Hydroxychloroquine to treat COVID-19? Serious side effects, no strong scientific backing

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Lt. Wade Miller treats a patient aboard the hospital ship USNS Mercy (T-AH 19), April 4, 2020, Los Angeles. Credit: U.S. Navy (CC BY 2.0). 

Over the weekend, President Trump again recommended hydroxychloroquine to treat COVID-19, and said the government has ordered 29 million pills of it. The drug is meant to treat malaria, lupus, and rheumatoid arthritis.

There’s only limited, anecdotal evidence that hydroxychloroquine works on the novel coronavirus. Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, said on CBS on Sunday, “The data are really at best suggestive. There are cases that show there may be an effect. And there are others that show there is no effect. So I think in terms of science, I don’t think we can say it works.” 

There have been a few studies in China and one in France, says Katie Thomas, New York Times reporter covering health care and the drug industry. 

She says the France study drew significant criticism from scientists and researchers for a lack of a placebo group. A more recent study had a control, but the sample size was very small, she adds. 

New York green lights hydroxychloroquine with Z-Pak

New York is giving doctors permission to use hydroxychloroquine with Azithromycin (so-called Z-Pak). Why?

“There are a lot of doctors and hospitals that share … a kernel of what President Trump is talking about. They say, ‘Look, this is a drug. It's been around for decades. It has side effects. But we as a medical community are pretty familiar with this drug, and we're familiar with its risks. And when we are facing a brand new disease where there are people who are dying from this disease, let's try it,’ ” says Thomas.

Serious side effects

Hydroxychloroquine can cause a heart arrhythmia and lead to sudden cardiac arrest in some patients. “People who have a severe reaction to the coronavirus also may be the very same people who could be at a higher risk to have this sort of reaction to the drug,” Thomas says. 

Hydroxychloroquine can interact poorly with other medications too, so if someone has underlying health conditions and is taking other drugs, they’re at risk for this side effect, Thomas points out.

“Some have pointed out to me as well — even though there is this risk for this heart arrhythmia for people who already have known heart problems, it can also pop up in people who thought that they had a normal heart. So it is rare, but it's deadly,” she adds.

—Written by Amy Ta, produced by Alex Tryggvadottir