still be infected and infectious. The implication is that Chloroquin shortened the course of the illness. The study may also have suggested that additional treatment with the antibiotic azithromycin led to better outcomes where secondary pneumonias of bacterial origin occurred. Raoult has the qualifications to make serious claims in this field. He is a microbiologist specialising in infectious diseases and a professor in the Medical Faculty at the University of Aix-Marseilles. He is widely recognised for his work. Since 2008 he has been director of the URMITE Research Unit in infectious and tropical diseases. Although the data are not yet published, the French Government is trying to reproduce the study. Olivier Veran, Minister for the French government has authorised the use of Chloroquine for treatment of very serious cases of COVID-19, under supervision by hospital medical teams, but does not authorise it for less serious ones. He has said that the French Government is working closely with Raoult's team. Didier Raoult disagrees with the French Government and says Chloroquine should be used at the earliest stages in the COVID-19 illness. The French Government is currently carrying out its own formal testing of this treatment, possibly in Lille, according to a report on 23 March 2020, on RT France, https://francais.rt.com/en-ce-moment/72699-chloroquin. The Chinese Government has used Chloroquine with COVID-19 cases. A Chinese study involving more than 100 patients was described in a letter published in BioScience Trends on 19 February 2020. Researchers said that Chloroquine phosphate was the most effective treatment available to contain the development of the viral form of pneumonia associated with COVID-19, improving the state of the lungs, to shorten the duration of the illness and the presence of the viral infection itself. Apparently the letter has not yet been followed up with formal data from the study. Anecdotally, Chinese researchers have apparently encountered obstacles in conducting formal trials involving controls because patients have obtained their own drugs in preference to submitting to the uncertainty of being part of a control group rather than a group actually receiving the drug in question. United States President Trump has initiated a trial in the United States, following an interview on Tucker Carlson Tonight with a person reporting on Didier Raoult's claims. Alert observers will, however, notice that Anglosphere reporting on this matter is political, rather than informative. This distraction from essential information for the public complements a race by pharmaceutical companies to corner the US and international market with an expensive 'cure'. Nonetheless Chloroquine can be used by any doctor to treat anything they consider appropriate in the United States and elsewhere. The World Health Organisation has also initiated trials of a few drugs, including Chloroquine. Other countries use of Chloroquine for COVID-19 South Korea reputedly has guidelines that recommend Chloroquine for cases of COVID-19 that require anti-viral intervention and for the elderly. It also recognises its use as a prophylactic against the virus.[1] In the meantime a number of countries are already using Chloroquine in treatment of COVID-19 with less restrictions. The Bolivian Republic has begun giving oral Chloroquine to COVID-19 patients and also to their immediate contacts, which tend to involve around 15 people on average, as well as to health professionals working with COVID-19 patients. In Venezuela similar regimes are being undertaken. Algeria strong> is also using chloroquin for COVID-19 patients. Use of Tolicizumab in Naples for COVID-19 In Naples there have been trials involving small numbers of hospitalised patients, using another old drug, usually used for arthritis, called Tolicizumab (also sold as Actemra). See "Coronavirus, Napoli: 5 pazienti gravi su 10 migliorano, grazie al Tolicizumab, il farmaco anti artritie." (15 March 2020, Ildenaro.it). The information I was able to access about this trial was fairly old. This monoclonal antibody used for the treatment of rhematoid arthirits is also effective against COVID-19 pneumonia, claim doctors involved in its use in Naples. This treatment was inititiated in Naples by Paolo Ascierto, Director for the Pascale Immunological Clinic and Vincenzo Montesarchio, infection specialist at Cotugno Hospital in Naples. For Saturday 7 March the two doctors said that ten patients, of whom 7 were intubated [presumably for pneumonia] and three had respiratory difficulty [but were unintubated], experienced strong improvement compared to controls. The first patient treated had improved enought to have his intubation removed. Of the other patients, four stabilised and one, unfortunately, quickly died from respiratory distress. Of the other three patients who where not intubated, after about 24 hours one was stable and one had shown signs of clinical improvement. The doctors also said they had received optimistic signs from other centres: Treatment centres or hospitals in Fano/Pesaro reported improvement in eight patients treated in a total of eleven. And a Dr Chiari from United Hospital in Padova South reported improvements in two patients treated over the previous 24 hours. NOTES My reference for this is called "An Effective Treatment for Coronavirus (Covid-19)," a paper attached to "Fosfato di Clorochina e Coronavirus," https://youtu.be/8TpvDixTivw., a presentation by James M. Todaro, MD Columbia and Gregory J. Rigano, Esq.. It was initially published as, "in consultation with researchers at the Stanford University School of Medicine, the UAB School of Medicine and the National Academy of Sciences, March 13, 2020." Stanford Univ has distanced itself. It looks as if the writers may have discussed things informally with various university researchers who did not expect to be named and quoted. [Good luck finding the article because at the moment the author is reduced to using a brand-name mobile phone that makes it almost impossible to see the URLs for articles.] TAGS: coronavirus, COVID-19, Didier Raoul, France, international, Trump, controversy