could chloroquine really work?

“Ultimately, it is probably the easiest and cheapest respiratory infection to treat of all viral infections“. While the first Frenchman died of the coronavirus epidemic, Didier Raoult, director of the Mediterranean Institute of Infection, in Marseille, published a video on Tuesday February 25 where he praised the merits of chloroquine, a drug traditionally used for malaria, to treat this new virus. Watched more than 210,000 times in 24 hours, this video immediately raised hope around the world. However, it is still a little early to rejoice.

Chloroquine is a substance in the amino-4-quinoline family. It is used to treat people suffering from rheumatoid arthritis, lupus erythematosus, systemic lupus and lucitis, but especially malaria. It kills the schizonts, the single-celled organisms responsible for this disease. Formerly very effective against the latter, the molecule has been prescribed so much, in the form of Nivaquine and Savarine, that a resistant form of malaria has finally developed. “Chloroquine is now ineffective almost everywhere in the world (…) Between 1999 and 2004, chloroquine was given to 95% of African children suffering from malaria, even though the drug no longer cures more than half the malaria cases in many countries ”, Wrote the WHO in 2006.

However, the year before, chloroquine had been shown to be effective against severe acute respiratory syndrome. (Sras) which killed nearly 800 people in Southeast Asia in 2002-2003. In 2013, it had also proven itself in tests carried out on animal models of the H5N1 virus. This year, researchers demonstrated its effectiveness against Covid-19 in laboratory tests. “We have found that Remdesivir (antiviral developed for the purpose of treating Ebola, Editor’s note) and chloroquine are very effective in controlling infection in vitro ”, wrote Chinese researchers in a study published in the journal Nature February 4.

Anti-viral and anti-inflammatory capabilities

Then, on February 19, results of clinical trials published on the journal’s website BioScience Trends and carried out on 100 people distributed in ten Chinese hospitals since the beginning of the Covid-19 epidemic reinforced this hope. In fact, three researchers from the university’s pharmacy school and the Qingdao hospital (China) declare having measured “the efficacy of chloroquine on the treatment of pneumonia associated with Covid-19“.

“The results obtained so far on more than 100 patients have shown that chloroquine phosphate was more effective than the treatment received by the comparison group to contain the evolution of pneumonia, to improve the state of the lungs, so that the patient becomes negative again for the virus and to shorten the duration of the disease (…) The antiviral and anti-inflammatory capacities of chloroquine could play a role in its potential effectiveness in treating patients suffering from pneumonia caused by Covid-19”, Write the researchers.

For microbiologist Didier Raoult, this study shows the effectiveness of chloroquine against Covid-2019 which, according to the latest estimates to date, has killed 2,761 and infected more than 80,000 people worldwide since its appearance in December. “We were waiting for clinical trials to report the effectiveness we were prejudging. Now it’s done. We have all the elements. There may be adjustments to the dose to be given and the time during which the drug should be administered ”, the specialist said on Franceinfo Tuesday, February 25.

500 mg of chloroquine per day for ten days?

“Just as it had been shown for SARS at the time and forgotten, chloroquine is active in vitro against coronaviruses (…) With 500mg of chloroquine twice a day for ten days, there is a dramatic improvement, and it is recommended for all clinically positive cases of Chinese coronavirus infection ”, he said, ensuring that the Chinese researchers behind this team are among the “best virology teams in the world“.

If the antiviral Remdesivir also performs well in tests to get rid of the coronavirus (clinical trials using this antiviral are in progress, their results should be known in the coming weeks), the chloroquine would be more complete. Whether it be “P.or contain the progression of pneumonia, to improve the condition of the lungs, to make the patient negative for the virus again and to shorten the duration of the disease ”says the study. Furthermore, “it costs less and it’s a long-standing, proven medicine that we know is safe in terms of the risk / benefit balance. ”

WHO has not yet decided on the issue

If these results are exciting, it is still too early to get carried away. On BFMTV, Minister of Health Olivier Véran said he had met with Didier Raoult on the subject. “He told me about his observations and the studies he highlighted, which I sent back to the General Directorate of Health, which is in the process of doing all the analyzes. We know that there are indeed interesting studies on an impact in vitro, but patient studies are yet to be determined. ”

While waiting to learn more about the effects of Remdesvir and chloroquine, the WHO is not making a decision and its recommendations remain the same. To protect against coronavirus, the Organization advises to wash your hands frequently, especially after taking the metro or after blowing your nose, to cover your mouth and nose with the crease of your elbow or a handkerchief in case of coughing or sneezing and avoid close contact with sick people as well as touching the eyes, nose and mouth.

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