The Combined Hydroxychloroquine Zinc COVID-19 Treatment Buzz - A Misunderstanding and/or Misinterpretation of Science.

The talk of the effectiveness of hydroxychloroquine in treatment of COVID-19 is often advocated for by those physicians who use it in combination with Zinc (a common nutritional supplement). Many studies, including a recent report by Horbym and Landray (2020), however have indicated that hydroxychloroquine has not been shown to be effective in treatment of COVID-19. The question then is, on what grounds are those claiming hydroxychloroquine being effective in treatment of coronavirus infection emanating from?

Advocates of effectiveness of hydroxychloroquine claim that evidence is obtained from their practical clinical practices. They use hydroxychloroquine in combination with zinc and have witnessed a hands on life-saving experience, attributing treatment success to hydroxychloroquine. However, are these assertions true? Apparently yes - a combination of hydroxychloroquine and zinc is believed to be effective in treating COVID-19, but of the two entities, the main player in the treatment process is not hydroxychloroquine, but zinc. Hydroxychloroquine is known to play a facilitating role, as noted by Nyandat (2020), that “Much of what makes Hydroxychloroquine effective in combination with Zinc is believed to be its Zinc Ionophore capability. That is, the ability for Hydroxychloroquine to transport Zinc into cells and inhibit viral replication.” A study by Carlucci and others (2020),  comparing hydroxychloroquine and azithromycin plus zinc versus hydroxychloroquine and azithromycin alone, may also help to explain the therapeutic effectiveness where zinc (Zn2+) is present. In any case, while evidence of  plausible effect-inducing mechanism/mode of action for zinc in the prophylaxis or treatent of COVID-19 has been documented or demonstrated (Wessels, Rolles & Rink, 2020 and Kumar et al., 2020), there has been no evidence or documentation of a plausible effect-inducing mechanism of action in hydroxycloroquine or chloroquine.

However, in view of the potential risk of side effects associated with  hydroxychloroquine, it’s zinc-ionophore capability role can be replaced by alternative zinc ionophores such as hinokitiol or pyrithione to enable use of zinc for prophylactic and therapeutic  purposes against COVID-19, Nyandat (2020) and Wessels, Rolles & Rink (2020).

Take Home Message:

Attributing hydroxychloroquine to effectiveness of prophylaxis or treatment of COVID-19 in a combined hydroxychloroquine and zinc protocol is a misunderstanding and/or misinterpretation of science

While there is ample evidence of  plausible effect-inducing mechanisms/modes of action for zinc in the prophylaxis or treatment of COVID-19, there appears to be no evidence or documentation of a plausible effect-inducing mechanisms of action in hydroxycloroquine or chloroquine, in the treatment of COVID-19.

The food as medicine (nutritional supplement) intervention approach has been shown to play an effective role  in prophylaxis or treatment  of COVID-19 and other respiratory viral infections, in contrast  to the  hydroxycloroquine, chloroquine or azithromycin  prescription drugs.


References

Carlucci, P, Ahuja, T, Petrilli, C.M. Rajagopalan, H. Jones, S. and Rahimian, J (2020). Hydroxychloroquine and azithromycin plus zinc vs hydroxychloroquine and azithromycin alone: outcomes in hospitalized COVID-19 patients. COVID-19 SARS-CoV-2 preprints from medRxiv and bioRxiv. Available at: https://www.medrxiv.org/content/10.1101/2020.05.02.20080036v1

Horbym P and Landray, M (2020). No clinical benefit from use of hydroxychloroquine in hospitalised patients with COVID-19. Statement from the Chief Investigators of the Randomised Evaluation of COVid-19 thERapY (RECOVERY) Trial on hydroxychloroquine, 5 June 2020. Available at: https://www.recoverytrial.net/files/hcq-recovery-statement-050620-final-002.pdf

Kumar, A., Kubota, Y., Chernov, M., & Kasuya, H. (2020). Potential role of zinc supplementation in prophylaxis and treatment of COVID-19. Medical hypotheses, 144, 109848. Advance online publication. https://doi.org/10.1016/j.mehy.2020.109848 

Nyandat, J (2020). The Japanese Alternative to Hydroxychloroquine: Zinc + Hinokitiol. Press Release. MarketWatch. Available at: https://www.marketwatch.com/press-release/the-japanese-alternative-to-hydroxychloroquine-zinc-hinokitiol-2020-06-09

Wessels, I., Rolles, B., and Rink, L (2020). The Potential Impact of Zinc Supplementation on COVID-19 Pathogenesis. Frontiers in Immunology. 11. 1712. 10.3389/fimmu.2020.01712. Available at: https://www.frontiersin.org/articles/10.3389/fimmu.2020.01712/full

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