For any treatment to be a good treatment, it should be effective but at the same time not cause harm and this has to be backed up by data from large scale well-designed clinical studies. More recently there have been some reports that Chloroquine and Hydroxychloroquine may offer some protection from the really harmful effects of the virus and this has led to some world authorities including President Trump declaring that this could be a game-changer as it is already widely used and safe and therefore may offer benefit without necessarily causing harm. The problem with this statement is that what may appear safe in a small number of patients may not be safe when given ‘en masse’ to hundreds of millions of people. Whilst only a small proportion of patients with COVID-19 (20%) will suffer a really severe course of illness, the truth is that many more would end up being given the drug and therefore it is feasible that if the drug were in any way not safe we could end up harming patients who would never even have had a severe form of the virus
In this blog, I was keen to review the evidence regarding the possible benefits of chloroquine and hydroxychloroquine and also the possible harm that could result from injudicious prescribing. At present there is just not enough high quality evidence to guide us either way. Happily however, there are almost 100 trials of chloroquine, hydroxychloroquine alone or in combination with other medications that have are being conducted and therefore we will hopefully know as results accrue.
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