The utilization of hydroxychloroquine to reduce the main signs and symptoms of COVID-19 patients, a cross-sectional study

Salem Alsuwaidan; Ziad A Memish; Faisal Alaklobi; Kholood Khan; Hamdan N Alajami

doi:10.1016/j.amsu.2021.102867

The utilization of hydroxychloroquine to reduce the main signs and symptoms of COVID-19 patients, a cross-sectional study

Ann Med Surg (Lond). 2021 Oct:70:102867. doi: 10.1016/j.amsu.2021.102867. Epub 2021 Sep 16.

Authors

Salem Alsuwaidan¹, Ziad A Memish^{1

2}, Faisal Alaklobi³, Kholood Khan⁴, Hamdan N Alajami⁵

Affiliations

¹ Research and Innovation Center, King Saud Medical City, Ministry of Health, Riyadh, Saudi Arabia.
² College of Medicine, Alfaisal University, Riyadh, Saudi Arabia.
³ Medical Affairs, King Saud Medical City, Ministry of Health, Riyadh, Saudi Arabia.
⁴ Obstetrics and Gynecology, King Saud Medical City, Ministry of Health, Riyadh, Saudi Arabia.
⁵ Pharmaceutical Services Administration, King Saud Medical City, Ministry of Health, Riyadh, Saudi Arabia.

Abstract

Hydroxychloroquine (HCQ) and chloroquine were found to have positive results in some non-randomized clinical trials with more benefit in decreasing the viral load of COVID-19. HCQ is a lysosomotropic and lipophilic drug that can penetrate cell membranes, and accumulates in the acidic lysosomes. The high concentration of alkaline HCQ increases the pH in lysosomes from the normal levels of 4.7-4.8 to 6 which leads to inhibition of lysosomes functions and thus, prevents the entry of coronavirus into cells.

Objectives: The main aim of this study is to find out the appropriateness of using HCQ in asymptomatic/mildly symptomatic COVID-19 positive patients in an attempt to reduce the development of signs and symptoms of COVID-19 and severe disease.

Methodology: Randomized selection, open-label trial to evaluate the efficacy of HCQ for patients presenting with asymptomatic COVID-19 upon diagnosis. Cases that met the inclusion criteria were divided into two arms [102 subjects to take HCQ (a loading dose of 400 mg twice daily given orally, followed by a maintenance dose of 200 mg twice daily for 4 days), and 100 subjects were used as a control group]. A follow-up for all the participants on daily basis for 14 days for any signs and symptoms (fever, cough, and shortness of breath). The main variables are action profile (represented by Area under the curve (AUC) for fever, cough, and shortness of breath statistically analyzed to differentiate between the two groups.

Results: Data in this study showed that HCQ was effective in reducing body temperature from the first day to the fifth day; this positive effect was significant with (p < 0.001) compared with subjects who didn't receive HCQ. While there was no significant effect on cough or Shortness of breath.

Conclusion: The recommendation of this study is to utilize HCQ to all subjects with asymptomatic COVID-19 infection providing that these subjects are within the inclusion criteria of this study. There was no adverse drug reaction observed for HCQ on daily follow-up.

Keywords: Area under the curve (AUC); COVID-19; Cough; Fever; Hydroxychloroquine; Shortness of breath.