Thread by @Gurdur

1/n This is my first thread collecting information on the use of #chloroquine, #hydroxychloroquine & similar against #COVID19. First of all, a review paper:
sciencedirect.com/science/articl…
It's a murky situation. Nothing known for sure yet. Note difference between in vitro & in vivo

2/ There are a great many efforts to find medications useful in treatment of severe #COVID19; the ones named here are only some of the ones currently being tried or in formal trials. Note the attempt with protease inhibitors (Kaletra) too.
jstage.jst.go.jp/article/ddt/14…

3/ There is a good deal of enthusiasm among some medicos & researchers for the use of chloroquine or hydroxychloroquine against #COVID19; caution: in vitro efficacy does not necessarily mean in vivo efficacy. Odd things can happen in vivo.
sciencedirect.com/science/articl…

4/ There is *much* enthusiasm for the use of chloroquine or hydroxychloroquine in clinical settings against #COVID19; caution: one has to say as yet not proven beyond all doubt. But quite a few efforts *already done clinically* (in China).
rs.yiigle.com/yufabiao/11823…

5/ There is a *lot* of this, regarding the use of #chloroquine or #hydroxychloroquine in clinical settings against #COVID19; caution: one has to say as yet not proven beyond all doubt, nor with long-term studies.
jstage.jst.go.jp/article/bst/ad…

6/ There are at least ten clinical trials, of use of #chloroquine or #hydroxychloroquine in clinical settings against #COVID19, going on right at the moment. Those meds seem to block "viral entry into the host cell".
nature.com/articles/d4158…

7/ Many questions. Cytokine storm may be a factor in v severe or critical #COVID19, but corticosteroids *before* hyperinflammation often considered a bad idea. #Chloroquine & #hydroxychloroquine not only anti-certain pathogens, but also anti-inflammatories
thelancet.com/pb-assets/Lanc…

8/ There was a silly tweet about a breakthrough in #SouthKorea, using #hydroxychloroquine against #COVID19. That tweeter (@/paulsperry_) is a dishonest one, so I looked around & found this myself.
koreabiomed.com/news/articleVi…

9/ Questions, questions. Of interest is that #chloroquine & #hydroxychloroquine *also* (among many other effects) seem to help uptake of zinc — which may well help against infections, including against #COVID19. So if you do these, do some zinc too?!
journals.plos.org/plosone/articl…

10/ If #chloroquine & #hydroxychloroquine are #zinc-ionophores (as above), then the below becomes very pertinent. Effect of zinc in inhibiting RNA polymerase activity in vitro, & inhibiting replication of viruses like a #coronavirus in cell cultures:
journals.plos.org/plospathogens/…

11/ As I said before, in vitro doesn't necessarily mean in vivo. But South Korea already officially recommends it in treatment.

https://twitter.com/DrAiLynTan/status/1238869215723077632

12/ A very good SPIEGEL article - in English - on various medications being used against #COVID19, including of course chloroquine etc., with good discussion of the pros, cons, doubts and questions.
spiegel.de/international/…

13/ small sub-thread with @irene_tosetti discussing preliminary in-vivo results from one of the Chinese clinical trials, press conference March 7th, 2020, at Sun Yat-sen University, of #chloroquine in treatment of #COVID19.

https://twitter.com/irene_tosetti/status/1237390780500561920

14/ A good thread discussing a very recent Chinese randomized trial of just #hydroxychloroquine by itself against acute #COVID19. tl:dr: results good; not dramatic, and small-group size, but good. Preprint of study only available, so be cautious.

https://twitter.com/GaetanBurgio/status/1244763937830088706