Treatment Strategies: Antimalarial Treatments
Twenty trials are currently studying the use of chloroquine and
hydroxychloroquine anti-malarial drugs (Table 2: Antimalarials).
Chloroquine has been found to have important inhibitory effects on the
input and in vitro replication of viral cells [10]. An early study
of clinical experience with chloroquine care in 100 COVID- 19 patients
reported both beneficial clinical and virological outcomes [62].
More recently, a non-randomized open-label study investigating the
impact of hydroxychloroquine (EU Clinical Trial Numbervii:
2020-000890-25; recruitment target specified as 25 registry
participants) published on a cohort of 36 patients [63]. Six days
after inclusion in the hydroxychloroquine community compared with
control it showed a substantial reduction in nasopharyngeal swab viral
positivity. However, 16 patients were assigned as controls in a
departure from their registry-described protocol, and six patients
received concomitant azithromycin treatment to avoid bacterial
superinfection. Patients receiving azithromycin were chosen based on
clinical judgment. After 6 days, the subgroup receiving azithromycin all
had negative viral swabs, compared to 57% (8/14) of hydroxychloroquine
alone and 12.5% (2/16) of control [63]. This research is
constrained by its lack of blinding and randomization, and low sample
size. There is a great deal of interest in chloroquine or
hydroxychloroquine for COVID-19 diagnosis, with another 34 studies
reported (Table 2: Antimalarials); however, only four reports using a
rigorous double-blind randomized controlled study to examine
effectiveness.