Hydroxychloroquine Doesn’t Benefit Severely Ill Coronavirus Patients—Here’s What the Latest Evidence Shows

It’s no game changer for people hospitalized with COVID-19.

Hydroxychloroquine, an anti-malarial drug commonly used to treat inflammatory conditions such as lupus and rheumatoid arthritis, gained significant attention earlier this year as a potential treatment for COVID-19. This drug and its cousin, chloroquine, were initially hailed as potential game-changers in the fight against the novel coronavirus. However, as the year progressed, the excitement over these medications waned. This article explores the evolving narrative surrounding hydroxychloroquine, its potential efficacy against COVID-19, the associated risks, and its journey from hope to skepticism.

The Promise of Hydroxychloroquine

The search for effective COVID-19 therapies began amidst a global pandemic that demanded rapid scientific response. Hydroxychloroquine and chloroquine, both well-established antimalarial drugs, were identified as potential candidates due to their antiviral properties. These drugs have been used since 1944 to prevent and treat malaria, caused by a parasite transmitted through infected mosquitoes. Additionally, hydroxychloroquine has been prescribed for individuals with autoimmune conditions like lupus.

Laboratory studies, including research published in the Virology Journal in 2005, suggested that chloroquine was effective in preventing and treating the virus responsible for severe acute respiratory syndrome (SARS), caused by another strain of coronavirus. The similarities in protein spikes between the COVID-19 virus and the SARS virus raised hope that hydroxychloroquine might inhibit the former’s ability to bind to human cells.

Clinical trials and studies were initiated at an unprecedented pace, driven by the urgent need to find therapies for COVID-19. However, while pre-clinical evidence seemed promising, the rigorous data from high-quality clinical trials remained lacking.

The Risks and Safety Concerns

Despite the initial enthusiasm surrounding hydroxychloroquine, concerns emerged regarding its safety and effectiveness in treating COVID-19. The body of evidence supporting its use for COVID-19 was described as “limited and inconclusive” by experts. Studies mainly consisted of laboratory experiments and small, poorly controlled trials.

One frequently cited French study that examined hydroxychloroquine in combination with azithromycin showed some benefits, but the study was small, non-randomized, and raised questions about methodological limitations. Separately, a Chinese study suggested that hydroxychloroquine could expedite recovery in patients with mild illness but excluded severely ill patients.

Significantly, hydroxychloroquine and chloroquine carried risks, particularly related to cardiac complications. A genetic cardiologist from Mayo Clinic warned of sudden-induced cardiac death associated with these drugs, emphasizing the importance of monitoring heart health indicators, like the QTc interval, when administering them. These cardiac risks were heightened when hydroxychloroquine was used in combination with other medications, such as azithromycin.

The FDA’s Involvement

The US Food and Drug Administration (FDA) played a pivotal role in shaping the narrative surrounding hydroxychloroquine. In June, the FDA withdrew its emergency approval for the use of hydroxychloroquine and chloroquine as COVID-19 treatments. The decision was based on the determination that these drugs were unlikely to provide a significant antiviral effect, and any potential benefits were outweighed by known and potential risks.

The FDA’s decision followed a series of disappointing trial results and was a response to the emerging evidence indicating that the drugs did not provide a substantial benefit in treating COVID-19. This marked a turning point in the discourse around hydroxychloroquine.

The Fallout and Misuse

The controversy surrounding hydroxychloroquine extended beyond clinical trials and scientific debates. Reports emerged of health professionals hoarding these medications for themselves and their families, sparking concerns about potential shortages for individuals who genuinely needed them, such as those with lupus and autoimmune conditions.

Tragically, a widely reported incident involved an Arizona couple who ingested a chemical fish tank cleaner containing chloroquine, believing it could prevent COVID-19. This tragic incident emphasized the dangers of misinformation and the unintended consequences of publicized drug use without scientific evidence.

Former President Donald Trump’s endorsement of hydroxychloroquine further fueled the debate. He initially touted the drug as a potential game-changer during White House briefings, leading to widespread attention. However, as the scientific community raised concerns and evidence against its efficacy mounted, President Trump’s stance evolved, and he refrained from using the drug when diagnosed with COVID-19.

Conclusion: From Hope to Skepticism

The trajectory of hydroxychloroquine’s role in the fight against COVID-19 reflects the complexities of medical research and the importance of evidence-based medicine. While it initially symbolized hope and potential, rigorous scientific scrutiny revealed limitations and safety concerns.

Hydroxychloroquine gained early attention in the context of the COVID-19 pandemic due to its known antiviral properties and its availability as a well-established drug. However, as the rush to find effective treatments reached a fever pitch, the drug was prescribed widely, often without the benefit of robust clinical trials. This hasty adoption underscored the importance of scientific rigor in evaluating potential treatments.

As more clinical trials were conducted, it became clear that hydroxychloroquine’s efficacy in treating COVID-19 was far from certain. Results were mixed, with some studies suggesting potential benefits while others showed no significant improvement. Additionally, concerns emerged about the drug’s safety profile, especially when used in high doses or in combination with other medications. Reports of cardiac arrhythmias and other adverse effects prompted regulatory agencies to issue warnings and restrictions on its use.

The lessons learned from the hydroxychloroquine saga underscore the critical need for thorough clinical trials, transparent reporting of results, and cautious public messaging during a global health crisis. Rushing to embrace unproven treatments can lead to false hopes and potentially harmful consequences. It is a reminder that science and medicine must be guided by rigorous investigation, where hypotheses are tested, results are analyzed, and conclusions are drawn based on data rather than anecdotal reports.

In the context of the COVID-19 pandemic, the healthcare community quickly adapted to prioritize evidence-based medicine. Clinical trials were designed and executed with unprecedented speed, and collaboration among researchers worldwide accelerated the pace of discovery. This commitment to rigorous research and transparent reporting led to the authorization and distribution of effective vaccines, which have become the cornerstone of global efforts to control the pandemic.

As the COVID-19 pandemic continues to evolve, the healthcare community remains committed to identifying safe and effective treatments while upholding the highest standards of scientific inquiry and medical ethics. It is a testament to the resilience and adaptability of the scientific and medical communities in the face of a global crisis. While the hydroxychloroquine episode may have been a detour in the quest for effective COVID-19 treatments, it serves as a valuable lesson on the importance of evidence-based medicine and the need for rigorous evaluation of potential therapies.