they may be untreated immediately

Dear Tadesse Fikre Teferra , I'd like to share the following with you.

I recommend you read the sections Pharmacodynamics and Mechanism of action of https://www.drugbank.ca/drugs/DB01611 .

I believe that the information in the article is accurate, but the biology of the viruses must be taken into account.

Hydroxychloroquine complicates the pathophysiology of COVID-19 development, but it is not a drug that targets the viral particle. Therefore, the effectiveness of treatment is unlikely to be great.

Because of the biology of viruses, it is very difficult to have anything truly successful.

I would take this paper with a large dose of salt. It is a poorly constructed study unfortunately, in the statistics 6 of the 26 patients in the testing group were lost to follow up which included worsening of symptoms and in once case a death (no loss to follow up in controls)(" three patients were transferred to intensive care unit" of which one who lost to follow up tested negative on day 2 (PCR) yet died on day 3). This will irreparably skew the statistics positively towards the treatment. As well as this they did not look at clinical endpoints such as clinically cured and discharged but just Covid PCR titers. This does not equate to a cure and was conducted over a very short time frame. There is also a very real risk of severe QT prolongation (heart rhythm) as the couple in America found out when they self administered.

I also think it was a bit short sighted to publish the pre-print prior to any peer review as it has pushed a media cycle where these results have been over blown. This is a very small scale study with a low strength behind its results, there may be something there but we do not know what it is at present

I really appreciate the detailed explanation provided by Stephen Reynolds and Jeysson Sánchez-Suárez on the technical limitations of the research on the treatment of coronavirus with two drugs in question and the nature of the virus.

I think, because of its dangerous side effects

Welcome, I think now more than ever with the rapid progression of new data on Covid-19 we really need to put our skeptical hats on. There is going to be a lot of new science and some of it will be poorly done and the media will spin what it likes.

https://www.researchgate.net/publication/340448998_Azithromycin_promising_medicine_for_COVID_19_in_early_stage_by_effecting_on_mTOR_and_immune_system

Severity of disease depends of the viral load which is highly infected the cells inside body that can measured just as like infectious rate of COVID19 in people, which can't control it without any prevention procedures in early stage. In addition to, the over expression of the proliferation of virus lead to inhibit differentiation of cells that effect immunity responses. For that, the medicines can't do nothing in late stage. So the patients who develop serious symptoms will not have the benefit of any medication except little.

Hydroxychloroquine alone or with Azithromycin for COVID-19: No benefit but increased risk

No significant benefit with Hydroxychloroquine and Azithromycin either alone or in combination on in-hospital mortality in COVID-19 patients in USA. However, increased risk of prolonged QT-interval with risk of ventricular arrhythmias.

References

Association of Treatment With Hydroxychloroquine or Azithromycin With In-Hospital Mortality in Patients With COVID-19 in New York State

https://jamanetwork.com/journals/jama/fullarticle/2766117

Observational Study of Hydroxychloroquine in Hospitalized Patients with Covid-19

https://www.nejm.org/doi/full/10.1056/NEJMoa2012410

Risk of QT Interval Prolongation Associated With Use of Hydroxychloroquine With or Without Concomitant Azithromycin Among Hospitalized Patients Testing

Positive for Coronavirus Disease 2019 (COVID-19).

https://www.ncbi.nlm.nih.gov/pubmed/32356863