Chloroquine shows promise against COVID-19. Quinine? Not so much

The recent buzz surrounding chloroquine and hydroxychloroquine as potential treatments for COVID-19 has led some individuals to incorrectly assume that quinine shares the same therapeutic benefits. Consequently, there's been a suggestion floating around encouraging people to fight the virus using quinine from their medicine cabinets. This assumption is flawed. Despite their shared historical origins and similar-sounding names, these compounds are fundamentally different. There’s no concrete evidence to support the idea that quinine offers any benefit against COVID-19. Chloroquine and hydroxychloroquine, however, hold significant promise. Both drugs are traditionally used as antimalarials and for managing certain autoimmune disorders. Early case reports dating back to February indicated their potential effectiveness against COVID-19. Research suggests that chloroquine modifies the chemical environment of cells rather than directly targeting SARS-CoV-2. Since those initial reports, further studies have emerged, including more in vitro experiments, additional case reports, and a non-randomized clinical trial conducted in China. The Chinese trial demonstrated that all patients treated with chloroquine and azithromycin tested negative for the virus via PCR within seven days, compared to most patients in the control group who remained positive. However, the study wasn't randomized, and the sample was limited, so the findings shouldn't be considered conclusive. Persistent rumors claim that randomized trials scheduled for completion in April might confirm these drugs' efficacy in reducing mortality and shortening recovery times for severe cases. While the non-randomized trial results are intriguing, they can't replace the rigor of randomized controlled trials. These trials are still ongoing, and their outcomes will ultimately determine the drugs’ true potential. Countries such as South Korea and Japan, which face substantial numbers of cases, have authorized limited use of chloroquine and hydroxychloroquine for severe cases, prescribing 500 mg of chloroquine or 400 mg of hydroxychloroquine orally once daily. Reports from China indicate that the government is moving to establish these treatments as standard care. Meanwhile, U.S. medical authorities have been more cautious, advising doctors to wait for trial results before prescribing these drugs. Nevertheless, some American physicians have reportedly used chloroquine analogues to treat critical cases of COVID-19, according to the CDC. Unfortunately, not everyone is willing to wait for scientific validation. A series of hospitalizations due to chloroquine overdoses linked to improper use has occurred in Nigeria, and a couple in an unnamed U.S. state tragically died after ingesting chloroquine phosphate meant for aquariums. It remains unclear whether the deaths were caused by an adverse reaction, an overdose, contamination, or unrelated factors. Regardless, these incidents underscore the dangers of self-medicating without proper guidance. The President has shown enthusiasm for these drugs, particularly on social media, which may have contributed to shortages in some supply channels. Fortunately, global supplies are unlikely to be depleted anytime soon. Millions of people already use chloroquine daily for malaria, and companies like Bayer and Sanofi have pledged five million tablets. Other manufacturers, such as Teva and Mylan, have announced plans to boost production. It’s crucial to understand that if these drugs prove effective, they will primarily serve as treatments for patients already infected with COVID-19 who require urgent care. They might lower the fatality rate and ease pressure on healthcare resources like ventilators and ICU beds. However, they are unlikely to prevent most new infections, as the majority occur before symptoms manifest. For milder cases, which constitute the bulk of COVID-19 infections, these drugs may not be necessary unless supplies are abundant. Even under the most optimistic scenarios, where these drugs prove highly effective and become widely available, they will only play a supporting role in combating the pandemic. Stay informed about updates regarding chloroquine and related drugs. As for quinine, it’s fine to keep a stockpile, but only for enjoying classic gin and tonics—nothing more.

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