The evidence is mounting from frontline caregivers dealing with Covid19 patients. Previous posts provide examples of HCQ treatment along with other proven medicines (eg. Azithromycin) and supplements (eg. Zinc, vitamins C and D). Summarized in the chart above is the role of HCQ+ according to the progression of the disease Covid19.
HCQ Prevents Covid19
The first column on the left is sometimes called PrEP, or pre-exposure to the virus SARS CV2. Now we are getting studies confirming that HCQ plays an important prophylactic role in blocking the virus from taking hold when someone is infected. The Times of India June 19, 2020, article is HCQ beneficial as preventive drug: SMS doctors told ICMR. Excerpts in italics with my bolds
JAIPUR: Sawai Man Singh Hospital was the first to use hydroxychloroquine (HCQ) and anti-HIV drugs — Lopinavir and Ritonavir — to treat the first few Covid-19 patients besides using the combination as a preventive drug on others.
More than 4,300 healthcare workers including doctors and nurses have been given HCQ to help them prevent the infection as there are high chances of them getting infected while treating Covid patients.
“As far as prophylaxis is concerned, more than 4,300 doctors and health works were given HCQ as approved by Indian Council of Medical Research (ICMR) out of which around 45 health persons tested positive and recovered later,” said Dr Sudhir Bhandari, principal and controller, SMS Medical College.
The hospital claimed that preventive treatment approach at SMS Hospital has been very rewarding and results of these have been shared with ICMR.
“We have used these drugs with perfect scientific background and proven efficacy in SARS Cov-2 Infection and SMS Medical College created a bridge between point of no specific treatment till the specific drug treatment is established. All these drugs were part of solidarity trial by WHO of which SMS Hospital is a centre,” said Bhandari.
SMS Hospital was declared as non-Covid hospital on June 1. But before that, it emerged as a role model of management of Covid patients. From the very beginning, 300 ICU beds and more than thousand IPD beds were dedicated for Covid patients. A separate Covid OPD and observation wards for suspects was created at Charak Bhawan. Also, 28 wards were created for Covid patients of different categories. For critically ill patients, Infectious Disease Hospital (IDH) was fully equipped with ICU facilities.
During the peak of the pandemic, average 500 plus patients were admitted to SMS from asymptomatic category to severe category.
Number of faculty was put on floor duty, which included consultants from the department of medicine and anaesthesia. Resident doctors were doing duty in each shift and hundreds of nursing, paramedics and technicians were on round-the-clock duty.
HCQ Clears the Virus Before Severity
A recent meta-study reports on HCQ efficacy post-exposure (PEP) and in Early stages I and II. Clinical Efficacy of Chloroquine derivatives in COVID-19 Infection: Comparative meta-analysis between the Big data and the real world Excerpts in italics with my bolds.
Only studies comparing a group of COVID19 patients treated with a chloroquine derivative to a control group without chloroquine derivatives were included. Non-comparative (single arm) studies and studies comparing two groups treated with chloroquine derivatives at different dosages or with different delay of treatment were excluded. Studies were classified as “big data” studies when conducted on electronic medical records extracted by public health specialists and epidemiologists who did not care COVID106 19 patients themselves. Conversely, studies were classified as “clinical studies” when mentioning details of treatments (dosages, duration, contraindications, monitoring…) and conducted by authors physicians (infectious diseases and internal medicine specialists, and pulmonologists) who cared for COVID-19 patients themselves.
Twenty studies were identified involving 105,040 patients (19,270 treated patients) from nine countries (Brazil, China, France, Iran, Saudi Arabia, South Korea, Spain, and USA). Big data observational studies were associated with conflict of interest, lack of treatment dosage and duration, and absence of favorable outcome. Clinical studies were associated with favorable outcomes and details on therapy. Among clinical studies, three of four randomized controlled trials reported a significant favorable effect.
Among clinical studies, a significant favorable summary effect was observed for duration of cough (Odds ratio (OR), 0.19, p = .00003), duration of fever (0.11, p = .039), clinical cure (0.21, p = .0495), death (0.32, p = 4.1×10-6) and viral shedding (0.43, p = .031). A trend for a favorable effect was noted for the outcome “death and/or ICU transfer” (0.29, p = .069) with a point estimate remarkably similar to that observed for death (∼0.3). In conclusion, a meta-analysis of publicly available clinical reports demonstrates that chloroquine derivatives are effective to improve clinical and virological outcomes but, more importantly, it reduces mortality by a factor 3 in patients infected with COVID-19.
All “big data” studies reported a lack of beneficial effect of the treatment and were significantly more likely associated with “Cons” variable (5/5 vs 3/15, p = .004). This was also observed by examination of the meta-analysis forest plot (Figure 2, Table S3 to S8). In addition, both “conflicts of interest” (p = .01) and “not described treatment protocol” variables (p = .004) were associated with “Cons” variable. Conversely, clinical studies were more likely to report a favorable effect of chloroquine derivatives in COVID-19 patients (p <.05). Consistently, clinical studies with detailed treatment protocol were more likely associated with the observation of a favorable effect of the treatment (p < .05).
In the big data analyses, 4 comparisons reported a significant effect, and all were deleterious (4/4). In the clinical studies, 17 comparisons reported a significant effect, and all were beneficial.
HCQ Saves Lives of Severely Sick Patients
The Henry Ford Hospital in Michigan reported ‘Trump Drug’ Hydroxychloroquine ‘Significantly’ Reduces Death Rate From COVID-19, Henry Ford Health Study Finds. H/T Jaime Jessop. Excerpts in italics with my bolds
A Henry Ford Health System study shows the controversial anti-malaria drug hydroxychloroquine helps lower the death rate of COVID-19 patients, the Detroit-based health system said Thursday.
Officials with the Michigan health system said the study found the drug “significantly” decreased the death rate of patients involved in the analysis.
The study analyzed 2,541 patients hospitalized among the system’s six hospitals between March 10 and May 2 and found 13% of those treated with hydroxychloroquine died while 26% of those who did not receive the drug died.
Among all the patients in the study, there was an overall in-hospital mortality rate of 18%, and many who died had underlying conditions, the hospital system said. Globally, the mortality rate for hospitalized patients is between 10% and 30%, and 58% among those in the ICU or on a ventilator.
“As doctors and scientists, we look to the data for insight,” said Steven Kalkanis, CEO of the Henry Ford Medical Group. “And the data here is clear that there was a benefit to using the drug as a treatment for sick, hospitalized patients.”
For more details on the meta-study see HCQ Hit Job by Big Pharma Data Miners
Full listing of research on HCQ+ regarding coronavirus is at The Palmer Foundation