Researchers are searching through available options to treat the coronavirus, which has killed more than 330,000 people, including drugs like the antimalarials that are also already approved to treat lupus and rheumatoid arthritis. "In the meantime, we suggest these drugs should not be used as treatments for COVID-19 outside of clinical trials".
A comprehensive study published yesterday in the medical journal The Lancet found that seriously ill Covid-19 patients who were treated with hydroxychloroquine or chloroquine were more likely to die or develop irregular heart rhythms. For those who received hydroxychloroquine plus an antibiotic, the death risk increased to 45% and heart problems to 411%.
"Urgent confirmation from randomised clinical trials is needed", they wrote.
Hydroxychloroquine is the most controversial in the latter group, and all thanks to the comments and actions of a single man who has been convinced of the efficacy of the drug in the fight against COVID-19.
However, it is by far the largest look at their use in real-world settings, studying 96,000 patients at 671 hospitals on six continents. All of the patients included in the study had either been discharged or had died by 21 April 2020. About 1 in 6 patients treated with chloroquine or hydroxychloroquine alone died in the hospital.
Researchers found the 14,888 patients in the treatment group suffered higher mortality when compared to the control group of over 80,000.
According to the global news agency, The death rates of the treated groups were: hydroxychloroquine 18%; chloroquine 16.4%; control group 9%. That's not what would be expected if the drugs were highly effective treatments. And a Brazilian study was shut down after two deaths and heart problems among patients who got a high dose of chloroquine. The drug and its more toxic predecessor, chloroquine, are also linked to a unsafe heart condition.
The death rates of the treated groups were: hydroxychloroquine 18%; chloroquine 16.4%; control group 9%.
The estimated excess risk attributable to the drug regimen rather than other factors, such as comorbidities, ranged from 34% to 35%.
"It really does give us some degree of confidence that we are unlikely to see major benefits from these drugs in the treatment of COVID-19 and possibly harm", said Aronoff, who was not involved in the research.
The drugs have now been shown to be tied to a greater risk of death and heart rhythm problems in the study of almost 100,000 patients around the world. Similarly, it is not possible to conclusively infer cause and effect between treatment with these medications and the onset of heart arrhythmias. If they show that the drugs were actually harmful, it will be another giant misstep in the response to the virus.
Results from some of the first large, randomized studies of hydroxychloroquine are expected soon, including a study being conducted by the French government and one at the University of Minnesota.