A decades-old drug, which President Donald Trump has consistently promoted as a possible weapon against covid-19, has become a standard of care in areas of the United States affected by the pandemic in weeks, but doctors who have prescribe they have no idea if it works.
Doctors and pharmacists from more than half a dozen major health care systems in New York, Louisiana, Massachusetts, Ohio, Washington and California said they routinely use hydroxychloroquine in hospitalized patients with covid-19.
However, several said they have seen no evidence that the drug, used for years to treat malaria and autoimmune disorders, has any effect on the virus.
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File image of President Donald Trump, during a press conference with the workforce to contain the spread of the coronavirus, at the White House, Washington, USA, on April 5, 2020.
Hydroxychloroquine use has exploded after the United States quickly became the epicenter of the pandemic. More than 355,000 people in the country have tested positive for the new coronavirus, and more than 10,000 have died.
Faced with the numbers and in the absence of known effective treatments, front-line doctors said they started using hydroxychloroquine and related chloroquine in patients who are deteriorating, because some small studies suggest a possible benefit.
Some said they had been pressured by patients to use the therapies widely touted by Trump and some of his supporters.
“I could take it,” Trump said Saturday, referring to hydroxychloroquine, although it has tested negative for the coronavirus twice, according to the White House. “We only hear really positive things and continue to collect the data.”
Possible side effects of hydroxychloroquine include vision loss and heart problems.
However, doctors said they were comfortable prescribing the drug for a short time for coronavirus patients, because the risks are relatively low and the therapies are inexpensive and generally available.
However, the protocols that indicate how these drugs should be used vary from hospital to hospital, including when to prescribe them and whether to combine them with other medications.
In addition, some studies with promising results involved patients who used therapy for mild or early-stage disease, so many of those people are likely to have recovered on their own.
Patients admitted to hospitals in the United States are generally much sicker than the mild cases cited in the studies. According to doctors, these factors have made it difficult for them to determine if medications are making a difference.
“I have seen hundreds of patients with severe covid-19 and most of these people are taking hydroxychloroquine,” Dr. Mangala Narasimhan, regional director of critical care for Northwell Health, a 23-hospital system in New York, said in an email.
“In my opinion, although it is very early, I don’t see a dramatic improvement in hydroxychloroquine in these patients.”
Dr Daniel McQuillen, an infectious disease specialist at Lahey Hospital and Medical Center in Burlington, Massachusetts, said he has so far prescribed a hydroxychloroquine course for about 30 covid-19 patients because the drug has shown “a little bit of antiviral activity ” But he has not seen “marked improvement in patients.”
“Anecdotally, it may have had a limited effect in patients with milder disease,” said McQuillen. The therapy “has had no effect in limiting or slowing the progression of our patients who were at or near the ICU level when they arrived.”
