Doctors embrace drug touted by Trump for Covid-19, without hard evidence it works

California told Reuters they are routinely using hydroxychloroquine on patients hospitalised with Covid-19.

At the same time, several said they have seen no evidence that the drug, used for years to treat malaria and autoimmune disorders, has any effect on the virus.

Use of hydroxychloroquine has soared as the United States has quickly become the epicentre of the pandemic.

More than 355,000 people in the United States have tested positive for the novel coronavirus, and more than 10,000 have died. The federal government estimates that as many as 240,000 people in the country may die from the disease before the outbreak is over. Facing those numbers, and in the absence of any known effective treatments, doctors on the frontlines said they began using hydroxychloroquine and the related chloroquine on patients who are deteriorating based on a few small studies suggesting a possible benefit.

Some said they had come under pressure from patients to use the therapies widely touted by Trump and other supporters. “I may take it,” Trump said on Saturday, referring to hydroxychloroquine, though he has twice tested negative for coronavirus, according to the White House.

“We’re just hearing really positive stories, and we’re continuing to collect the data.” Potential side effects of hydroxychloroquine include vision loss and heart problems. But doctors interviewed by Reuters say they are comfortable prescribing the drug for a short course of several days for coronavirus patients because the risks are relatively low and the therapies are inexpensive and generally available.

However, protocols directing how these drugs should be used vary from one hospital to another, including when to introduce them and whether to combine them with other drugs. In addition, some studies showing promise involve patients who took the therapies for mild or early-stage illness. Many of those people are likely to recover from the virus on their own.

Patients admitted to the hospital in the United States are generally much sicker than the mild cases cited in such studies when they receive therapy.

These factors, doctors said, have made it difficult for them to determine whether the drugs are making a difference.

“I have seen hundreds of patients with severe Covid and most of these people are on hydroxychloroquine,” Dr Mangala Narasimhan, regional director of critical care at Northwell Health, a 23-hospital system in New York, said in an email.

“In my opinion, although it is very early, I do not see a dramatic improvement from the hydroxychloroquine in these patients.” Dr Daniel McQuillen, an infectious disease specialist at Lahey Hospital and Medical Centre in Burlington, Massachusetts, said he has prescribed a course of hydroxychloroquine for about 30 Covid-19 patients so far because the drug has shown “a little bit of antiviral activity”.

But he has not seen “marked improvement for patients”. “Anecdotally, it may have had limited effect in patients with milder disease,” McQuillen said.

The therapy “has had no effect in limiting or slowing progression of our patients that have been at or near ICU level when they arrived”.