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Infectious Diseases

Updated 12 August 2020

Covid-19: What's happening with hydroxychloroquine?

Read about the latest research and insights into one of the most controversial drugs in the fight against Covid-19.

  • Scientific studies overwhelmingly agree that hydroxychloroquine is ineffective against Covid-19.
  • The World Health Organisation has halted its trials on this antimalarial medication.
  • American experts have since moved on from the debate.

Who would have thought that a drug primarily used to treat malaria would cause such controversy amid the Covid-19 pandemic?

Hydroxychloroquine's rise to fame began when Chinese researchers found the drug to have some anti-inflammatory and anti-viral effects against the coronavirus in a lab setting.

Then it made global headlines thanks to US President Donald Trump, who touted it as a cure for Covid-19, despite researchers not having concluded their research on the drug. Many countries started stockpiling hydroxychloroquine, causing shortages, and negatively impacting on people who really needed it.

Then a study came out stating that the medication might actually be dangerous for coronavirus patients, and scientists around the world almost universally halted their research.

One would have thought that would be the end of it, but not so. After publication, the drug was retracted due to serious methodological and data issues, reigniting once more the debate over whether this medication could help treat Covid-19.

But what's the latest on the drug?

READ | Covid-19: What's next for hydroxychloroquine?

Studies haven't changed their conclusions

Despite the retraction of one major study, multiple other studies have found no benefit in taking hydroxychloroquine to combat Covid-19.

The Oxford RECOVERY study found no clinical benefit in hospitalised patients, and has since halted the trial.

Another study in the Annals of Internal Medicine also found no reduction of symptoms in outpatients with mild Covid-19 symptoms, and the most recent study from Brazil found it did not improve hospitalised patients' clinical status compared to normal treatment without hydroxychloroquine.

The World Health Organisation (WHO) also released a statement on 29 July, officially declaring that hydroxychloroquine has no proven benefits in treating the coronavirus, after halting trials earlier during July.

READ MORE | 'Gold standard' clinical trial finds hydroxychloroquine won't prevent Covid-19

"This decision applies only to the conduct of the Solidarity trial in hospitalised patients and does not affect the possible evaluation in other studies of hydroxychloroquine or lopinavir/ritonavir in non-hospitalised patients or as pre- or post-exposure prophylaxis for Covid-19," the WHO said in a statement.

In another laboratory study, hydroxychloroquine was found to block the virus in monkey cells, but the same effect couldn't be replicated in human cells.

You can also watch Dr Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases in the US, take down the merits of a Henry Ford Health System study which found that hydroxychloroquine, in combination with azithromycin, reduced Covid-19 deaths.

READ | Top journal pulls paper on hydroxychloroquine which put trials of the drug on hold

Researchers recently reacted to criticisms of their study, defending the merits of their observational study in terms of time constraints, while still supporting randomised, double-blind trials.

"Unfortunately, the political climate that has persisted has made any objective discussion about this drug impossible, and we are deeply saddened by this turn of events," write the researchers in their letter.

"Our goal as scientists has solely been to report validated findings and allow the science to speak for itself, regardless of political considerations."

American experts moving on

Despite Trump's insistence on the efficacy of the drug – as evidenced by his recent sharing of a now-deleted video of doctors expounding the benefits of hydroxychloroquine – medical experts and US health organisations are now trying to move past the debate.

Based on clinical studies, the American Food and Drug Administration revoked the drug's emergency use authorisation outside clinical trials in June, and last month released a report that hydroxychloroquine and chloroquine might cause serious heart rhythm problems; blood and lymph system disorders; kidney injuries; and liver problems and failure.

Even Brett Giroir, the US assistant secretary of health and human services, told NBC News the department does not recommend the drug for treating Covid-19, and they want to move past this debate and focus on the drugs that are showing promise.

There's also the unfortunate case of the US donating two million doses of the drug to Brazil, who is still promoting hydroxychloroquine for Covid-19 treatment. It has, however, remained untouched since arriving there in May, according to CNN.

The reason behind the drug's popularity in the country are the claims by the Brazilian president that it helped him fight the virus after contracting it in July.

READ MORE | Hydroxychloroquine worsens odds for cancer patients with Covid-19

Chloroquine trials in SA

While the WHO's Solidarity Trial arm in South Africa discontinued studies on hydroxychloroquine, the Crown Coronation global study on chloroquine is still ongoing.

In this trial, they are testing whether low doses of the drug in participating healthcare workers show any preventative effects. The trial is being conducted at academic hospitals in Bloemfontein, Johannesburg, Pretoria and Cape Town.

It is estimated that the study will be completed by February 2021.

Until then, overwhelming evidence and recommendations from the experts advise against the use of hydroxychloroquine for treating Covid-19, and no amount of tweeting from presidents and conspiracy theorists will change the facts. It would be better to focus instead on the medications that are showing promise.

READ | Prescriptions for discredited Covid drugs surged 2 000% after Trump's support

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