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Coronavirus Plaquenil

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Last Updated: 02 July 2021

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General | Latest Info

People WHO take Hydroxychloroquine are increasingly having trouble getting refill from their retail or mail order Pharmacy. Doctors are getting questions about this after news about the potential for drug to help shorten the course of COVID-19 was broadly reported on March 19. Erin Fox, associate adjunct professor of pharmacology at University of Utah and expert in drug shortages, says four of eight suppliers of Drug report normal supplies. Others report back orders. The drug, originally approved for malaria in 1955, has been approved for decades as a disease-modifying antirheumatic drug to treat rheumatoid arthritis and systemic lupus erythematosus and is used in treatment of juvenile idiopathic arthritis. Fox said that sudden high demand come from people and clinics that want to use Hydroxychloroquine for COVID-19 Prevention or treatment, although the drug is not approved for either indication, and there is limited evidence to support its use in COVID-19. Researchers are preparing to launch rigorous studies of its safety and effectiveness. Despite that, people and clinicians are putting their hope in Hydroxychloroquine. But that is leaving many people WHO have lupus, RA and JIA without medication they depend on and May have been taking for years. State boards of Pharmacy in Nevada, Ohio, Texas and Idaho have established new rules to control run on Drug, requiring diagnosis for indicated disease be written on prescription. If diagnosis is COVID-19, further restrictions apply, such as 14-day supply limit, no refills and other measures intended to stop hoarding and maintain adequate supply for patients WHO have been taking the drug for indicated uses. Jenny Wai, chief pharmacist, Ohio Board of Pharmacy, said of her States ' new Emergency rule, I hope we have stopped bleeding now. Several manufacturers have pledged to donate tens of millions of doses of Hydroxychloroquine, or Plaquenil, brand version, or chloroquine. Pharmaceutical manufacturer Novartis Sandoz has increased its donation pledge from 20 million doses to as many as 130 million doses, which includes both its current stock and supply expected from increase production through May. Access to donated supplies is controlled by the Department of Health and Human Services. Any requests from new customers go to HHS, say Linda Krystek, from Novartis customer operations Department. She said the company is referring to HHS many requests it is receiving from Health Organizations, hospitals and doctor offices. Michelle Petri, MD, rheumatologist at Johns Hopkins University School of Medicine, in Baltimore, said she would never want her patients to stop Disease-modifying Drug or reduce frequency or doses to conserve pills. Systemic lupus erythematosus patients cannot ration their drug, as that would lead to subtherapeutic Hydroxychloroquine blood levels and loss of efficacy, she say. It should not be forgotten that SLE is the fifth or sixth leading cause of death in African-American and Hispanic-American young women. Hydroxychloroquine is the only SLE treatment shown in multiple studies to improve survival in SLE.

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* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions

Related Information

Colorize scanning electron micrograph of cell heavily infected with SARS-CoV-2 virus particles, isolated from patient sample. Image capture at NIAID integrate Research Facility in Fort Detrick, Maryland NIAID National Institutes of Health Clinical trial evaluating the safety and effectiveness of Hydroxychloroquine for Treatment of adults with coronavirus Disease 2019 has formally concluded that the drug provides no clinical benefit to hospitalize patients. Though found not to cause harm, early findings in June when trial was stopped indicated that the drug was not improving outcomes in COVID-19 patients. Final data and analyses of the trial, which was funded by the National Heart, Lung, and Blood Institute, part of NIH, will appear online Nov. 9 in the Journal of American Medical Association. The Trial, called Outcomes relate to COVID-19 treat with Hydroxychloroquine among Inpatients with symptomatic disease, began after lab studies and preliminary reports suggest that Hydroxychloroquine commonly used to treat malaria and rheumatic conditions like arthritis, might have promise in treating SARS-CoV-2, virus that causes COVID-19. Prevention and Early Treatment of Acute Lung Injury Clinical Trials Network of NHLBI started trial in April at 34 hospitals across the United States and enrol 479 of an expected 510 patients. By June, preliminary evidence indicated Hydroxychloroquine was unlikely to offer any benefit. NIH officials say careful design, implementation, and oversight of study was key to its results, AS well AS recommendation by the data and safety monitoring board to stop trial early. Having rigorously designed Clinical trial that capture patient-Center, clinically meaningful outcomes was critical to reaching unequivocal conclusions about the use of Hydroxychloroquine in COVID-19. ORCHID shows that Hydroxychloroquine does not improve Clinical Outcomes in hospitalized COVID-19 Patients, say James P. Kiley, ph. D, director, Division of Lung Diseases at NHLBI. We hope this clear result will help practitioners make informed treatment decisions and researchers continue their efforts pursuing other possible safe and effective treatments for patients suffering with this disease. ORCHID trial enrol participants between April 2 and June 19 who were median age of 57. They include 290 Hispanic and Black participants and 212 female participants. All participants receive Clinical Care AS indicate of their condition. Participants were randomly assigned to the treatment group and received 10 doses of either Hydroxychloroquine or placebo over five days. Researchers then assess each Patient's Clinical Status 14 Days after being assigned to the Treatment group. They use a seven-category scale ranging from one to seven. Researchers also measured 12 additional outcomes, including death that occurred 28 days after participants assignment to the Treatment group. At day 14, those who received Hydroxychloroquine and those who received placebo had similar health status, with most participants in both groups discharged from hospital and able to perform a range of activities. The number of participants in both treatment groups who died at day 14 was also similar.

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Rheumatoid Arthritis (RA)

If you have rheumatoid Arthritis, youare more likely to get certain infections. That means you may have a higher chance of getting COVID-19. If you do get sick, your symptoms could be more serious than someone who doesnat have RA. Some medicines you take might also make infections more likely. On the flip side, researchers are looking into the benefits of some RA Drugs for COVID-19, infection caused by the New Coronavirus. But more research is needed to know if and how they could prevent or treat COVID-19. Experts arenat sure how this Coronavirus affects people with RA or those who take drugs that affect their immune systems. That means you shouldnat change your treatment without talking to your doctor. For now, best way to stay healthy is to keep taking your medicine. And try to avoid contact with viruses There are daily steps you can take to stay safe.


RA and Your Risk of COVID-19

RA raises your chances of getting any kind of infection. Youare also more likely to end up in hospital when you get sick. Your illness is likely to be more serious when your RA is active. You may hear that called flare. You may also have other health problems along with RA. Some that can make it harder to fight off infection like COVID-19 include: chronic obstructive pulmonary disease and other lung diseases, heart disease, Diabetes, Kidney failure. Thereas also some evidence that respiratory infections spread by viruses, like COVID-19, may raise the risk of getting RA. One study shows that women and older people who had other kinds of coronaviruses were more likely to get RA after theyad been sick. But more research is needed to know whether COVID-19 can actually trigger RA.


What if You Canat Get Hydroxychloroquine?

Hydroxychloroquine is an oral drug. It was originally used to prevent and treat malaria. Today, it was approved by the Food and Drug Administration to treat RA. In March 2020, FDA issued emergency use authorization allowing hydroxychloroquine to be used in some people with COVID-19 only if medical professionals could monitor them, or if they were enrol in clinical trial with appropriate screening and monitoring. Lab studies have reported that hydroxychloroquine could prevent growth of a new coronavirus. There were also a few reports of people with COVID-19 taking the drug and getting better. Hydroxychloroquine was thought to help because it has an antiviral effect that disrupts enzymes virus needs to infect healthy cells. FDA continued to explore research as it becomes available. US President Donald Trump publicized hydroxychloroquine for COVID-19 just before EUA was issue. EUA also permits states to stockpile drugs for this use. All of these factors result in hydroxychloroquine shortage. However, these studies were retracted in early June. And on June 15 2020, FDA revoked EUA for hydroxychloroquine. It concludes that medication isnt effective for COVID-19. In fact, hydroxychloroquine was associated with serious heart problems in people with COVID-19. The FDA rules that potential risks outweigh benefits. Moreover, Trumps ' support for hydroxychloroquine references small, poorly designed 2020 study. For several months, people with RA and other autoimmune conditions had difficult time getting their prescribed medication. But the shortage is now resolve, according to the FDA.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions

Sjogren's Syndrome

Though the exact etiology of autoimmune diseases still remains unknown, there are various factors which are believed to contribute to the emergence of autoimmune disease in the host, including genetic predisposition, environmental triggers such as bacterial infections, including gut microbiota, viral fungal and parasitic infections, as well as physical and environmental agents, hormonal factors and hosts immune system dysregulation. All these factors interplay was coin by Shoenfeld et al., Many years ago Mosaic of Autoimmunity,]. Most prominent pathogenic viruses which have been proposed in triggering and initiation of autoimmune diseases include: Parvovirus B19, Epstein-Barr-virus, cytomegalovirus, herpes virus-6, HTLV-1, Hepatitis and C virus, and Rubella virus,]. These viruses have been implicated in the initiation of chronic inflammatory or autoimmune diseases such as rheumatoid arthritis, Systemic lupus erythematosus, Sjogren's syndrome, primary billiary cholangitis, multiple sclerosis, polymoysitis, uveitis, Henoch Schonlein Puprpura, Systemic Juvenile Idiopathic arthritis, Systemic sclerosis, Hashimoto thyroiditis and autoimmune Hepatitis. Suggest mechanisms of induction of Autoimmunity include both molecular mimicry as well as bystander activation whereby infection may lead to activation of antigen presenting cells that may in turn activate pre-primed auto-reactive T-cells, thus leading to production of pro-inflammatory mediators, which in turn may lead to tissue damage. Alternative suggested mechanisms include epitope spreading as well as presentation of cryptic antigens. Corona viruses represent a major group of viruses mostly affecting human beings through zoonotic transmission. In the past two decades, this is the third instance of the emergence of novel coronavirus, after severe acute respiratory syndrome in 2003 and Middle East respiratory syndrome coronavirus in 2012. In December 2019, a novel outbreak of a new strain of coronavirus infection emerged in Wuhan, China. SARS-CoV-2 or Covid-19. The disease, which was declared as pandemic in early March 2020, is characterized by fever, dry cough, myalgia and or extreme fatigue, may be asymptomatic or with minimal flu-like constitutional symptoms, leading to favorable outcome in many instances. However, some patients encounter severe pneumonia with sepsis leading to acute respiratory distress syndrome with respiratory failure requiring mechanical ventilation, and at times accompanied by hyperferritinemia and multiple organ involvement including hematological, gastrointestinal, neurological and cardiovascular complications leading to death,]. ARDS described in up to 20 % of Covid-19 cases, is reminiscent of cytokine release syndrome-induced ARDS and secondary hemophagocytic lymphohistiocytosis observed in patients with SARS-CoV and MERS-CoV as well as in leukemia patients receiving engineered T cell therapy. These cases with Covid-19 are those who develop through excessive cytokine release and uncontrolled immune activation, multiorgan failure with grave prognosis.


What is COVID-19?

Since the breakout of COVID-19 in late 2019 in China, many unresolved issues regarding both dealing with the fate of preexisting autoimmune Rheumatic diseases in patients who are affected by the virus, including those under immunosuppressive and biologic therapy, as well as the impact of these therapies on the severity of viral disease itself. Early reports on the course of pandemia suggest that, based on data recovered from other and previous viral infections, there would be an increased probability for patients with Rheumatic diseases to acquire COVID-19 Disease or are they prone to increased severity of infection if they do acquire it. On contrary, however, early on, there was some evidence regarding the potential benefit of some of drugs which have been used in therapy for Rheumatic Disease. Patients with SLE had posed serious concern during COVID-19 pandemia. This group of patients is well known to bear increased risk of severe infections, due to both their immune system and related organ damage as well as due to therapies use including immunosuppressive drugs. In report of 19 SLE patients from France who were clinically quiescent on long-term treatment with Hydroxychloroquine and were infected by COVID-19 virus, authors were able to conclude that the clinical course of these lupus patients did not show any signs of disease exacerbation, except for a single case of tenosynovitis. Preliminary analysis of patients included in the COVID-19 Global Rheumatology Alliance registry, shows that 17 % of 110 patients with Rheumatic diseases who have been diagnosed with COVID-19 as of April 1 2020-were patients with lupus. Thus, the frequency of patients with lupus who have been diagnosed with COVID-19 was over-represent, at about twice as compared to rheumatoid arthritis, which is a much commoner Rheumatic Disease among the adult population. In a recent small report from northern Italy of SLE patients with either swab confirmed COVID-19 infection or clinical diagnosis, based on 3 out of 4 symptoms of viral infection, authors state that the disease course was generally mild and self-resolving although one of four patients who was on haemodialysis due to end-stage renal Disease, need intensive care for development of Acute respiratory distress Syndrome. Base on clinical information published to date from new and previous outbreaks caused by coronaviruses, there is no overwhelming evidence that patients with Rheumatic Disease are at increased risk compared with other comorbidities,]. In a rather larger prospective report from New York, authors review a group of 86 patients with immune-mediate inflammatory disease including 59 cases of inflammatory arthritides with confirmed COVID-19, and 27 additional patients with suspected COVID-19. Two-thirds of patients were on biologics or other immunomodulatory drugs. Hospitalize patients, as compared to those who were only followed on out-patient basis, had more classical COVID-19 comorbidities.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions

Sources

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions

A striking observation

Complex decisions facing clinical teams caring for patients WHO are critically ill with coronavirus Disease 2019 are compounded by the absence of proven treatment strategies. Lacking robust trial evidence, clinicians are forced to consider all options based on preclinical and small observational studies, often in heart-wrenching settings of patients WHO are deteriorating in throes of severe pneumonia, acute respiratory distress syndrome, cytokine storm, and in many cases, cardiovascular complications. Among possible therapies, Hydroxychloroquine has been advocated and even politicized as a promising therapy because of its anti-inflammatory and potential antiviral properties. The drug, known for its immunosuppressive and antimalarial effects, has risen to the top of many treatment algorithms alone or in combination with azithromycin. Hydroxychloroquine was first approved in 1955 by the US Food and Drug Administration and has been viewed as generally safe and well-tolerate in patients treated for chronic inflammatory conditions. However, Hydroxychloroquine prolongs QT interval because of blockade of inward cellular potassium current and has a known risk of proarrhythmia, 1-3 especially in the setting of other drugs that also prolong QT interval. Drug-induced QT prolongation has long been considered surrogate for risk of Drug-associate torsades de pointes. 4 Although widely used, azithromycin has also been increasingly recognized for risks of QT interval prolongation and sudden death. 5 Opinions vary regarding the optimal dose of Hydroxychloroquine and stopping points based on corrected QT prolongation. In patients with COVID-19, there may be greater risk tolerance among clinicians for QTc prolongation and toxicity in patients WHO are very sick, but at the same time, there may be increased risk of ventricular arrhythmias because of electrolyte abnormalities, hypoxia, concomitant QT-prolonging medications, and underlying cardiovascular Disease. 6 7 risk-benefit trade off of Hydroxychloroquine may also depend on whether other drugs with unclear benefits are available as alternative therapies. Give paucity of evidence of benefit and risk for treating COVID-19 with Hydroxychloroquine alone or With azithromycin, findings of Bessiere and coworkers 8 and Mercuro and coworkers 9 are welcome and important. These reports from Lyon, France, and Boston, Massachusetts, provide concordant insights regarding the potential for QTc prolongation with this treatment in patients hospitalized with COVID-19. Excessive prolongation of QTc was observed in 14 of 40 patients in the intensive care unit, as reported by Bessiere et al, 8 With cutoffs defined either as increase in QTc of 60 milliseconds or more or prolongation of QTc of 500 milliseconds or more. What is most striking, however, is pair data demonstrating that 37 of 40 patients manifested increase in QTc with Hydroxychloroquine alone or in combination with azithromycin. 8 similarly, in cohort report by Mercuro et al, 9 18 of 90 patients treated with Hydroxychloroquine alone or in combination with azithromycin developed QTc prolongation of 500 milliseconds or more. The magnitude of increase in QTc compared with baseline values was more pronounced in those treated with both agents. One-third of hospitalized patients in this series were treated in the intensive care unit.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions

Deepening skepticism

If one take Donald Trump and his Administration TO embody modern conservatism, it IS easy TO see in their response TO Coronavirus pandemic rights final divorce from Science and expertise. There was the case of Rick Bright, Health and Human Services scientist WHO claimed that the Trump Administration retaliated against him WHEN he objected TO administration's rapid push TO distribute anti-Malaria DRUGS that were largely untested for treating Coronavirus patients. There are reports that the President for months ignored his own intelligence Experts warnings that VIRUS threaten our shores. There was ongoing drama over whether Trump would fire Anthony Fauci, WHO has headed the National Institute of Allergy and Infectious Diseases since 1984. And there was President Daily's passion playthe White House press briefings where he stood next to scientists WHO grimace as he speculated that the DEATH toll was exaggerated and that sunlight inside body MIGHT kill VIRUS. White Houses sorry COVID-19 track record has sparked a chorus of dissent recently distil by New York Times columnist Michelle Goldberg, WHO argue that the crisis displays conservatives ' long-standing antipathy to Science, owing to populist distrust of experts, religious rejection of information that undermines biblical literalism and efforts by giant corporations TO evade regulation. But this narrative IS TOO pat. While something IS plainly amiss in the relationship of Trumpian RIGHT to Science, it IS hardly as principled as the religious objections of, say, creationists opposing evolutionary theory. Neither IS it straightforwardly hostile. Whats more curious about the response by the President and his allies TO VIRUS IS rather their embrace of scientific expertise of sort. TO counter models that claim more than two million Americans MIGHT die, skeptics advance contrary models claiming tolls are vastly lower. And in opposition TO prevailing estimates of infection fatality rate of 1 TO 2 percent, Stanford epidemiologist John Ioannidis Advanced series of studies claiming that the real rate MIGHT be lower than roughly 0. 1 percent that accompany seasonal flu. Fox News hosts glom on TO viral media Post by Silicon Valley entrepreneur arguing along the same lines. Most infamously, Didier Raoult, roguish French researcher, became an overnight cause celebre WHEN he claimed TO offer evidence that Hydroxychloroquine and azithromycin, two widely available DRUGS, MIGHT be highly EFFECTIVE in treating Coronavirus infectionleading, President TO proclaim TREATMENT possible miracle cure. The narrative that pandemic reveals the damning failure of Republicans to listen TO Experts IS also complicated by another element of the crisis: Experts got many things about the pandemic badly wrong.

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What next?

May 7 Update: Blue Cross NC has modified its COVID-19 coverage policies for hydroxychloroquine and chloroquine. Please see this story for details. Hydroxychloroquine and chloroquine are two medications being evaluated for possible effectiveness against the novel coronavirus COVID-19. The safety and efficacy of these medications have not been approved by the Food and Drug Administration or the World Health Organization for use in COVID-19 treatment. Early patterns of prescribing across the nation are showing prescriptions being written for people without active COVID-19 in what look to be preventive or just in case situations. These behaviors may lead to potential shortages for patients who have confirmed diagnosis of COVID-19 and members who need this medication for ongoing treatment of chronic conditions. The National database of Drug shortages is reporting shortage issues with both medications. To ensure adequate access for Blue Cross and Blue Shield of North Carolina members, prior authorization will be in place for hydroxychloroquine and chloroquine, effective March 22, 2020, for coverage through retail pharmacies. By adding prior authorization to these two medications, Blue Cross NC will increase access to those who really need it, when they need it, and mitigate potential drug shortage. Blue Cross NC will cover medication when provider attests to ANY of the following: member is currently utilizing medications for chronic condition. The patient has one or more of the following conditions: COVID-19, discoid erythematosus, lupus erythematosus, rheumatoid arthritis, sarcoidosis, uncomplicated malaria and / or extraintestinal amebiasis. Patients start medication during recent hospitalization and require continuation. For members diagnosed with COVID-19, Blue Cross NC will cover these two medications when prescribe at doses being studied in ongoing clinical trials. It is important to note that members who are diagnosed with COVID-19 would be covered regardless of trial as pharmacy drugs are blind to patient diagnosis unless prior authorization or prior Plan approval is in place. Our intention with the decision to add prior authorization is simply to limit stockpiling and as-need prescribing, rather than getting in the way of clinical management or fiscal issues. Members who are currently using these medications will not need prior authorization if they have paid claim with Blue Cross NC for medication in the past 120 days. New members seeking coverage of these medications will need prior review by Blue Cross NC for coverage. All reviews will be completed in less than 24 hours after Blue Cross NC has received information from the provider. Additional payment restrictions are not being placed on medication if given during hospitalization or when administered directly from provider. This policy does not affect our Medicare members or groups that do not utilize Blue Cross NC pharmacy benefit, such as State Health Plan, Federal Employees Program, or self-fund groups that do not use Blue Cross NC pharmacy benefits. Please visit http: / www. Bluecrossnc. Com / coronavirus-providers for additional information. If you have questions regarding these COVID-19 measures, you can submit inquiries here.

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* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions

Malaria

As of March 2020, there have been reports of the suspension of insecticide-treated nets and indoor residual spraying campaigns in several African countries due to concerns around exposure to COVID-19. Suspending such campaigns will leave many vulnerable populations at greater risk of Malaria, particularly young children and pregnant women. WHO strongly encourages countries not to suspend planning for-or implementation of-vector control activities, including ITN and IRS campaigns, while ensuring these services are delivered using best practices to protect health workers and communities from COVID-19 infection. Modifications of planned distribution strategies may be needed to minimize exposure to coronavirus. WHO commends leaders of Benin, Chad, Central African Republic, Democratic Republic of Congo, Mali, Niger, Sierra Leone and Uganda for committing to moving forward with ITN campaigns during the pandemic. Other countries are adapting their net distribution strategies to ensure households receive nets as quickly and safely as possible. Together with partners, WHO has developed guidance to ensure that those suffering from Malaria can safely receive care they need in COVID-19 settings. Tailoring Malaria interventions in COVID-19 response includes guidance on prevention of infection through vector control and chemoprevention, testing, treatment of cases, clinical services, supply chain and laboratory activities. The document is consistent with broader WHO guidance on how to maintain essential health services during pandemic. Yes, delivery of intermittent preventive treatment in pregnancy, seasonal Malaria chemoprevention, and intermittent preventive treatment in infants should be maintained provided that best practices for protecting health workers-and other front-line workers-from COVID-19 are follow. Ensuring access to these and other core Malaria prevention tools saves lives and is an important strategy for reducing strain on health systems in the context of COVID-19 response. Tailoring Malaria interventions in COVID-19 response, developed by WHO and partners, includes guidance on how to deliver preventive therapies for pregnant women and young children in ways that protect health workers and communities against potential COVID-19 transmission. WHO guidance remains the same. Countries should not scale back efforts to detect and treat Malaria; doing so would seriously undermine the health and well-being of millions of people infected with potentially life-threatening disease. As signs and symptoms of Malaria and COVID-19 can overlap, public health messages will need to be adapted in Malaria-endemic settings so that people WHO have fever are encouraged to seek immediate treatment rather than stay at home; without prompt treatment, mild case of Malaria can rapidly progress to severe illness and death. In addition to routine approaches to Malaria control, there may be a case for special measures in the context of the COVID-19 pandemic-such as temporary return to presumptive Malaria treatment, or use of mass drug administration-which have proven useful in some previous emergencies. Presumptive Malaria treatment refers to treatment of suspected Malaria case without benefit of diagnostic confirmation. This approach is typically reserved for extreme circumstances, such as disease in settings where prompt diagnosis is no longer possible.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions.

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Adverse Effects

The use of CQ and HCQ in COVID-19 has been the focus of tremendous public attention. To scrutinize this, systematic review was performed to identify studies where CQ and HCQ had been used to treat COVID-19. The PRISMA checklist was used to conduct systematic review. MEDLINE and EMBASE were search from inception to 18 April 2020, using keywords chloroquine and COVID-19, and Hydroxychloroquine and COVID-19, to find articles providing information on the efficacy and safety of these formulations in patients with SARS-CoV-2 infection. Search also includes articles relating to in vitro studies. There was no language barrier employed and searches were expanded using the snowballing method to retrieve relevant papers. Several Clinical Trial registries were also searching to identify publish results from ongoing trials. Articles available in the press and media were scrutinized to search publish source articles. Articles were also searched in preprint repositories, namely medRxiv, ResearchGate, figshare, etc. The Systematic review protocol was not registered due to the urgency of the matter. Two contributors mention in acknowledgements independently screen databases and Trial registries, and extract relevant information. Discrepancies and doubts about relevance of sources were solved by consensus with inputs from all three US. Initial search identified 293 articles. Several trials are being undertake, which include, amongst others: WHO mega Trial, B Columbia University Trial, c University of Minnesota, New York, Trial, and d 23 registered ongoing trials in China. However, none of these trials results are currently available. Following screening of titles and abstracts and removing duplicates, 17 articles about HQ and / or HCQ in coronavirus infection were evaluated table 3. This include four in vitro studies and 13 clinical trials. Two of these trials evaluate prophylactic use of HCQ in COVID-19,. There are several in vitro studies performed on Vero E6 cells that have evaluated antiviral efficacy of CQ and HCQ against coronaviruses. All of these studies have shown strong antiviral activity of CQ and HCQ against coronaviruses. Authors believe that antiviral activity was due to well-know lysosomotropic property of the drug, causing high endosomal pH and interfering with virus cell fusion. Besides, CQ / HCQ Drug was found to interfere with virus entry due to interference with terminal glycosylation of ACE2. Vincent et al. Study in vitro antiviral properties of CQ on SARS-coronavirus, namely SARS-CoV on primitive Vero E6 model: CQ shows strong inhibitory effect on virus. Recently, Wang et al show low micromolecular concentrations of CQ to be highly effective with high selectivity index in blocking SARS-CoV-2 infection in vitro, both at entry and post-entry stages of infection. Seven drugs were tested in experiments, which include ribavirin, penciclovir, favipiravir, nafamostat, nitazoxanide, remdesivir, and CLQ. Two of seven drugs-namely remdesivir and CQ-potently block virus infection at low molecular concentration and show high selectivity index. The fact that drugs demonstrate anti-viral effects at low concentrations could show favorable Clinical Response in human infection.


What is hydroxychloroquine?

The Debate over the use of anti-malaria drug hydroxychloroquine as a possible prevention method or treatment for COVID-19 reignited Monday after President Donald Trump said he's been taking the drug for about week and a half. Scientists, journalists and politicians were quick to criticize the President, pointing out the drug's ineffectiveness against coronavirus in few recent studies and a long list of potentially dangerous side effects. Multiple government agencies have warned against improper use of hydroxychloroquine outside hospital or clinical trial setting, yet the President has been touting the drug since early April, often relying on anecdotal evidence for his arguments. You'd be surprised about how many people are taking it, especially front line workers, before you catch it, Trump say. So what have we learnt about hydroxychloroquine since it was first mentioned during the pandemic weeks ago?

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions

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