OUTCOMES OF PRELIMINARY STUDY:
A preliminary study of 123 subjects covering all categories listed above resulted in 100% positive outcomes: Nil death, Nil relapse in symptomatic persons and total recovery with no relapse after 6 weeks lockdown, and asymptomatic persons.
TABLE 1: Designation of respondents
Study Protocol
|
Frequency
|
Inpatient
|
11
|
Outpatient
|
1
|
PEP
|
34
|
PrEP
|
76
|
ICU_Patient (Treated on Quinine i.v.)
|
1
|
Grand Total
|
123
|
As seen in Table 1, 62% of respondents took the 4-aminoquinolines prophylactically, and 27% were administered the drugs because of their contact with positive COVID-19 patients.
TABLE 2: Age of respondents
Age (Years)
|
Frequency
|
18-35
|
65
|
36-55
|
55
|
>55
|
3
|
Grand Total
|
123
|
From table two, 52.85% of the respondents were adults, while 2.4% were above 55 years.
TABLE 3: Gender of respondents
Gender
|
Frequency
|
Male
|
76
|
Female
|
34
|
Grand Total
|
123
|
Table 3 shows that 69% were males, while 31% were females.
TABLE 4 – LABORATORY TESTING FOR COVID-19:
CLASSIFICATION
|
LABORATORY TESTED (n)
|
NON-TESTED (n)
|
ONLINE TESTED - AWAITING LABORATORY TESTING (2)
|
PrEP
|
NIL
|
75
|
1
|
PEP
|
NIL
|
31
|
3
|
OutPatient (U.K. Nurse)
|
1
|
-
|
-
|
Inpatient / Isolation Center (Oyo State Isolation Center)
|
11
|
-
|
-
|
Critical Care / Ventilator Patient (Canada) *treated on Quinine Injection i.v.
|
1
|
-
|
-
|
TOTAL
|
13
|
106
|
4
|
TABLE 5– SYMPTOM OUTCOMES ASSESSMENT BEFORE AND AFTER USE OF CHLOROQUINE AND HYDROXYCHLOROQUINE FOR COVID-19 PROPHYLAXIS:
SYMPTOMS & TESTING STRATIFICATION
|
Number (n)
|
Comments - AFTER
|
SYMPTOMATIC, ONLINE TESTED, Awaiting Laboratory Test
|
3
|
General Public – Awaiting Laboratory Test for 3 weeks but now symptom-free
|
SYMPTOMATIC NOT LABORATORY TESTED
|
8
|
4 Frontline Workers, 4 Frontline Healthcare Workers. No Symptoms
|
SYMPTOMATIC, LABORATORY TESTED POSITIVE
|
13
|
1 inpatient in Canada, 1 Self Quarantined HCW in the UK, 11 Isolation Center inpatients in Nigeria. No Symptoms.
|
TOTAL
|
24
|
COVID-19 Free 100% NIL mortality NIL morbidity
|
TABLE 6– OUTCOMES OF PRE-EXPOSURE PROPHYLAXIS USING CHLOROQUINE / HYDROXYCHLOROQUINE FOR COVID-19 PRE EMPTIVE-THERAPY:
CATEGORY
|
PrEPPre Exposure Prophylaxis (n)
|
Post-Lockdown/6 weeks after
|
Comments
|
FRONTLINE HEALTHCARE WORKER FHCW
|
4
|
NIL SYMPTOMS
|
COVID-19 Free
|
HEALTHCARE WORKER HCW
|
2
|
NIL SYMPTOMS
|
COVID-19 Free
|
FRONTLINE WORKER FW
|
42
|
NIL SYMPTOMS
|
COVID-19 Free (22-man Cohort of Security men and 20 Bankers)
|
GENERAL PUBLIC /FAMILY MEMBERS
|
28
|
NIL SYMPTOMS
|
COVID-19 Free
|
TOTAL on PrEP
|
76
|
Post-PrEP Post-Lockdown Symptom-free after 6 weeks
|
TABLE 7– OUTCOMES OF POST EXPOSURE PROPHYLAXIS USING CHLOROQUINE / HYDROXYCHLOROQUINE FOR COVID-19 PROPHYLAXIS
CATEGORY
|
PEP Post Exposure Prophylaxis
|
Post-Lockdown/6 weeks after
|
Comments
|
FRONTLINE HEALTHCARE WORKER FHCW
|
3
|
NIL SYMPTOMS
|
COVID-19 Free (3 Isolation Center Staffers)
|
HEALTHCARE WORKER HCW
|
15
|
NIL SYMPTOMS
|
COVID-19 Free (15 Community Pharmacists)
|
FRONTLINE WORKER FW
|
-
|
-
|
-
|
GENERAL PUBLIC
|
16
|
NIL SYMPTOMS
|
COVID-19 Free
* 2 persons awaited Laboratory Testing after symptoms but are now symptom-free
|
TOTAL on PEP
|
34
|
Post-PEP Post-Lockdown Symptom-Free after 6 weeks
|
DISCUSSION
As of present, there is yet to be a validated and consensus treatment for COVID-19, and the treatment is mainly supportive. However, repurposed drugs with unique strengths, such as chloroquine and its analogue hydroxychloroquine, as well as quinine, from time immemorial have been largely touted as possessing anti-inflammatory and immunomodulatory properties, hence their use in the treatment of systemic lupus erythematosus (SLE) and other rheumatism[3]. As the mechanisms of action of the 4-aminoquinolines have been further elucidated, it is believed to distort the ACE2 receptor by altering glycan attachment, thereby preventing the attachment of SARS-COV2. It is also believed to decrease the pH of the cell, thereby inhibiting viral replication, altering the viral particle assemblage and stopping the cytokine storm [4], [5], [6]). Researchers have even reported both prophylactic and therapeutic advantages of CQ for SARS-CoV infection [7]. However, other researchers have reported in a retrospective study with no defined administration time that no evidence in the use of hydroxychloroquine either with or without azithromycin reduced the risk of a mechanical ventilator in patients hospitalized with COVID-19 [8].
[9] in an open-label nonrandomized clinical trial concluded that hydroxychloroquine showed a significant association with viral load reduction/disappearance in COVID-19 patients, and its effect is reinforced by azithromycin. In a randomized controlled trial in China of 62 patients who were positive for COVID-19 and hospitalized, Chen reported that 31 patients received hydroxychloroquine 400 mg per day, and the remaining 32 received a placebo. Chen concluded that pneumonia improved in 81% of patients compared to 55% of controls [10].
The LWI study protocols have undergone hypothesis testing among physicians, researchers, pharmacists and clinicians, with online debates on several professional health platforms.
The results in this preliminary study are based on preliminary data gathered from Physician-Patient recommendations of Prophylaxis using the 4-Aminoquinolines in COVID-19 Treatment and Prophylaxis. It also recognises some self-medicating individuals who took advantage of the non-prescription remedy.
The LWI study protocols are currently being used in Kaduna State, Bauchi State, and some other states in Nigeria. The unique thing about the Study Protocols, the 4-Aminoquinolines offer an end-to-end care in COVID-19, from CQ/HCQ in Pre and Post Exposure to Mild and Moderate COVID-19 and escalating into QUININE I.V. for Critical Care in COVID-19.