Please take a look at this useful link.
https://link.springer.com/content/pdf/10.1007/s40495-020-00216-7.pdf
Azi could be easy -- A plausible explanation might be its activity against opportunistic bacterial infections, which try to exploit tissue disruption by the virus. Any reasonable antibiotic should do that to some degree. It's what they happened to be using in that study, and now everybody is copying it. It might be not particularly special.
HCQ... Tricky. The most plausible story I've heard would be elevation of endosomal pH. It could be that this prevents the activation of viral endosome escape. It would get trapped until endosomes fuse with lysosomes, and then there's too much protease, and it gets chopped. Maybe...? As far as I can see, there are open questions, before we can call this a "mechanism".
(1) Does it happen at physiological dose in vivo?
(2) What is the molecular target?
(3) How well would the efficacy hold up in a trial designed to the toughest standards?
Chloroquine works as an antiviral , and it is not new. It has been in use for some time, and it was tried in some cases of SARS in 2002, and it affects the virus by two ways:
1.increases late endosomal and lysosomal pH, resulting in impaired release of the virus from the endosome or lysosome – release of the virus requires a low pH. The virus is therefore unable to release its genetic material into the cell and replicate.
2.Chloroquine also seems to act as a zinc ionophore, that allows extracellular zinc to enter the cell and inhibit viral RNA-dependent RNA polymerase.
As for azithromycin, I think to be used for second bacterial infection or as prophylaxis from it.
Thanks
Article Acquired Long QT Syndrome: A Review of the Literature
This review discusses the points I outline below.
A note of caution.
Several medications that have been recommended for the treatment of Covid-19 are associated with prolongation of the QTc interval and therefore torsade de pointes and sudden cardiac death.
The evidence of the potential benefit of chloroquine and hydroxychloroquine in the treatment of Covid-19 is increasing.
Other medications which may be used in this cohort include the macrolide antibiotics (e.g. azithromycin). These can also prolong the QTc interval. Administering several medications that may prolong the QT interval is associated with a high risk of complications.
In medicine risks and benefits must be balanced. Safety netting is important whenever there is a great potential benefit but also a very significant risk. In that context QTc intervals, renal and liver function must be monitored closely in patients treated with chloroquine and or macrolides. They should probably not be started if the baseline QTc is more than 450 ms. It should probably be stopped if the QTc increases 25% above baseline. It should definitely be stopped if QTc is above 500 ms. This is an evolving situation and recommendations may change as the potential risks and benefits become clearer.
Beta-blockade is used in the treatment of congenital and acquired long QT syndrome, so may be beneficial in this setting.
hydroxychloroquine treatment is significantly associated with viral load reduction/disappearance in COVID-19 patients and its effect is reinforced by azithromycin
see this link Article Hydroxychloroquine and azithromycin as a treatment of COVID-...
Please take a look at this useful link.
https://link.springer.com/content/pdf/10.1007/s40495-020-00216-7.pdf
Please have a look..
Article Hydroxychloroquine and azithromycin as a treatment of COVID-...
I need not have to say anything but to second Mr omar Al ani. Just to add one more point chance of QT prolongation (Ventricular Arrhythmia)is hgher if you prefer this combination. Remdesevir has shown some effective ness against this virus. So I am copy, pasting his statement. Chloroquine works as an antiviral , and it is not new. It has been in use for some time, and it was tried in some cases of SARS in 2002, and it affects the virus by two ways:
1.increases late endosomal and lysosomal pH, resulting in impaired release of the virus from the endosome or lysosome – release of the virus requires a low pH. The virus is therefore unable to release its genetic material into the cell and replicate.
2.Chloroquine also seems to act as a zinc ionophore, that allows extracellular zinc to enter the cell and inhibit viral RNA-dependent RNA polymerase.
As for azithromycin, it is primarily used tto treat lower respiratory tract secondary bacterial infection or as prophylaxis from it.
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