Laura Ng, who is suffering from lupus and recently had to call at least five pharmacies before she could find a place to fill her hydroxy-chloroquine prescription, photographed in Seattle, Washington, USA, March 31, 2020. REUTERS / Lindsey Wasson
(Reuters) – Large hospitals in New York, Louisiana and other areas hardest hit by coronavirus outbreaks routinely use hydroxychloroquine in patients treated in hospitals with COVID-19, despite strong evidence about whether it works some weeks, if not a few more months.
Hydroxychloroquine is a treatment for malaria and autoimmune diseases that has been used since the 1950s. Chloroquine related drugs have been used for longer, but are considered less safe. Medications can have serious side effects, including vision loss, heart problems or even death, if used incorrectly. Below is an example of how some hospitals use therapy:
NORTHWELL HEALTH, NEW YORK: The 23 hospital health care system began in late March to routinely use hydroxychloroquine in patients treated with deadly respiratory diseases caused by viruses, according to Dr. Kevin Tracey, chief executive of the Northwell research arm. This is based on preliminary data that “it might be beneficial,” said Pharmacy Pharmacy Chief Onisis Stefas. Hydroxychloroquine is given to patients who “really have no other choice,” and do not yet qualify for clinical trials of other potential coronavirus treatments, he said. Northwell also allows doctors to prescribe it along with azithromycin antibiotics on a case-by-case basis, but that is not a standard of care.
NYU LANGONE HEALTH, NEW YORK: NYU has been giving medicines to patients since early March, according to Dr. Michael Belmont, a rheumatologist. Some doctors at NYU also prescribe azithromycin in combination with hydroxychloroquine, although Belmont said the medical literature he saw was “not enough to draw the conclusion that this combination is very effective.”
CALIFORNIA UNIVERSITY, MEDICAL CENTER LOS ANGELES CENTER: UCLA has advised doctors since mid-March to consider hydroxychloroquine for COVID-19 patients who are seriously ill. “Our recommendations are based on restrictions on use, enabling it as a type of Hail Mary treatment for very ill patients,” Dr. Otto Yang, an infectious disease specialist.
WASHINGTON MEDICINE UNIVERSITY: The hospital system recommends that seriously ill patients should be prescribed hydroxychloroquine if they do not qualify for the trial of remdesivir, an experimental antiviral therapy developed by Gilead Sciences Inc. Gilead earlier this month put loving access to use remdesivir on hold because of extraordinary requests. Health system care guidelines warn that the combination of azithromycin and hydroxychloroquine “has not been thoroughly studied; it is not known whether it provides additional benefits. This combination can cause significant cardiac toxicity. ”
OCHSNER MEDICAL CENTER, LOUISIANA: The largest hospital system in Louisiana prescribes hydroxychloroquine extensively, according to its chief medical officer, Dr. Robert Hart. “We have been using this since the beginning of the outbreak to see if this helps,” he said.
LAHEY HOSPITAL & MEDICAL CENTER, MASSACHUSETTS: The hospital system began using hydroxychloroquine around March 27 for inpatient care for COVID-19 patients whose oxygen levels dropped below a certain level and which had risk factors for severe disease. The system protocol takes into account the patient’s heart history and does not recommend combining hydroxychloroquine with azithromycin because of the increased risk of heart problems.
Reporting by Michael Erman in New York and Deena Beasley in Los Angeles; Editing by Michele Gershberg and Bill Berkrot
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