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Hydroxychloroquine ...the wonder drug! to consume or Not?

Dear doctors,
This antimalarial drug has been used for not only malaria but even in autoimmune disorders like Rhumatoid arthritis&LUPUS.its advisable to take HC as prophylactic.
400mg weekly for 4 to 7 weeks for all front line covid warriors.

Let us analyse the dynamics&kinetics of HCL!
·       Inhibition of the Glycosylation of the ACE2 receptor, thus making Unglycosylated ACE2 interacts less with SARS-CoV-2.

·       Chloroquine has a lysosomotropic effect.This lysosomotropic effects also inhibit cytokine production and modulation of certain co-modulating molecules, hence used as a treatment for Rheumatoid arthritis and lupus erythematosus.

·       Chloroquine interferes with lysosomal activity, apoptosis, and autophagy, interacting with the membrane stability and altering signaling pathways and transcriptional activity, causing an acidic environment in parasites, which interferes with its essential processes.

·       Chloroquine has antiviral effects whereby they increase the pH of the lysosomes and the late endosome, cause the impaired release of viruses from the lysosome or the endosome. This makes the virus unable to release its genetic material into the cell and replicate.

·       Chloroquine also acts as a zinc ionophore that allows extracellular zinc to enter the cell and inhibit viral RNA-dependent RNA polymerase.
·       Inhibition of thiamine uptake by acting on the transporter thiamine transporter.

Basing on this molecules anti viral property and inhbition of glycosylation of ACE enzyme, A recent case-controlled study by Indian Council of Medical Research (ICMR) has underlined the benefit of hydroxychloroquine (HCQ) as prophylaxis, showing that the sustained use of the anti-malaria drug along with the use of personal protective equipment (PPE) was associated with a significant decline in risk of Covid-19 infection rate by upto 80% among the health care workers.

Some of the studies.

Approximately, 23 trials are underway regarding the role of Hydroxychloroquine or Chloroquine against COVID-19. Among the 23 trials, 22 are on the efficacy of Hydroxychloroquine or Chloroquine in COVID-19-associated pneumonia, and one trial is on the use of Hydroxychloroquine in post-exposure prophylaxis. No trial has been done on the role of Hydroxychloroquine in pre-exposure prophylaxis. However, there is no strong scientific evidence for the application of Hydroxychloroquine in COVID-19 cases until now. Hydroxychloroquine can be advised to individuals aged above 60 years with comorbidities (e.g. diabetes, hypertension, etc.) if they are exposed to confirmed or suspected cases of COVID-19. Individuals below 60 years of age without any comorbidity do not require Hydroxychloroquine. The Indian Council of Medical Research (ICMR) has recommended that asymptomatic healthcare workers, who are exposed to the suspected or confirmed cases of COVID-19, should be treated prophylactically with Hydroxychloroquine (400 mg) twice daily on day 1 followed by a weekly dose of 400 mg for next seven weeks. For asymptomatic individuals, who are not healthcare workers but are in contact with confirmed cases of COVID-19 should receive Hydroxychloroquine (400 mg) twice daily on day 1, followed by 400 mg once weekly for the next 3 weeks.[1] The therapeutic dose of Hydroxychloroquine is 400 mg twice daily, followed by 200 mg twice daily for 4 days for COVID-19-related pneumonia. Hydroxychloroquine should be taken with meals. Hydroxychloroquine or Chloroquine has adverse effects like QTc prolongation1 and liver diseases, and thus, it is important to perform an ECG and administer Hydroxychloroquine or Chloroquine as per the guidelines provided.


According to the ICMR study published in the Indian Journal of Medical Research (IJMR), consumption of four or more maintenance doses was associated with a significant decline (>80%) in the risk of Covid-19 infection among the ‘participants’. The study also found that there was no significant association between HCQ and adverse drug reactions.

CONTROVERSY or Conspiracy? a large observational study published in the medical journal The Lancet which showed that HCQ or HCQ with azithromycin had no significant therapeutic benefit, increased mortality and irregular heart rhythm in Covid-19 patients. 

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