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NatMed - JAMA Show Serious Side Effects of Hydroxychloroquine / Chloroquine, FDA Warns

NatMed - JAMA both show serious side effects of hydroxychloroquine / chloroquine. US FDA warns against out-of-hospital use

On April 24, two well-known journals, Nat Med and JAMA, published very important studies, showing that high-dose hydroxychloroquine treatment of COVID-19 is a very dangerous clinical option.

On the same day, the US Food and Drug Administration (FDA) issued a warning: Do not use hydroxychloroquine outside the hospital to treat COVID-19.

Previously, the FDA granted "authorization for emergency use" for hydroxychloroquine / chloroquine treatment of COVID-19. US President Trump has repeatedly advocated that hydroxychloroquine / chloroquine treatment of COVID-19 is "the biggest game-changing drug in the history of medicine."

Hydroxychloroquine is an old drug widely used in clinic

In a laboratory test, chloroquine was found to have the potential to fight the new coronavirus (SARS-CoV-2).
Later small sample clinical studies also showed that hydroxychloroquine / chloroquine in the treatment of COVID-19, is effective.

On the face of COVID-19, which ravages the planet without any effective drugs, the results of these studies of hydroxychloroquine will undoubtedly become a life-saving straw.

It is not only President Trump who has repeatedly expressed praise for hydroxychloroquine / chloroquine, scientists from all over the world have also shown great concern for it. 

According to a tweet by Jesse Burk-Rafel on April 6, the most common of the 301 COVID-19 clinical trials at that time was the study of chloroquine / hydroxychloroquine, which actually reached 45 trials, while the trial against redoxir Only 9 items.

On April 3, the Interim Guidelines for the Treatment of COVID-19 completed by the International Working Group on New Coronavirus Diseases composed of 80 clinical experts from 20 countries.
Hydroxychloroquine / chloroquine became the only drug recommended by the international working group.

Hydroxychloroquine / chloroquine became the most dazzling star.

However, in further research, the clinical results of Chinese () and French () scholars published on April 14 showed that hydroxychloroquine was ineffective in treating new coronary pneumonia and had significant side effects.

And doctors who are cautious about hydroxychloroquine / chloroquine have been constantly warning that hydroxychloroquine / chloroquine and azithromycin can cause fatal arrhythmias.

Two important articles published on April 24 provided the most serious warning about the side effects of hydroxychloroquine.

JAMA magazine published an important RCT test of chloroquine diphosphate in Brazil

The study enrolled 81 patients with COVID-19, 41 of whom received high-dose chloroquine (600 mg b.i.d.) and 40 received low-dose (450 mg b.i.d. on the first day, followed by 450 mg q.d.).

Main results

Mortality rate: 39% in the high-dose group! 15% in the low-dose group.

Side effects of prolonged QT interval: 
The proportion of QT interval greater than 500ms in the high-dose group was higher than that in the low-dose group (18.9% vs 11.1%). Among them, 2 patients (2.7%) in the high-dose group developed ventricular tachycardia before death.

Because of these results, the high-dose chloroquine treatment group was discontinued.

Nat Med published the analysis results of American cardiologists on the same day

They found that 84 patients who received hydroxychloroquine (400 mg on the first day, then 200 mg, b.i.d.) + azithromycin experienced prolonged QT intervals after receiving treatment (mean 3.6 days).

As shown in Figure 1, the QT interval of patients in this treatment group was extended from the baseline mean of 435ms to 463ms (P <0.001).

In 11% (9/84) of patients, the QT interval was severely extended to> 500 ms, which is a sign of high risk of malignant arrhythmia and sudden cardiac death, and 5 of these 9 patients had normal ECG before medication.

Based on this, the researchers suggest that patients with COVID-19 receiving hydroxychloroquine plus azithromycin, especially those with underlying disease and those receiving other QT prolonged medications, should repeat QT intervals.

Based on the latest clinical trial data, the US Food and Drug Administration (FDA) warned on April 24 local time: Do not use hydroxychloroquine to treat COVID-19 outside the hospital.

The FDA says they are "aware of reports of serious heart rhythm problems in patients with COVID-19 treated with hydroxychloroquine or chloroquine." The agency said they tried to “remind healthcare professionals and patients of the known risks associated with hydroxychloroquine and chloroquine.”

In a statement, FDA Commissioner Stephen Hahn encouraged healthcare professionals to "screen and monitor carefully" those patients taking the drug to treat COVID-19.

Hanson interpretation 
According to the Johns Hopkins database, 2.89 million cases of COVID-19 have been diagnosed worldwide, of which 200,000 have died.

New Corona virus itself leaves due to temperature and other reason

According to the current prevention measures in Europe and America, unless the New Corona virus itself leaves due to temperature and other reasons, it can hardly be completely prevented and controlled, and moving towards group immunization has become a helpless reality.

There used to be hope that neither hydroxychloroquine nor ridcive can currently be an effective choice. In the search for COVID-19, medical scientists are still struggling.

At the end of this month and next month, more clinical trial data will be released. Hope to surprise people.
Simulation for NatMed / JAMA Serious Side Effects of Hydroxychloroquine / Chloroquine, FDA Warning

Although we strive to express clearly and accurately, subject to the editor's level of knowledge and understanding, there may still be a fallacy, and everyone is very welcome and grateful for your corrections.

This public account tweet is for academic exchange only and does not constitute an opinion on clinical diagnosis and treatment.

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Hanson's clinical research is presided over by three medical scientists and two practicing physicians in the United States. 

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Author's Bio

Doctor Shawna Reason, Virologist
Dr. Shawna Reason
Name: Shawna Reason

Education: MBBS, MD

Occupation: Medical Doctor / Virologist 

Specialization: Medical Science, Micro Biology / Virology, Natural Treatment

Experience: 15 Years as a Medical Practitioner

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