The following is a google translation from the original article published by IL TEMPO, April 28, 2020
"Out of 65,000 chronic patients (Lupus and Rheumatoid Arthritis), who systematically take Plaquenil / hydroxychloroquine, only 20 patients tested positive for the virus. Nobody died, nobody is in intensive care, according to the data collected so far."
IL TEMPO, April 28, 2020 - Coronavirus, svelato come agisce: ecco perché l'idrossiclorochina potrebbe funzionare
Coronavirus, revealed how it works: that's why hydroxychloroquine could work
Annalisa Chiusolo, a young pharmacology scholar, sensed the mechanism of action of Sars-Cov-2. By understanding this mechanism, the most effective contrast drugs can be targeted and carefully selected. Coronavirus would affect the ability of hemoglobin to transport oxygen, creating the underlying assumptions of the impulsive complications in the lung, unfortunately known: breathlessness, dyspnea, up to severe acute respiratory syndrome and death.
Theory is the first step in any verification. Science proceeds by refutations. If this thesis were confirmed, many unknowns would be explained, for example why Covid-19 affects more men, diabetics, and less women in general, and even less pregnant women, and very little children and thalassemia. The circle would close.
But let's get into the merits of the theory. The virus needs porphyrins for its survival, probably for its replication, therefore it attacks hemogloblin (the protein that carries oxygen in the blood), in particular the OFR10 and OFR3 proteins attack the beta chain and orf1ab subtracts porphyrin. The concepts seem a little abstruse, for a non-expert, but simplifying this translates into a lower availability of oxygen available to our body, with consequent accumulation of carbon dioxide. So the lung cells become distressed and become the site of the cytokine cascade - that is, a huge immune response - responsible for the acute inflammation that characterizes Covid-19 pneumonia. The hemoglobin value in the blood can be an important parameter for evaluating Sars-Cov2 infection: in men the normal value of Hb (hemoglobin) is higher than in women, which would explain the higher incidence of Covid pneumonia in men than to women, the lower incidence and the better prognosis in children and pregnant women, where the Hb values are lower due to an increased need for iron, which makes the "nourishment" of the virus less available. In elderly or middle-aged patients with diabetes, Covid pneumonia19 has a higher incidence, therefore linked to the increase in blood glucose Hb, and therefore there is greater "nourishment" for the virus.
Viral damage, therefore, is systemic, that is, it affects the blood and is not confined only to the lung. This would also explain the birth of healthy babies from positive Covid mothers. Because in fetal Hb - stay seated, we will now use some technical concepts, but let's go back immediately - the two beta chains are replaced by two gamma chains, a difference is the presence of a residue of serine, instead of a histidine present in the same position of the beta chain, probably responsible for the binding with viral proteins, which could mimic the action of 2,3bifosfoglicerato. Now you can get up, let's go back to using more understandable language. All this would explain the lower incidence and the best course of the pathology in infants, missing the main site of action of viral proteins, namely the beta chains of Hb, in short in infants the same concept of "nourishment is lacking ”For the coronavirus.
The same goes for a chronic disease called Beta-Thalassemia, where the "beta" chains of hemoglobin (the target of the virus) are deficient or even absent. This would demonstrate the lower incidence and better prognosis and course of the pathology in beta thalassemia, which in Italy are widespread in Mediterranean areas such as Puglia, Sicily and Sardinia (in particular in the southern area) where there is an equal rate of thalassemia at 12% (alpha and beta). To confirm this theory, there is a scientific publication that has linked subjects affected by beta thalassemia and Covid19, in the data taken from pubmed: as of 10 April 2020, 11 cases of positive Covid beta-thalassemia were recorded in Northern Italy, where the rate of contagiousness is higher: 10 of which have transfusion-dependent thalassemia, the most severe form, only one with non-transfusion-dependent thalassemia.
All patients who contracted the virus, however, had concomitant, very serious diseases: splenectomized, pulmonary hypertension, lymphoma and chemotherapy. Despite this multi-pathological picture, no death, no cytokine storm or severe Sars occurred in the 11 subjects. (HERE THE SOURCE)
Once the main mechanism of action of the virus has been revealed, many other things can be understood. For example, the central mechanism of action of hydroxychloroquine can now be explained and fully understood, and its effectiveness in countering Covid19. What this mechanism consists of is immediately said: the drug by binding permanently with ferriprotoporphyrin (of the Eme group of Hb) removes the substrate from viral proteins and also becomes an important means of prophylaxis. Although there are still no Italian publications on the effectiveness of hydroxychloroquine as a "shield" from the virus, among the directors of the infectious disease wards, the specialists, Primaries and general practitioners contacted during this research, many admitted - under a whisper - to use the drug as a "prophylaxis", that is, to prevent infection. Healthcare professionals who are in close contact with contagious patients take the drug in advance, precisely to decrease the probability of contracting the infection. For now, in support of this prophylaxis effect, there is a recent publication, involving 211 people. It was published in the International Journal of Antimicrobial Agents, the official body of the International Society of Antimicrobial Chemotherapy. Of 211 people exposed to Covid19 positive individuals and subjected to prophylaxis with hydroxychloroquine, none were infected.
Finally, further confirmation of this hypothesis are the data collected in the register of the SIR (Italian rheumatology society). To assess the possible correlations between chronic patients and Covid19, SIR interrogated 1,200 rheumatologists throughout Italy to collect statistics on infections.
Out of 65,000 chronic patients (Lupus and Rheumatoid Arthritis), who systematically take Plaquenil / hydroxychloroquine, only 20 patients tested positive for the virus. Nobody died, nobody is in intensive care, according to the data collected so far.
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SCIENCE DIRECT: Can post-exposure prophylaxis (PEP) for COVID-19 be considered as an outbreak response strategy in long-term care hospitals?
(It appears President Trump may have been administered hydroxychloroquine as "post-exposure prophylaxis")
In the context of the ongoing global outbreak of coronavirus disease 2019 (COVID-19), management of exposure events is a concern. Long-term care hospitals (LTCHs) are particularly vulnerable to cluster outbreaks because facilities for patient isolation and healthcare personnel to care for these patients in isolation are difficult to arrange in a large outbreak situation. Although several drugs have been proposed as treatment options, there are no data on the effectiveness and safety of post-exposure prophylaxis (PEP) for COVID-19. After a large COVID-19 exposure event in an LTCH in Korea, PEP using hydroxychloroquine (HCQ) was administered to 211 individuals, including 189 patients and 22 careworkers, whose baseline polymerase chain reaction (PCR) tests for COVID-19 were negative. PEP was completed in 184 (97.4%) patients and 21 (95.5%) careworkers without serious adverse events. At the end of 14 days of quarantine, all follow-up PCR tests were negative. Based on our experience, further clinical studies are recommended for COVID-19 PEP.
CONCLUSION: "In this study, PEP (post-exposure prophylaxis) with HCQ was implemented safely under proper monitoring and no additional patients were diagnosed with COVID-19. Randomized clinical studies are needed to evaluate whether PEP is an effective option for an outbreak response strategy against COVID-19 in LTCHs (Long-term care hospitals )."