COVID-19 Update: Old drug shows new promise; Younger patients hit hard

By Paul Basilio, MDLinx
Published March 19, 2020

Key Takeaways

Chloroquine, which has been used to prevent and treat malaria since 1944, has shown promise in treating COVID-19 in many patients outside the US. The drug, which is already FDA-approved to treat malaria, will be used in a clinical trial, according to FDA Commissioner Stephen Hahn, MD, to test for efficacy in patients with COVID-19. Currently, physicians can use the drug off-label to treat COVID-19 patients.

Old drug shows new promise

Due to its effectiveness during the SARS outbreak, some investigators have been focusing on chloroquine as a potential treatment for the current virus.

“The way that it worked against SARS was by preventing the attachment of the virus to the cells. Chloroquine interfered with the attachment to that receptor on the cell membrane surface," Len Horovitz, MD, a pulmonologist at Lenox Hill Hospital in New York City, told ABC News. “So it’s disrupting a lock and key kind of mechanism of attachment.”

Doctors in China who administered chloroquine to patients with COVID-19 noted that those patients were more likely to have shorter hospital stays and improved outcomes. French investigators found that patients with COVID-19 who were treated with a combination of hydroxychloroquine and azithromycin were virologically cured after 6 days. 

Although it was claimed that the drug has been FDA-approved for use against COVID-19, it is still only approved to treat malaria. Currently, the drug is being tested for use in patients with COVID-19 infection to fastrack FDA approval for that indication. In other circumstances where an unapproved drug shows efficacy, the FDA allows “compassionate use” of a medicine, in which very ill patients can be administered a drug not yet approved for widespread use.

Younger patients hit hard

Despite early indications that COVID-19 would mainly affect the elderly, a CDC analysis of the 4,226 US cases as of March 16 shows that older adults are not, in fact, the largest group of hospitalized patients. Here’s the breakdown by age:

  • 9% aged ≥85 years

  • 26% aged 65-84 years

  • 17% aged 55-64 years

  • 18% aged 45-54 years

  • 20% aged 20-44 years

  • <1% aged <19 years

Among 121 patients admitted to ICUs for COVID-19, most (36%) were adults between the ages of 45 and 64 years.

Deborah Birx, MD, the response coordinator for the US coronavirus task force, called on younger generations to take the outbreak more seriously.  

Share with emailShare to FacebookShare to LinkedInShare to Twitter