Hydroxycholoroquine Risks and Effectiveness in Covid 19

August 20, 2020

Outside my practice I have been remotely following two young patients, both of whom have tested positive repeatedly for Covid-19  longer than 30 days.  A 24 year old male initially symptomatic with loss of taste was treated with zinc, quercetin, vitamin D and vitamin C with resolution of symptoms within 2 weeks,  and a 15 year old female completely asymptomatic.

Covid Test Positivity

One reason for continued positivity can be the presence of viral fragments triggering the PCR test to be positive. If this is the case the person would not be infectious.

The male patient was scheduled for surgery which kept getting postponed because of his Covid positive testing.  I suggested he start Hydroxychloroquine (HCQ) and azithromycin to end the viral shedding within 6 days as some articles have shown this to be the case. The immediate question I received was, ‘What about dangerous side effects of HCQ?” 

My Review of the ‘Dangerous Side Effects of HCQ’ Literature is Below

Curiously, all the side effects listed below were outlined by the FDA in 2006 except for prolongation of the QT interval seen on EKG leading to cardiac arrhythmias which is the one side effect that has received the most focus during the pandemic. The only mention of cardiac side effects in the 2006 FDA paper was one line, “Cardiomyopathy has been rarely reported with high daily dosages of hydroxychloroquine.”

 In a retrospective study May-2020 of 2541 Covid positive monitored patients treated with HCQ at Henry Ford Health System in Detroit 2020,  no arrhythmias were noted, and patients treated early with HCQ had better outcomes.

In a retrospective study May 2020, of 90 Covid positive monitored patients at Beth Israel deaconess in Boston, 10 out of 37 patients treated with HCQ developed prolongation of QT interval, and 18 out of 53 patients on HCQ and Azithromycin developed prolongation of the QT interval.  One patient went into an abnormal rhythm that was reversed.  This was the study upon which the FDA revoked the use of HCQ in an emergency setting.

I invite you to read a well done article on ventricular arrhythmia risk based on ethnicity and decreased vitamin D levels in Covid patients.

Obviously, studies are differing widely in their reported outcomes.  One then has to wonder what the real difference is between how one institution treats a Covid patient versus another.  I’d rather be treated at Henry Ford than Beth Isreal. The side effect of QT prolongation was not a thought in most doctors minds when dispensing the drug to thousands of people over the last 60 years.

One recurrent theme is people symptomatic with Covid 19 should be treated early.  When people are treated early, everyone survives.

Reviewed Literature Concerning HCQ Side Effects. 

Side Effects Include:

    1. Prolongation of the heart beat called ‘QT prolongation’. Azithromycin also has this as a side effect.  This prolongation detected on EKG can lead to heart arrhythmias, and heart arrhythmias can be fatal. No incidence was reported!
    2. Retinal toxicity with long term use. 0.1 to 1%
    3. Cardiotoxicity 0.01-.1% 70 cases as stated by a review article in 2013 and predominantly in patients with systemic Lupus* given in doses twice the recommended dose. 0.01
    4. Sensorimotor disorders 0.01 to .1% Headache 1-20%
    5. Abnormal Liver functions 0.1-1%
    6. Gastrointestinal: abd pain, nausea 10%, diarrhea , vomiting 1%
    7. Dermatologic: Skin rash, itching, alopecia, 1-10%
    8. Bone marrow depression 0.01 to 0.1%
    9. Emotional liability

All side effects are reversed immediately with the exception of muscle involvement that may take months to recover.

To me, it is amazing and a miracle we have treatments for Covid;  HCQ being only one of them.  This is not true for many other viral infections.  We are all very blessed.  Let’s get on with our lives with our eyes open and without fear of Covid.

Have an awesome day.  Dr D

Contact Dr. Valerie Donaldson, MD – Regenerative Medicine Center

For Details and Appointments

1-412-767-9890

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