What Is Hydroxychloroquine — And Could This Malaria Drug Treat Coronavinus?
New tests show that hydroxychloroquine might kill the virus.
Getty Images For the first time since we learned about deadly coronavirus in January, we are seeing a glimmer of hope for an effective treatment, The new disease has been sweeping around the globe, infecting countless people, many of whom end up hospitalized. The demand for ICU beds and ventilators has left healthcare systems overwhelmed and unable to help people who are very sick or perhaps dying.
For months, doctors have struggled to figure out what medicine might help people who have become infected with the novel virus. Because it is a virus, antibiotics — which only kill bacteria — can't help and currently known anti-viral drugs weren't effective in limited studies. But now some researchers have turned to a well-known drug that has been used for years. Hydroxychloroquine is a medicine that has been used to treat malaria as well as inflammatory conditions like arthritis.
What is hydroxychloroquine — and can it help treat coronavirus?
1. Why are we talking about a malaria drug in the first place?
Malaria has been long known as one of the deadliest diseases in the world. The mosquito-borne virus infects hundreds of millions of people every year and results in about half a million deaths. Treating and preventing malaria have been major global health priorities for decades. One known treatment for malaria is a drug called chloroquine, or hydroxychloroquine, which can be given to prevent infection or after infection to reduce the severity of the disease. It's been approved for use in malaria treatment since 1944.
2. What does this have to do with coronavirus?
While coronavirus seems different from malaria in nearly every way, including the fact that it's spread from person to person, instead of through mosquito bites, scientists decided to take a look at malaria treatment as a possible avenue to helping COVID-19 patients. Researchers in China isolated the viruses in the lab and treated them with hydroxychloroquine to see what would happen. The news was promising. The drug killed the bug in laboratory conditions. “(W)e predict that the drug has a good potential to combat the disease,” the study’s authors, most from the Chinese Academy of Sciences in Wuhan, wrote of their findings.
3. But would it work once people are infected?
Researchers in France picked up where the Chinese team left off and started administering the medication to actual patients. In a study of 36 confirmed COVID-19 patients — including 20 individuals who got the treatment and 16 who got a placebo — Didier Raoult, an infectious disease expert from l’Institut Hospitalo-Universitaire in Marseille determined that the medication had a significant effect on recovery. 50 percent of patients receiving treatment went from positive to negative for the virus by the third day. By day six, 70 percent of treated patients were negative for the virus.
4. A second drug may boost the effects even further.
The other thing the French study found eas that pairing hydroxychloroquine with azithromycin, a common antibiotic, seemed to supercharge the treatment. Six of the treated patients in the study got both medications and five of them were negative for the virus by day three, and the sixth person was negative by day five.
“Despite its small sample size our survey shows that hydroxychloroquine treatment is significantly associated with viral load reduction/disappearance in COVID-19 patients and its effect is reinforced by azithromycin,” the study concluded.
5. How does it work?
Researchers have figured out that the virus that causes SARS and the virus responsible for COVID-19 has very similar protein spikes on the surface of the on their surfaces. Those protein spikes bind to special receptors on the outside of human cells and cause both kinds of infections. Scientists already know that hydroxychloroquine can help with the treatment of SARS by interfering with those receptors and block the virus’s ability to bind to cells. On a hunch, they checked to see if COVID-19 responds the same way and the news so far is very promising.
"The way that it worked against SARS was by preventing of the attachment of the virus to the cells. Chloroquine interfered with the attachment to that receptor on the cell membrane surface," Dr. Len Horovitz, a pulmonologist and internist at Lenox Hill Hospital in New York City told reporters. "So it’s disrupting a lock and key kind of mechanism of attachment."
6. What is hydroxychloroquine — and can it help treat coronavirus?
Because hydroxychloroquine is already approved for use in humans, the process for approving it for this use will be relatively fast. It's been around for over 80 years so doctors already know what it does. The FDA is working to expedite approval to use it for COVID-19 treatment under "compassionate use" guidelines, as well as greenlighting further study of its effects on the virus. The federal government is planning to start making it available as soon as possible, according to a White House press conference on March 20.
The FDA continually updates the guidance on COVID-19 best practices.
7. The FDA has issued new guidance on using hydroxychloroquine.
Because the initial trial was such a small group of people, doctors in the US were being cautious about using the hydroxychloroquine, even though there was considerable excitement about it online. There were reports of people asking their doctors to prescribe it to have on hand just in case, causing shortages for those who really need it, such as lupus patients. One man tried using an aquarium cleaning chemical called chloroquine phosphate, which is a poison that killed him and left his wife in critical care.
Now, the FDA is finally giving a go-ahead for use of the medication for COVID-19 under certain conditions. The change in status for the drug comes after other countries have been using in in the treatment of some patients. It's also part of a massive WHO-run clinical trial of multiple therapeutic drugs that is on-going. The positive evidence of effectiveness from these new datasets has spurred the FDA to allow use of it for patients with COVID-19 who are hospitalized — however, if you are able to recover at home from a bout of coronavirus, you are not eligible to get it.
The idea of a safe and effective treatment for this disease would be exactly the kind of good news everyone needs right now.
Rebekah Kuschmider has been writing about celebrities, pop culture, entertainment, and politics since 2010. She is the creator of the blog FeminXer and she is a cohost of the weekly podcast The More Perfect Union.