Tags: Coronavirus | Donald Trump | hydroxychloroquine | trump | covid19 | coronavirus

Dr. David Samadi: Why Trump's Use of Hydroxychloroquine Makes Sense

Dr. David Samadi: Why Trump's Use of Hydroxychloroquine Makes Sense

President Donald Trump speaks Monday at the White House. (AP/Evan Vucci)

By Tuesday, 19 May 2020 12:48 PM Current | Bio | Archive

President Donald Trump made a huge revelation announcing he has been taking one pill a day of hydroxychloroquine along with zinc for more than a week as a prophylaxis in hopes of preventing contracting COVID-19. He stated, "So far, I seem to be okay" when confronted by reporters after the unexpected news. Ever since coronavirus arrived in the U.S., the president at no time has ever displayed any symptoms of the virus.

Trump's decision likely based on personal contacts with COVID-19

This virus has struck close to home several times for President Trump in recent weeks. It began with one of Trump's closest political allies, U.K. Prime Minister Boris Johnson, who was sidelined with COVID-19 first in self-isolation, then hospitalized, but managed to avoid going on a ventilator and has since recovered.

In April, President Trump's closest friend, Stanley Chera, a prominent New York City real estate mogul, died from complications of COVID-19. Then, just last week, two White House staffers tested positive for the virus, Vice President Mike Pence's press secretary and one of President Trump's valets.

With this many close contacts being diagnosed with the virus, I support President Trump in his decision for taking extra precautions by resorting to the use of hydroxychloroquine as a preventive measure against COVID-19. He's the most powerful man in the world and has the right to make this decision between him and his doctor. Other than some struggles with high cholesterol, he has no other health conditions that would disqualify him from taking this drug.

President Trump's abrupt disclosure, will however, set the wheels in motion. Doctors will be flooded with questions from patients — "Is it safe?" "Who is eligible?" "Does it prevent COVID-19?"

My take new on this newsflash is after weeks and weeks of the fear of being infected with coronavirus, Americans simply want answers. They're looking for solid information and advice that needs to be thoughtfully considered and answered carefully. What it boils down to is this and as I stated previously: The decision is really up to and between a patient and their doctor. The government should not be in the business of dictating what medications we can be prescribed if our doctors have approved them for our own personal use.

If one of my patients asked me about the use of hydoxychloroquine as a prophylaxis to prevent COVID-19 or the use of it in the early stages of the virus, as long as they meet the criteria of it being safe for them to use, I would answer, why not?

Currently, Remdisivir, an antiviral medication, has been approved by the Food and Drug Administration (FDA) for treating severe cases of COVID-19. But we need medications that can stop the virus early on, reducing its chance of advancing to a more severe, life-threatening form, leading to more deaths.

Across the country, numerous physicians and other health professionals support hydroxycholoroquine as a possible treatment. In fact, on May 14 the National Institute of Allergy and Infectious Disease started a Phase 2b clinical trial, enrolling 2,000 adults with mild to moderate COVID-19 to evaluate if hydroxycholoroquine together with the antibiotic azithromycin can reduce hospitalization and death from the virus. They apparently must see a glimmer of hope in what this medication may have to offer.

Despite this new clinical trial startup, this drug is still coming under intense scrutiny with many critics including the FDA, declaring it unsafe for widespread use.

Hydroxycholorquine's long history as an antimalaria and autoimmune disease medication, but not without some risks

For the past 60 years, FDA-approved hydroxychloroquine, sold under the brand name Plaquenil, has been used to treat malaria and has a long track record as a well-established safe and effective therapy for use in autoimmune diseases such as lupus and rheumatoid arthritis.

But like any medications, there are risks and benefits to taking hydroxycholoroquine. It's the risks and benefits that need to be weighed carefully by any doctor writing the prescription for any patient using this drug.

There will be patients who should not be given hydroxychloroquine due to having certain health conditions: anyone with heart disease or a heart rhythm disorder, diabetes, allergy to quinine, psoriasis or liver or kidney disease. These individuals would be disqualified from consideration of using the medication for COVID-19. Patients who are approved to use hydroxychloroquine should be closely monitored for any signs of adverse symptoms.

What are the benefits of hydroxychloroquine effectively fighting COVID-19?

To answer this question, let's review what we know so far about this virus and how it behaves. From what we've learned about people infected with this virus is the huge disparity in how it presents itself: Some people have no symptoms or very minor while others become very sickly requiring a ventilator. Why? Right now there is no definitive answer but many experts suspect that in some patients who did not survive COVID-19, their immune systems may have gone rogue, producing what is called a cytokine storm.

Cytokines are biological chemicals that signal the immune system to do its job of responding to an infection. Normally when our body fights infections, cytokines are produced in moderate amounts to help support the immune system in responding the way it should.

But sometimes too many cytokines are released, literally flooding the body causing too much inflammation known as a cytokine storm. This cascade of cytokines can seriously affect the kidney, heart and lungs of someone infected with COVID-19 and have proven to be deadly.

A recent 2020 review in the International Journal of Antimicrobial Agents, discusses how using both chloroquine and hydroxycholorquine can reduce the production of various pro-inflammatory cytokines helping avoid dangerous and deadly cytokine storms. For patients who are eligible and are either asymptomatic or have only minor or moderate symptoms, the use of hydroxychloroquine makes logical sense.

I'm also in favor of using hydroxychloroquine as a combo with other medications such azithromycin (z-pack) and zinc. These could be smart strategies going forward in our fight against this virus.

Others who are planning encouraging research on hydroxychloroquine as a prophlaxis is the Henry Ford Health System in Detroit leading a study appropriately named WHIP COVID-19. It aims to enroll 3,000 volunteers to determine the drug's effectiveness in preventing this infection.

A May 2020 study found on medRxiv and has not yet been evaluated by the medical community and is under peer-review, has found encouraging data that showed when zinc sulfate was used in combination with hydroxychloroquine and azithromycin, patients were discharged from the hospital sooner and had reduced admission to the ICU or the need for a ventilator.

In conclusion

Medicine is a science and an art. When confronted with a contagious and potentially deadly novel virus like COVID-19, using our knowledge, skills, and talents to investigate all potential treatments is the best way to be practicing medicine. So far, experts have found the antiviral drug Remdesivir to lead the pack in providing hope and healing for those with COVID-19.

Even though some say hydroxychloroquine should not be considered for treating this coronavirus, we do know there are patients who have used it successfully with a full recovery. At the same time, we also know hydroxychloroquine is not meant for use for everyone.

We are at the beginning of gathering more information about hydroxychloroquine as a prophylaxis for COVID-19. We must continue research of it adding to our knowledge base of what medications work for treating COVID-19.

President Trump, in true American form, is an individualist who takes matters into his own hands. He is leading the way and should be applauded for being willing to give hydroxychloroquine a chance. Because by not trying, we may miss our opportunity of one more valuable drug that could help us treat and defeat COVID-19.

Dr. David Samadi is Director of Men's Health and Urologic Oncology at St. Francis Hospital in Long Island. He is a renowned and highly successful board certified Urologic Oncologist Expert and Robotic Surgeon in New York City. He is regarded as one of the leading prostate surgeons in the U.S., trained in oncology, open, laparoscopic, and robotic surgery. He has vast expertise in prostate cancer treatment and Robotic-Assisted Laparoscopic Prostatectomy. Read Dr. David Samadi's Reports – More Here.

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Tuesday, 19 May 2020 12:48 PM
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