Bunda Thamrin and Murni Teguh Hospital Medan

Approach to USD 210.000

Wellcome Trust

Oxford University (UK) , Mahidol University (Thailand), Mahidol Oxford Tropical Medicine Research Unit (Thailand), Aga Khan University (Pakistan), Institut National de Santé Publique (Côte d’Ivoire), University of Zambia School of Medicine (Zambia), University of Abomey-Calavi (Benin), Patan Academy of Health Science (Nepal)

As of writing, the novel betacoronavirus SARS-CoV-2 has infected more than 80,000,000 individuals, killed more than 1,800,000 people and has spread globally. The main mode of transmission of COVID-19 is respiratory droplet spread, but spread by direct contact also occurs with the finding of SARS-CoV-2 in faeces, an oral faecal route of transmission is also possible. There is no proven effective prophylaxis, and no widely available proven effective antiviral treatment.

We hypothesise that chloroquine and hydroxychloroquine might both slow viral replication in exposed participants, attenuating or preventing the infection even if they are shown not to work in treatment or in post-exposure prophylaxis. It is a basic principle of infectious diseases that preventing an infection developing (i.e., preventing pathogen multiplication) requires less drug activity (I.e. lower doses or a less active drug) than treatment. In COVID-19 illness the total viral burden is highest at the time of initial illness. Viral burdens are often reduced by the time of hospitalization in COVID-19 so that the window of opportunity for antiviral medicines is at the earliest stages of infection. In addition, in vitro studies show the greatest activity of chloroquine and hydroxychloroquine at the initial time of cellular infection and decrease in vitro antiviral effects if the drug is exposed at later time points. We believe these drugs may have their greatest utility in preventing COVID-19 in pre-exposure prophylaxis.

Under Analysis