As countries around the world explore the potential of hydroxychloroquineto treatCOVID-19patients, several experts have sounded a note of warning to sayit is not a wonder drug and may even be fatal in some cases.
While frantic efforts are underway to develop a vaccine anddoctors all over try and control the spread of the disease for which there isyet no cure, hydroxychloroquine, or HCQ, has emerged as a prime focus area oftreatment.
This reliance on HCQ must immediately stop, the experts say,adding their voices to the growing debate to stress that there is no scientificevidence to prove that it is beneficial in treating COVID-19.
It is only on anecdotal evidence that doctors are using HCQalong with other antiviral medication (used in HIV and other viral infections)as empiric therapy to treat COVID-19 patients as there is no definite treatmentavailable yet, said M C Misra, former director of the All India Institute ofMedical Sciences (AIIMS) in Delhi and one of India’s top surgeons.
However, there have been reports of some patients developingcardiac arrhythmias due to hydroxychloroquine which can cause sudden cardiacdeath,Misra told PTI.
Yudhyavir Singh, a core member of AIIMS’ COVID-19 teamdeployed at the hospital’s trauma centre, agreed.
Globally, some deaths have been reported due to theadministration of HCQ alone and along with azithromycin as well. HCQ blocks thepotassium channel and potentially prolongs the QTc (heartbeat) withconsequences of sudden cardiac arrest death and various arrhythmias. This hasalso been documented in prominent studies, he explained.
The assistant professor of anaesthesia at AIIMS said thereare contradictory reports on HCQ usage for treating COVID-19.
As the pandemic spreads and the urgency for effective treatmentof COVID-19 mounts, several countries, including the US, have started relyingheavily on HCQ, majorly used in the treatment of malaria andrheumatoid-arthritis.
India has become the biggest supplier of the drug and hasfulfilled large orders from countries such as the US, UAE and UK.
With US President Donald Trump touting the anti-malariadrugas a definite cure for COVID-19, his administration has stockpiled millionsof doses of HCQ despite the US Food and Drug Administration (FDA) issuing asafety communication regarding the known side effects of the drug.
The FDA said HCQ has been given Emergency Use Authorisation’for the treatment of patients who have tested positive for coronavirus but itsside effects include serious and potentially life-threatening heart rhythmproblems.
In India too, HCQ is being used by many hospitals to treatCOVID-19 patients though there is no scientific proof of its benefit for thedisease.
We are using HCQ among other drugs but ignoring its extremehazardous side effects, Misra said.
In the first week of April, when coronavirus cases in Indiastarted to surge, a doctor in Assam who was put on a high dose of HCQ after heshowed COVID-19 symptoms died of a cardiac arrest, he said.
Citing a research from France in which one half of COVID-19patients was administered hydroxychloroquine while the other half was not,Misra said the recovery and outcomes of the two groups were same.
Another study submitted in The New England Journal of Medicineon April 4, 2020 concluded that HCQ administration to the hospitalisedSARS-CoV- 2 positive population was associated with an increased need forescalation of respiratory support, he said, adding that hydroxychloroquine wasnot a wonder drug.
COVID-19, which broke out first in China’s Hubei province,has caused havoc across the world, claiming the lives of more than 2.5 lakhpeople and infected over 36 lakh.
Ashraf Ganie, professor of endocrinology atSrinagar’sSher-I-Kashmir Institute of Medical Sciences, described as brazen themanner in which HCQ was being projected as a cure for treating coronavirus.
HCQ can have serious cardiac side effects and cannot be usedwithout prior evaluation, Ganie told PTI. “There is no quality scientificevidence available, which can prove the efficacy of the drug in prevention orcure of COVID 19, added D K Mangal, director of the Centre for Health Systemsand Policy Research in Jaipur’s IIHMR University.
It should be used with precautions for patients with severeheart disease and require continuous monitoring of QT interval. HCQ is knownfor its cadio-toxicity. Hence it should be used in health care settings only,he told PTI. Rajesh Kumar, a doctor of Internal Medicine at Gurgaon’s ParasHospital, said HCQ can also cause hypoglycemia in diabetes patients.