Current situation of COVID19 is playing a huge impact on community and the health professionals in Bangladesh like any other affected country. But as a developing country with dense population it is almost impossible to identify and point out the COVID19 cases in mass population living in a non understanding situation. Curretly the testing facility for COVID19 is not available except only one centere in the capital of of Bangladesh. Also this is the time of viral flue presenting with similar symptoms like COVID19 infection. A broad spectrum antibiotic is given to treat and prevent secondary infection during this time in most of the patients. Besides as tropical country malaria is a common disease; often the treatment of malaria is offered based on symptoms only. Chloroquine has been described as a potential anti 2019-nCoV drug along with other antiviral agents. Currently Faviparavir is not available in Bangladesh. So my question is can we prescribe a early treatment in combination with Chloroquine and Azithromycin with or without Glucocorticoids (Depending on cases only) in all the suspected COVID19 cases as a routine (unless there is any existing contraindication to these drugs)? What could be the outcome? What difficulties we might face? What might be the potential risk and befinit situation regarding this regiment?
Chloroquine is very safe. In Africa we use in the treatment of maleria. It is not out of place to commence it in all patients with suspected covid-19. I even will suggest that it should be used as prophylaxis for all risk group. Bureaucracy and politics will not help us in d emergency. Also apply to Azithromycin.
@ Abu Taiub Mohammed Mohiuddin Chowdhury
Downside of using Chloroquine-Azithromycin combination in patients with COVID-19
Chloroquine and its less toxic derivative Hydroxychloroquine, both can cause prolonged QT interval. A combination with a macrolide Azithromycin, which itself causes prolonged QT interval, can be problematic particularly in older patients who may be having silent or subclinical ischemic heart disease (IHD) and may result in fatal arrhythmias.
Considering that older people may be taking drugs used for psychiatric issues, as well as may be using drugs for urinary incontinence (all causing prolonged QT interval) may be dangerous. Both Chloroquine and Hydroxychloroquine can also hypoglycemia that may precipitate arrhythmias in the seriously-ill COVID-19 patient who are in 80% cases are old and mostly diabetic or having other risk factors of IHD, such combination should not be used without a baseline ECG and regular monitoring.
It has been observed that 85% of COVID 19 cases are mild & would recover with symptomatic treatment . It would be preferable to treat moderate & severe cases with HCQS & Azithromycin after confirming the diagnosis & it is important to increase the use of diagnostic tests to confirm COVID 19 by PCR & serological tests . Empiric therapy for all suspect cases might deplete the availability of these drugs for deserving patients .
Dear: no doubt it pendemic. It is laboratory virus or what so over. But it more likely as infleuenza virus spread in 1918.
At that time the acual figures are not available but one fact is common that synthetic medicines were failed. And natural herbal treatment was practiced. It is history of old book at that time.
Covid signs and symtoms are more resumbling to thae same flue virus.
The actual death ratio is about 1.4% .
It is most important here that that the figures are manuplated. But each pern is afraid of this: it is of media.
Now come to the poind.
As a preventive care the use of garlic is more effective here: as i am advising to my patients since december 19: no one is effected from neither influenza. On google there many researchers denied but they did apply on vitro.and on infected persons. This treatment i am advising as a preventive medicine.
The treatment is easy of covid is easy. But no antibiotis is needed. It is very mindful there are no treatment of most of the virusesin Allopathic system but the are practicing like research on lab animals. China is an example who used.chinese traditional medicines and get controlled ane cure: not china is using thses medicines for prevention: why we no.
Zinc might be added to chloroquine or hydroxychloroquine to promote Zn to enter the cell and inhibit viral replication (there is evidence in vitro and trials are testing this).
NIH begins clinical trial of hydroxychloroquine and azithromycin to treat COVID-19. The Phase 2b trial will enroll approximately 2,000 adults. Though a small trial data from China (DOI: 10.1016/j.ijantimicag.2020.105949) showed promise. While other studies from New York (DOI:10.1001/jama.2020.8630) show no benefit. The data from the NIH trial can clarify the doubt better.