Abridged Version of an Academic Article of Chloroquine Effect on Corona (with references)
How Chloroquine will act as a prophylactic drug and is acting as a therapeutic agent against COVID-19 infection and Why Trump is saying Chloroquine is a game changer in fight against the COVID-19.
Chloroquine acts on host target respiratory cells by:
(1) Chloroquine increases the pH required for the virus- host fusion. The Increase in the pH disrupts the normal viral function.
(2) In SARS-coronavirus, which is a sister to COVID-19, Chloroquine was found to interfere with the glycosylation of cellular receptors of the virus and resulted in the disassociation of the virus and the target cells in the body.
(3) Chloroquine increases the influx of zinc ions into the cytoplasm of host target cells regardless whether the host target cells are infected or not.
All the above-mentioned mechanism is on the host cells and COVID-19 cannot mutate and cause resistance to these 3 mechanisms.
Chloroquine results in disablement of ACE2 ( found on a host cell) which leads to the morphological change; This results in the disruption in the association between the COVID-19 and target host cell as COVID-19 requires ACE-2 receptor ( which is disabled by Chloroquine) to attach to a cell.
Because the action is on the target host cell, Chloroquine won’t develop resistance therapeutically. If a person uses Chloroquine as a prophylactic agent (500mg once in a week for adults and 8.3 mg per kg once in a week for children) against COVID-19 then, it will act pre-infection and post-infection.
Chloroquine mechanism “1” and mechanism “2” will prevent the union of virus-target host cell.
If some of the viruses enters the target host cell, there Zinc ions RNA polymerase enzyme of the virus and stops COVID-19 polymerization in the cell.
If COVID-19 mutates inside the cell several times, even then the Zinc ions will actively inhibit the viral multiplication inside the host respiratory cells, irrespective of the viral strain.
Chloroquine molecules will not lose its effect in an individual pre and post infection.
There are some concerns of its use in glucose-6-phosphate dehydrogenase enzyme deficient children but the recommended prophylactic and therapeutic doses, Chloroquine is safe to be used in these children. Some persons may complain of acidity and nausea, but it can be resolved if Chloroquine is taken post meal.
In these doses it will be effective against COVID-19 prophylaxis.
The treatment doses against COVID-19 as used in China, America and India are Chloroquine 500mg BD for 5 days with other anti-viral drugs like Oseltamivir, Lopinavir, Ritonavir etc. and in complicated COVID-19 pneumonia cases.
In India as it is a very cheap, safe and easily available drug and can be prescribed against the Malaria as a prophylactic drug.
It will surely work prophylactically against the COVID-19 outbreak and we can use this opportunity to prescribe it in larger amount as Malaria is endemic in India.
It will act on Malaria and COVID-19 infection prophylactically without it being included in the guidelines.
Trump’s excitement for Chloroquine in his announcement can be related with the fact that American researchers are currently working on the Chloroquine drug.
Hydroxychloroquine is less toxic but original Chinese work is based on Chloroquine phosphate. Hydroxychloroquine can be used with equal efficacy.
If one starts prophylactically with Chloroquine, then one must stick with Chloroquine and must not switch to Hydroxychloroquine and vice-versa. This switch may result in increase QT interval.
*REFERENCES*
Zhu N, Zhang D, Wang W et al. A novel coronavirus from patients with pneumonia in China, 2019. N Engl J Med 2020
Gao, J., Tian, Z. and Yang, X., 2020. Breakthrough: Chloroquine phosphate has shown apparent efficacy in treatment of COVID-19 associated pneumonia in clinical studies. BioScience Trends.
Vincent, M., Bergeron, E., Benjannet, S., Erickson, B., Rollin, P., Ksiazek, T., Seidah, N. and Nichol, S., 2005. Virology Journal, 2(1), p.69.
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