Anti-Malarial Drug for Treating COVID-19 is Approved in US

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Neucrad Health News Desk April 2, 2020

COVID-19 pandemic is taking an unprecedented form, with every passing day. The number of positive patients has skyrocketed to nearly 9.6 lakhs, and the outbreak has claimed more than 49100 lives till April 2, 2020. Doctors and scientists are trying out every possible measure to control the spread of the SARS-CoV-2 virus. The U.S. Food and Drug Administration recently approved the use of anti-malaria medicines for treating novel coronavirus patients [1]. In many countries, patients have reacted positively to the administration of hydroxychloroquine sulphate and chloroquine phosphate. Their symptoms became manageable, and hospitals have successfully discharged many COVID-19 cases after they tested negative for the virus in two consecutive samples [1].

How did the United States react to the new development in COVID-19 Treatment?

The Emergency Use Authorization (EUA) of anti-malarial drugs in novel coronavirus treatment by the FDA has led to large scale donation of these medicines to the Strategic National Stockpile (SNS) in the United States. The U.S. Department of Health and Human Services (HHS) accepted a donation of 30 million units of hydroxychloroquine sulphate from Sandoz, the Novartis Generics and Biosimilars division. They also received one million doses of chloroquine phosphate from Bayer Pharmaceuticals. Pharma companies have also ramped up the production of these medicines so that the government has enough stock of chloroquine and hydroxychloroquine for treating COVID-19 patients. Officials are now busy in drafting a suitable distribution network so that hospitals can quickly access these medicines [1].

Why do doctors recommend chloroquine and hydroxychloroquine for treating COVID-19?

Hydroxychloroquine is a less toxic derivative of chloroquine- which is a potent antimalarial oral medicine. Doctors also prescribe this medication for treating other medical issues including, rheumatoid arthritis, lupus, and porphyria cutanea tarda. Physicians all across the globe are advocating the use of chloroquine and hydroxychloroquine for treating COVID-19 patients because new drugs like Remdesivir, are under clinical development stage. On the contrary, chloroquine and hydroxychloroquine- being old medications are available in sufficient doses in many Pharmaceutical Companies. Authorities feel the use of anti-malarial medicines for treating novel coronavirus is a practical choice [2, 3].

High concentration of cytokines were detected in the plasma of critically ill patients infected with SARS-CoV-2, suggesting that cytokine storm was associated with disease severity [3]. Hydroxychloroquine has its direct antiviral activity. It is a safe and successful anti-inflammatory agent that has been used extensively in autoimmune diseases and can significantly decrease the production of cytokines and, in particular, pro-inflammatory factors. It is assumed that hydroxychloroquine may contribute to attenuating the inflammatory response on COVID-19 patients.

What are Hydroxychloroquine Sulphate and Chloroquine Phosphate?

Hydroxychloroquine (HCQ) sulphate was first synthesized in 1946. Researchers introduced a hydroxyl group into chloroquine (CQ), thereby rendering it 40 per cent less toxic than the parent CQ molecule. It was extensively tested on animals, and then Pharmaceutical Companies made it commercially available for treating autoimmune diseases like systemic lupus erythematosus and rheumatoid arthritis. Both HCQ and CQ have similar chemical structures. They act as a weak base and immunomodulator for treating SARS-CoV-2 infection [2].

What Precautions should you undertake before prescribing Hydroxychloroquine?

Doctors should be cautious while prescribing Hydroxychloroquine as long-term consumption of this medicine can cause irreversible damage to the retina. Patients can develop a condition known as retinopathy leading to permanent impairment in vision. Besides, it is also dangerous for candidates already who have psoriasis, porphyria, and liver diseases. [1, 4]

Common side effects of Hydroxychloroquine include:

  •        headache with chest pain
  •        severe dizziness
  •        muscle weakness
  •        nausea and vomiting
  •        diarrhoea
  •        reduced appetite
  •        ringing in the ears
  •        skin rash
  •        hair loss
  •        cardiac issues

However, patients must always consume this drug under medical supervision as there are chances of developing side effects if the doses are not optimised. World is waiting to know the efficacy of these anti malarial drugs in controlling or reducing COVID-19 infections.

References:

1.     HHS accepts donations of medicine to Strategic National Stockpile as possible treatments for COVID-19 patients

2.     Hydroxychloroquine, a less toxic derivative of chloroquine, is effective in inhibiting SARS-CoV-2 infection in vitro

3. Huang, C. et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet395, 497–506 (2020).

4.     Hydroxychloroquine

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