Henry Ford Health System says it’s been using the drug hydroxychloroquine to treat severe cases of COVID-19 in hospitalized patients.

Hydroxychloroquine recently gained a large amount of attention after President Donald Trump mentioned the anti-arthritis and anti-malaria drug in his March 20 press conference as being promising. Since then, there has been much discussion as to whether the drug is actually effective in treating COVID-19.

Dr. Marcus Zervos is an infectious disease specialist at Henry Ford. He says staff at Henry Ford has been using hydroxychloroquine to treat the most severe cases of COVID-19 in hospitalized patients.

“We are not using it in outpatients, we're not using it in patients with mild infection, we are using it, however, in patients that are sick enough to be hospitalized with pneumonia that we feel are at risk of progressing their infection.” He adds, “We feel that there is data both from the early published studies as well as from our colleagues in China that have treated a number of patients to justify its use in the therapy of sicker patients that are hospitalized with coronavirus infection.”

Dr. Zervos says the goal of using hydroxychloroquine is to prevent patients with symptoms like shortness of breath and pneumonia from progressing further in their illness, and to get those patients already in an intensive care unit and on a ventilator off the ventilator earlier and out of the hospital.

“What we know about the drug now is that it does reduce viral shedding, you know, the amount of virus a person has, it’s lower. There have been studies from China to show that patients have shorter hospitalizations, fewer complications, lower likelihood of progression.”

He’s quick to mention, however that hydroxychloroquine is not the end-all-be-all or a miracle cure: doctors are using it because they think the benefits outweigh the risks.

“I don’t want to give the idea that hydroxychloroquine is the only treatment, or is going to be some sort of a miracle cure. Really, that still has to be looked at in a formal, clinical trial, we still need more data,” he says. “We are in a very difficult situation right now where we have to do our best to do whatever we can to prevent complications and prevent patients from going into intensive care units and death. We feel this is an important option, but there may be other options that are better, that are able to address the issue.”

Zervos also mentioned the use of hydroxychloroquine in combination with the drug azithromycin and the antibiotic doxycycline.

“One of the reasons that the virus can be so deadly is it activates the immune system, there’s an overreaction of the immune system, and the azithromycin might also help to reduce some of that overactivity of the immune system which is another mechanism by which the hydroxychloroquine works."

He says Henry Ford has been using both combinations of hydroxychloroquine with azithromycin and with doxycycline because there appears to be fewer side effects with the combinations of drugs.

Clinical trials allow researchers and doctors to observe side effects and overall effectiveness of a treatment. Since hydroxychloroquine has been around for awhile as a treatment for arthritis, malaria, and lupus, researchers have a general idea of what the side effects are. One of those side effects is cardiac issues, which is one of the reasons only hospitalized patients have been given the drug, so doctors can monitor their heart activity. Zervos says this illustrates the necessity for a formal, clinical trial to be done on hydroxychloroquine as treatment for COVID-19, but acknowledges the urgency of the situation.

“In the absence of a formal clinical trial, the next best evidence would be clinical experience and how people do when they get one treatment or another… the potential benefit of keeping someone out of an intensive care unit, getting them out of the hospital earlier, reducing mortality, we feel far outweighs any potential risk.”

A national trial examining the effectiveness of hydroxychloroquine is underway.

Editor's note: Henry Ford Health System is one of Michigan Radio's corporate sponsors.

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