1. Chloroquine is an old drug used to treat and prevent malaria. The success story of Chloroquine against COVID-19 is encouraging! Chloroquine has been known to cause a redox imbalance in viral endosome thereby inhibiting acid mediated replication of SARS-Covid-2. Chloroquine also inhibits the fusion of viral S Spike protein with ACE2 enzyme in type 2 pneumocytes in the lung. Thomas Dorner, a colleague at Charite-Berlin University, has it that Chloroquine prevents an over-activation of the immune system and therefore permits a more efficient viral clearance. Other scientists point to work done with the original SARS virus that suggests Chloroquine alters glycosylation, a process of decorating proteins with unique patterns of sugar. From the above mechanisms of actions, it is diaphanous that Chloroquine has got some antiviral properties.
2. Pockets of researches all over the world using monkeys infected with SARS-Covid-2 and treated with Chloroquine have shown some success in viral clearance. Moreso, the little clinical trials with human subjects in US, Italy, China, Nigeria etc have yielded 'mixed' success story. A small clinical trial in France suggested that hydroxychloroquine helped patients recover from the virus faster, while another small study in Beijing reported that the drug offered no noticeable benefit. A team of researchers led by Didier Raoult at France’s IHU Méditerranée Infection published a small study (using 20 COVID-19 patient) on March 20 suggesting that hydroxychloroquine and the antibiotic azithromycin could pack a powerful punch against the virus. It was this study that Donald Trump cited on March 21 to make his admonishment. The above study has several caveats. For a start, the trial samples were small and open label, meaning the doctors knew who was getting the drugs. The samples for the trial was taken by swabbing only an opening behind the nasal cavity and above the throat, meaning the virus could still be in the pneumocytes(lung cells), blood, or elsewhere in the body. Furthermore, six patients who received hydroxychloroquine did not stay in the study and so forth.
3. US has recorded more than 23,600 Covid-19 related deaths and counting. Italy has got more than 21,000 deaths and counting. Other countries too are sadly receiving their own 'fair share' of mortality. The case-to-deaths ratio is 6% as of early April though with regional variation. The WHO, which is the world arbiter in accurate health/medical information is yet to approve the global use of Chloroquine for the treatment of positive humans with the virus despite US admonishment. Till date, China that claimed to have treated COVID-19 with Chloroquine is yet to publish or make open to the scientific community her research methodology and results analytical method. The use of Chloroquine at several Swedish hospitals has been halted following untoward side effects. Magnus Gisslen, a professor and chief physician at Sahlgrenska University Hospital Infection Clinic, has it that they do not have strong evidence that Chloroquine has an effect on COVID-19.
4. At this juncture, it has become of imponderable importance to ask: is Chloroquine no longer effective? What then is the drug of choice for Covid-19? What then is the truth and the drawback to Chloroquine use for COVID-19? Well, as of now, COVID-19 has no definite drug cure! The scientific truth is that Chloroquine/hydroxychloroquine is an immune modulator that has got some anti-SARS-Covid-2 clearance properties mostly in nonhuman living systems.
5. Chloroquine has not been proven globally to be effective against a reasonably large number of human beings with COVID-19. The few human trials are not adequate and reproducible. Many workers consider the side effects of Chloroquine as its major drawback in human testing. Again, most researchers has it that Chloroquine is needed in a higher dose for it to 'gun' down COVID-19 effectively in human!!! The adverse effects that accompany this hard-dosed drug can make living worthless. Simply put, the few successful trial on humans subjects are not reproducibly adequate for global consumption. Therefore, more exigent and large-based works are needed.
6. Well, active human researches are ongoing all over the world with respect to finding a drug candidate molecule with global therapeutic efficacy and whose side effects will be compatible with life. Studies of Chloroquine and hydroxychloroquine for treating COVID-19 are planned or underway in England, France, Norway, Spain, Thailand, and the US. WHO has also added Chloroquine, Remdesivir among the six drugs in its Solidarity Trials Study that started in March 2020. Research results will start coming in very soon.
7. Until then, the treatment of choice for COVID-19 in the words of Dr Stanley Boniface is common sense! Common sense is the treatment of choice for every ailment with/without a definite chemical panacea. It is a superset to symptomatic management. Whatever symptoms a COVID-19 patient presents with or whatever signs that are being elicited... we treat! The very few with respiratory distress are supported with oxygen/ventilator; those with features of bacteria superimposition, antibiotic comes in. Fluids, immune booster, intravenous amino acids etc are all case-specific treatment/supportive measures.
8. Immune booster and modulators at normal dose are also helpful for prevention. Good hygiene, healthy dieting, good mental state, exercise are good preventive adjuncts to physical distancing, hand washing/sanitization. Indiscriminate use of face masks and 'surgical 'gloves have done more harm than good. Stay safe. Try and stay at home. My free bit of advice to colleagues and other health workers that are actively in contact with COVID-19 patients is to insist on PPE before work...not even for all the tea in China. A common adage among the Fulanis in Northern Nigeria has it that 'Likita nda ya mutu shi ya so'...?
9. Any person that has some COVID-19 related symptoms should please call the Emergency team first. Do not rush to the hospital first! There is no love in sharing neither is it more blessed to give than to receive COVID-19. You are laughing. The Emergency team will move the client appropriately after a positive result.
10. In conclusion, I must add, COVID-19 is not the worst pandemic that has ever befallen the son of man. It has come. Men and brethren, it will surely go in less than no time. Provided He tarries, I am sure as egg is egg that we shall meet on the other side when COVID is over!
Dr Stanley Boniface is a researcher, author, neuroscientist and surgeon
Opinion AddThis : Original Author : Boniface Stanley Disable advertisements :
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