Hydroxychloroquine Not Recommended for Treatment of COVID-19
Newswise — Recently, several physicians hosted a press conference in which one physician claimed that the combination of hydroxychloroquine, the antibiotic azithromycin and the mineral zinc could cure COVID-19. The video footage of that press conference went viral on social media, and soon many social media platforms removed the videos for providing inaccurate, non-scientifically backed claims. But questions from the public may still remain.
According to Johns Hopkins experts, there are no significant clinical trials to date showing that these drugs are an effective treatment against COVID-19. At least three controlled, large trials showed either no advantage or higher risk of cardiovascular complications in patients receiving the drug.
“Patients infected with COVID-19 often have compromised heart and vascular systems, and receive other drugs that can interact with hydroxychloroquine and can put patients at increased risk of arrhythmias or irregular heartbeats,” says cardiologist Oscar Cingolani, M.D., associate professor of medicine at the Johns Hopkins University School of Medicine. “These cardiovascular side effects in some COVID patients aren’t often seen in patients receiving the drug for other purposes like autoimmune disorders, so therefore the safety observed in these other patients can’t be inferred for COVID-19 patients.”
To date, Johns Hopkins physicians endorse the latest Centers for Disease Control and Prevention recommendations on not using these drugs for treatment of COVID-19.
Cingolani is available to speak with reporters about why people shouldn’t take hydroxychloroquine to treat COVID-19.
Seasonal Poliolike Syndrome Outbreak in Children Could Be Smaller in Light of Covid-19 Pandemic
Early data from U.S. infectious disease experts suggests that physical distancing has affected infection rates of seasonal viruses, such as this year’s shorter, more abrupt flu season. Other seasonal viruses, such as enterovirus D68, the virus thought to be behind the poliolike syndrome acute flaccid myelitis (AFM), may also be affected by changes in how people interact with society. AFM affects children and can cause inflammation in the spinal cord, which can lead to muscle weakness and paralysis in the arms and legs. AFM outbreaks occur every other fall, with this autumn expected to be the next big one.
“We speculate that there will be a slowdown of AFM in this upcoming season because of physical distancing,” says Carlos Pardo-Villamizar, M.D., professor of neurology at the Johns Hopkins University School of Medicine. “As different states are managing COVID-19 in different ways, our main concern is if they open schools that would increase the risk of circulating enteroviruses, which could lead to a larger outbreak than anticipated.”
Pardo is available to speak with reporters about what we have discovered to date about AFM and how physicians are preparing for an outbreak in light of the COVID-19 pandemic.
What Hospitals Have Learned About Treating COVID-19 Patients — and What Challenges Might Be Ahead
As coronavirus infections continue to surge throughout the United States, the best way to help hospitals handle the influx of patients is not to become one, says Clare Rock, M.B.B.Ch., associate hospital epidemiologist at The Johns Hopkins Hospital. That is, maintain physical distancing of at least 6 feet, avoid large gatherings and wear face coverings in public.
“When those things are being done in the community, we usually don’t see very high hospitalization rates,” says Rock, an associate professor of medicine in the Division of Infectious Diseases at the Johns Hopkins University School of Medicine.
Once patients are in the hospital, however, the safety of health care workers and other patients is “paramount” in preventing transmission from COVID-19 patients, says Rock. At Johns Hopkins, that means health care workers wear masks at all times in the hospital as well as eye protection when interacting with patients. A health care worker showing any symptoms of COVID-19 must immediately contact Occupational Health Services and get tested, and that person is taken off the work schedule until cleared by Occupational Health Services, she adds.
After an initial “steep learning curve” in treating a new virus, clinicians have now seen enough COVID-19 cases to recognize patterns in how patients react to the virus and what treatments would be most effective, Rock says.
“It’s through the experience our clinical teams have of seeing, caring for, managing and treating these patients that we’ve been able to garner that expertise,” she says.
Hospitals nationwide have largely standardized care for COVID-19 patients, according to Rock, with some, including Johns Hopkins, now testing all newly admitted patients for the virus. Her larger worry moving forward for hospitals in general is the strength of the national supply chain.
“The main concern now as we see rates increasing dramatically in parts of the country is potentially a scarcity of adequate supplies for testing and personal protection equipment for health care workers,” she says.
Rock is available for interviews to discuss best practices at hospitals for COVID-19 and how health care institutions can prepare for spikes in cases.
Inside a Coronavirus-Infected Cell
Coronaviruses are tiny. They’re so small that scientists need a special microscope to spot them. This video animation is an artist’s rendering of how coronaviruses invade, replicate and assemble a new army of viruses inside a host cell.
To build a better vaccine, stop a virus from replicating or attaching to host cells, help the immune system fight the virus, or find any type of remedy to the current COVID-19 pandemic, scientists need to understand how coronaviruses work. These scientists focus on the so-called “basic” or “fundamental” biology of viruses.
For example, coronaviruses are known to invade and replicate within host cells, and newly made viruses escape through the host cell’s outer membrane. But instead of going straight to the cell membrane to get ready to be shipped out of the host cell, coronaviruses stop at a pancakelike structure in the cell called the Golgi complex, a kind of post office that sorts and processes proteins and spits them out of the cell after enclosing the proteins in a compartment called a vesicle.
Johns Hopkins scientists have been working to determine why coronaviruses make this extra stop in their replication and escape process. One reason, they found, is that coronaviruses neutralize the acidity of the Golgi complex, potentially paving a better path to help the viruses, with their spiky halo, escape cells.
Cell biologist Carolyn Machamer is available to discuss the role of basic science research in overcoming pandemics. Watch the video on how coronaviruses work.
Department of Defense Funds $35M COVID-19 Blood Plasma Trials Led by Johns Hopkins
Johns Hopkins Medicine researchers have received $35 million in funding from the U.S. Department of Defense to test the effectiveness of a convalescent blood plasma outpatient treatment. The treatment is a transfusion of a blood product from COVID-19 survivors that contains antibodies that may help the patient’s immune system fight the virus.
Two clinical trials totaling 1,100 people will be conducted at over 20 outpatient centers in medical centers across the U.S., including the Navajo Nation, and will help researchers determine whether convalescent blood plasma therapy can effectively be used to treat people in the early stage of COVID-19 illness or prevent the infection in those at high risk of exposure to the virus at their home or jobs.
The prevention trial will include 500 people who have been exposed to COVID-19 in their home or at work as health care providers. A second trial will recruit 600 participants who have early COVID-19 disease, meaning they are within eight days of their first symptoms but are not sick enough to be in a hospital. All participants will be over age 18. The researchers aim to complete recruitment of participants to the trials in early fall 2020.
Convalescent blood plasma therapy involves transfusing a portion of blood called plasma from people who have recovered from the virus. When separated from red and white blood cells and platelets in the blood, plasma is the yellow-tinged liquid that includes proteins called antibodies, which glom on to foreign substances such as viruses and either mark them for destruction by the immune system or disrupt a virus’ ability to multiply and grow.
There is very little clinical data proving the effectiveness of using the therapy in outpatient clinics, according to the researchers. Currently, only hospitalized patients have access to any type of therapy for COVID-19.
The research team is available to discuss this research and the new funding.
Read more about the new studies in our Newsroom.