Research Article Review: A Hospital Observational Study of a Drug for Covid-19

by Rida Khan


Research Article Review: Is Immunomodulatory Property of Hydroxychloroquine Beneficial for Severe COVID-19? A Hospital Based Retrospective Observational Study


Overview

A drug called Hydroxychloroquine is being prescribed by doctors all over the world. Why? And can it really prevent Covid-19?


COVID-19 has had a widespread impact on not just the US, but also the rest of the world. Medical practitioners have been advising and authorizing the use of hydroxychloroquine for the treatment and prevention of COVID-19. COVID-19 is a disease that primarily affects the body’s immune system, which has led scientists to believe that hydroxychloroquine, an agent that can supposedly activate or suppress its function, may be advantageous in the treatment of the disease. This study analyzed 27 severe cases of COVID-19 that were treated with low doses of hydroxychloroquine and found some interesting results.


Introduction

This study is exploring the potential advantageous effects of hydroxychloroquine(HCQ), originally an antimalarial drug now used to treat rheumatoid arthritis, on the immune system in response to Covid-19. To provide some context, HCQ is used as an immunosuppressive agent, a drug that keeps an individual’s immune system in check by suppressing their immune response so that the body does not attack its own cells and tissue. As a side note, many Covid deaths have been linked to an overactive immune system. Furthermore, prior to the 2019-2020 outbreak, HCQ was found to have in-vitro (tested outside of a living organism in a laboratory setting) activity against the virus. Because of its success outside of a living body, scientists were optimistic of the drug’s efficacy in live patients.


Background & Importance

Studies testing this drug have been done in several countries such as France and Belgium. While a study in the US did not find any significant effect of HCQ on Covid related deaths in hospitalized patients, a study in France found a significant decrease in viral load, the amount of virus in an organism, after use of this drug. Furthermore, a Belgian study’s findings concluded that low dose HCQ positively correlated with less Covid-related deaths.


This study’s importance lies in its potential to either confirm the efficacy of HCQ against Covid-19, a very fatal and debilitating disease, or bust myths regarding its benefits to the immune system. Researchers from all around the world have been considering this drug in relation to treating Covid-19 but have not found any conclusive data to support its medical benefits, which already hints at its ineffectiveness. It has even been prescribed by doctors for the treatment and prevention of Covid-19 even though there is little substantial evidence that supports its effectiveness.This study by Mohanta et al. is looking to either reinforce the results of those studies or offer a new perspective on why this drug should be used in the treatment of Covid-19.


Goal & Logistics

The purpose of this study is to learn of the potential benefits offered by the use of HCQ in regards to the treatment of severe cases of Covid-19 during the pulmonary phase, when the virus moves into the lungs.


The subjects were patients with severe Covid-19 who either received or did not receive HCQ as part of treatment.


The control group comprised subjects that were not treated with HCQ. The experimental group comprised subjects that were treated with HCQ for seven days or more.


This study used age and sex matched controls. In other words, if 25% of the cases were male, then hypothetically, 25% of the controls would also be male.


Data & Results

Statistical analysis was done using Medcalc, a web-based software.


Out of the 27 patients that received HCQ as treatment,

  • 77.7% were discharged from the hospital

  • 22.2% passed away


Out of the 27 patients that did not receive HCQ as treatment

  • 70.4% were discharged from the hospital

  • 26.9% passed away


HCQ did not have any effect on the experimental group because the outcome was similar to that of the control group. The number of Covid-related deaths and use of ventilators was also similar for both groups.


Some limitations of the study were that it had a small sample size. It was also a retrospective observational study, a study that was based on past events, which itself has its own limitations. Future studies should focus on the toxicity and side-effects of HCQ.


Conclusion

Although it is generally associated with the treatment of autoimmune diseases such as rheumatoid arthritis, this study argued that HCQ is not a reliable treatment for Covid-19 because although some studies do have promising results, there are many studies, including this one, that demonstrate the ineffectiveness of this drug. It does not significantly reduce mortality in severe Covid-19 cases or even reduce the number of patients that had to be transferred to ventilators.


The main takeaway from this study is that this drug should only be used to treat the diseases that it was intended for and not for immunological diseases such as Covid-19 until conclusive research has been done. To anyone looking to stay healthy from Covid-19, vaccines are by far the safest and most effective way to prevent this disease, so those who are eligible should consider getting vaccinated. Remember to check out cdc.gov to find vaccines near you and stay up-to-date on the lastest Covid-19 regulations and tips!


link to article: https://www.proquest.com/docview/2535397463/fulltextPDF/ECFF21A5B12442A8PQ/6




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