Hydroxychloroquine is a drug with effectiveness against malaria organisms. These are unicellular protozoans, so not a virus, not a bacterium, but the most primitive forms of animals.
Hydroxychloroquine has been used as a generic anti-auto-immune disease drug of low to medium potency, low to medium effectiveness, and relatively low toxicity (compared to high potency autoimmune disease drugs). It has been used for lupus with some efficacy. It is for this reason that I have used hydroxychloroquine as a drug member of the regimen I term AMASE (autoimmune medication and supplement envelope) because of its relatively low cost, low toxicity and efficacy as a generic autoimmune drug - the last reason the one it makes sense for GDD.
I am not convinced it is particularly effective for GDD, yet it makes sense for that indication.
Do I think it will have efficacy against COVID-19, probably close to 0 chance that it will be effective. Now why is it effective against autoimmune disease? I suspect it may have weak anti-cytokine storm properties, and by ameliorating cytokine storm it probably helps against autoimmune disease. There has been some report on cytokine storm arising with COVID-19. My opinion is that cytokine storm is triggered by some infective organisms/foreign antigens. The more likely to result in cytokine storm, the more likely to affect young healthy adults. So the Spanish Flu of 1918 was particularly lethal to young healthy adults (which is exceedingly rare with viruses and infective organism in general). COVID-19 is most lethal in the elderly and relatively rare in younger healthy adults. So my opinion, cytokine storm is relatively rarely triggered with COVID-19, and mainly it has the conventional effect of overwhelming a senescent immune system, to either kill the host on its own, or to allow secondary, usually not so lethal, organisms (some species/strains of bacteria) to kill the host.
So it is conceivable that hydroxychloroquine may have positive effect in younger previously healthy adults to ameliorate cytokine storm... This may end up having the exact opposite of the desired effect in elderly patients, blocking cytokine release. Time will tell if I am right.
I do not know how the FDA fast-tracked hydroxychloroquine to be used in COVID-19 - it seems based on the gut-instinct of president Trump.
In the mean-time patients with lupus and rheumatoid arthritis who are on hydroxychloroquine and benefitting from it, will now have diminished ability to get it.
Richard Semelka MD Consulting
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