gabrielsgoncalves/covid-19_prevention_trials

Repository for discussion of strategies related to prevention clinical trials against Covid-19

Covid-19 Prevention Clinical Trials Repository

Original article published by Gabriel S. Gonçalves with the title "Urgent call for Data on the prophylactic use of Hydroxychloroquine for Covid-19"

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Current clinical trials investigating drugs against the Covid-190

• Post-exposure Prophylaxis/Preemptive Therapy for SARS-Coronavirus-2 (COVID-19 PEP, NCT04308668
• Treatment of COVID-19 Cases and Chemoprophylaxis of Contacts as Prevention (NCT04304053)

Results for clinical trials for Covid-19

• Efficacy of hydroxychloroquine in patients with COVID-19: results of a randomized clinical trial
• Hydroxychloroquine and azithromycin as a treatment of COVID-19: results of an open-label non-randomized clinical trial

In vitro inhibition of SARS-Cov-2 Chloroquine and Hydroxychloroquine

• Chloroquine is a potent inhibitor of SARS coronavirus infection and spread
• Remdesivir and chloroquine effectively inhibit the recently emerged novel coronavirus (2019-nCoV) in vitro
• Hydroxychloroquine, a less toxic derivative of chloroquine, is effective in inhibiting SARS-CoV-2 infection in vitro
• Chloroquine analogues in drug discovery: new directions of uses, mechanisms of actions and toxic manifestations from malaria to multifarious diseases

SARS-Cov-2 evolution and outbreak

• A pneumonia outbreak associated with a new coronavirus of probable bat origin

Open Data projects

• Zika researchers release real-time data on viral infection study in monkeys

covid-19_prevention_trials's Issues

Is HCQ testing ethical given its side effects and (lack of) evidence?

As a drug for malaria prophylaxis, the recommended HCQ dosage is 400mg weekly, starting two weeks prior to exposure and ending for weeks after. When used in lupus or rheumatoid arthritis treatment, the recommended daily dose is between 200mg and 400mg. Daily usage above 5mg/kg body mass/day is discouraged due to increased risk of retinopathy, especially in older or obese patients (who are at higher risk of developing covid19 in the first place). Moreover, nearly 50% of patients report gastrointestinal side effects to HCQ.

Didier Raoult proposes 600mg daily, which is between 1.5 and 2 times the recommended daily dosage when applied to chronic disease treatment. Besides, given current spread of the disease, it's unlikely that the treatment could have clear start and end dates, as is the case when applied to malaria prophylaxis (which requires a dose 10 times smaller).

The only hard evidence presented so far is a trial with 42 patients, out of which 16 were the control group, and from the 26 remaining, 2 quit the study due to the side effects, 3 were moved to the ICU (presumably after having a decline in their condition) and 1 died. That's nearly 25% of the test group, yet the report concludes 100% effectiveness of the treatment, with p<0.001 somehow.

Considering how thin the actual published evidence is, is it not irresponsible to encourage testing of prophylactic use of HCQ? Especially at doses known to be dangerous?

Welcome! Please introduce yourself and tell us where are you from.

Hi everyone,

My name is Gabriel S. Gonçalves and I'm the creator of the repository and author of the original article published at Medium.

I'm currently a Data Scientist, originally coming from the field of Bioinformatics with a focus on viral genetics.