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Some hope fionwe1987 Send a noteboard - 22/03/2020 05:51:50 PM

Just finished reading the results of a non-randomized clinical trial for using azithromycin and hydroxychloroquine against Covid-19. If you'd like to read it, the PDF can be gotten at the link below.

In summary, they used either hydroxychloroquine (an anti-malarial drug that's also used to treat rheumatoid arthritis and lupus) alone, or paired it with azithromycin, which is an antibiotic. The combination, when used for about 5-6 days, showed patients testing positive for SARS-CoV-2 at significantly lower levels. There were some exceptions, and they'll need to investigate why.

The mechanism of action is not known. Hydroxychloroquine modulates the immune system. Azithromycin kills bacteria and may be helping by preventing secondary bacterial infections which are often the cause of death in patients who have respiratory viral infections. This is me speculating, by the way. The paper doesn't delve into mechanism of action at all, because they rushed this to publication to spread the word.

Early Chinese studies had used chloroquine, which is similar to hydroxychloroquine, but somewhat more toxic, so you have to restrict the dose. The French team that did this study used the hydroxyl derivative instead, and paired it with an antibiotic. There have also been studies pairing chloroquine with ramdesivir, a new antiviral drug that's showing some efficacy against SARS-CoV-2.

This was the most hopeful study to me, because both drugs used are well tested, and have established production lines, the absence of which is often the reason we don't move from study to widespread availability quickly.

There will need to be wider trials that are actually randomized, of course. And Trump will need to shut up about it being a done deal so people don't start pre-emptively hoarding the drugs when they don't need it, but both are drugs with a long history of manufacture, and even if they're effective in significantly less than 100% of the cases, it's still useful to reduce the load on hospitals.

It's very likely such trials are underway right now in the United States. I'll update the post if I hear more about any results.

Link to journal article
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Some hope - 22/03/2020 05:51:50 PM 52 Views

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