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Hydroxychloroquine, Used Early, Is the Most-Effective COVID-19 Treatment, and Is Likely Much Better Given Supplemental Zinc

On July 1st the Henry Ford Health System showed that hydroxychloroquine is safe and much-more effective than remdesivir or dexamethasone, even without supplemental zinc.

James Anthony
July 30, 2020

Years ago a kindly mentor of mine, a chemical engineer, abruptly retired, and very-seriously advised me to never just trust that a doctor’s advice is correct. These are words to live by. 

Hydroxychloroquine is the best-available treatment

A peer-reviewed retrospective Henry Ford Health System study published online July 1st showed highly-promising results from treating COVID-19 with hydroxychloroquine [1]

Safety of hydroxychloroquine in hospital use was demonstrated by the study. Patients were treated consecutively in multiple hospitals using standardized guidelines that included a QTc interval-based algorithm designed to ensure safe use of hydroxychloroquine. The records of hydroxychloroquine-treated patients who died were reviewed, and major cardiac arrythmias were not seen in any of these patients. 

Efficacy of hydroxychloroquine was also demonstrated. The study provided internal results comparing 190 COVID-19 patients who were given hydroxychloroquine to an exactly-matched 190 COVID-19 patients who were not given hydroxychloroquine. In this face-off, hydroxychloroquine was associated with a mortality hazard decrease of 51%. 

This level of efficacy placed hydroxychloroquine at the top of the elite tier of effective COVID-19 treatments. 

Antiviral generic hydroxychloroquine, in this study started a median of 1 day after hospital admission, is the most effective, with a 28-day mortality hazard decrease of 51%. Antiviral branded remdesivir, started a median of 9 days after symptom onset, is the least effective, with a 14-day mortality hazard decrease of 26% [2]. The steroid generic dexamethasone, started on patients who were on ventilators, is of intermediate effectiveness, with a risk-adjusted 28-day mortality hazard decrease of 35% [3]

The earlier-stage antiviral treatments hydroxychloroquine and remdisivir have the advantage of also reducing disease progression and associated damage. 

Even better, hydroxychloroquine, already the most effective, also has huge potential to be used even-more effectively. 

Hydroxychloroquine plus zinc: better together

COVID-19 is an RNA virus. RNA viruses get reproduced by the host’s cells. RNA virus reproduction is reduced when zinc ions are present in adequate concentrations in cells. Zinc ions become present at much-higher concentrations in cells when ionophores like hydroxychloroquine transport zinc ions through the cell membrane [4]

At the hydroxychloroquine and zinc concentrations that are the most effective, the zinc ions are present at large enough concentrations that the treatment’s effectiveness depends almost entirely on the hydroxychloroquine concentration [5]. The more hydroxychloroquine, the more zinc ions make it into cells. Meanwhile when more zinc ions are present outside cells, hardly any more zinc makes it into cells. 

At hydroxychloroquine and zinc concentrations that are less effective, the zinc ion concentrations outside cells matter too, and need to reach a suitable threshold value like the recommended-minimum zinc level. 

But the recommended-minimum zinc level isn’t present in large numbers of US adults as they grow older. The Henry Ford Health System study’s exactly-matched patients had a median age of 65. When studied in the US in 1988–1994, the percentage of adults of ages 51-70 who had adequate zinc intake was just 51% [6]

Remember, the Henry Ford Health System study’s exactly-matched patients who were treated with hydroxychloroquine, without supplemental zinc, experienced a mortality hazard decrease of 51%. And the percentage of US adults the same ages who had adequate zinc intake was that same 51%. 

Imagine that. 

Each patient gets just one chance at life

It’s hard to know what hydroxychloroquine researchers have been thinking, since zinc isn’t mentioned once in much high-potential work, for example the Didier Raoult group study [7], the Henry Ford Health System study [1], and the WHO Solidarity trial [8]—in the WHO’s case, in spite of timely, direct, clear, persuasive advice [9]

Hydroxychloroquine does have at least six putative antiviral mechanisms [10]. Researchers may imagine that it’s best to not focus on just one mechanism, or that it’s best to control just one variable at a time.

What’s best for patients, though, is way different. Patients get just one chance at life. They need to take the absolute-best shot from the start.  

Treating a lethal virus with antivirals is like treating cancer: the key is early detection and prompt best-available treatment. 

Early detection of SARS-CoV-2 virus and COVID-19 disease is now very feasible. 

The best-available treatment—safe and effective, legal, available, affordable hydroxychloroquine plus zinc—is also very feasible, and can be started promptly. 

Months after my mentor advised me to never just trust a doctor’s advice, he was dead from cancer. Take his advice. 

Trust, but verify. 


  1. Arshad, Samia, et al. “Treatment with Hydroxychloroquine, Azithromycin, and Combination in Patients Hospitalized with COVID-19.” International Journal of Infectious Diseases, vol. 97, 1 July 2020, pp. 396-403. 
  2. Beigel, John H., et al. “Remdesivir for the Treatment of Covid-19 — Preliminary Report.” The New England Journal of Medicine, 22 May 2020. 
  3. Horby, Peter, et al. “Effect of Dexamethasone in Hospitalized Patients with COVID-19 – Preliminary Report.” 22 June 2020. 
  4. Shittu, Mujeeb Olushola, and Olufemi Ifeoluwa Afolami. “Improving the Efficacy of Chloroquine and Hydroxychloroquine against SARS-CoV-2 May Require Zinc Additives-A Better Synergy for Future COVID-19 Clinical Trials.” Le Infezioni in Medicina, vol. 28, no. 2, 2020, pp. 192-7.
  5. Xue, Jing, et al. “Chloroquine Is a Zinc Ionophore.” PLOS ONE, vol. 9, no. 10, 2014, e109180.
  6. Briefel, Ronette R., et al. “Zinc Intake of the U.S. Population: Findings from the Third National Health and Nutrition Examination Survey, 1988–1994.” The Journal of Nutrition, vol. 130, no. 5, 2000, pp. 1367S-73S.
  7. Gautret, Philippe, et al. “Clinical and Microbiological Effect of a Combination of Hydroxychloroquine and Azithromycin in 80 COVID-19 Patients with at Least a Six-Day Follow Up: A Pilot Observational Study.” Travel Medicine and Infectious Disease, 2020, 101663.
  8. “’Solidarity’ Clinical Trial for COVID-19 Treatments.” WHO.int, 6 July 2020, www.who.int/emergencies/diseases/novel-coronavirus-2019/global-research-on-novel-coronavirus-2019-ncov/solidarity-clinical-trial-for-covid-19-treatments. Accessed 30 July 2020. 
  9. Derwand, R., and M. Scholz. “Does Zinc Supplementation Enhance the Clinical Efficacy of Chloroquine/Hydroxychloroquine to Win Today’s Battle against COVID-19?” Medical Hypotheses, vol. 142, 2020, 109815.
  10. Noël, François, and Jaderson Lima. “Pharmacological Aspects and Clues for the Rational Use of Chloroquine/Hydroxychloroquine Facing the Therapeutic Challenges of COVID-19 Pandemic.” Latin American Journal of Clinical Sciences and Medical Technology, vol. 2, 2020, pp. 28-34.

James Anthony is a chemical engineer with a master’s in mechanical engineering, and author of The Constitution Needs a Good Party: Good Government Comes from Good Boundaries, and rConstitution Papers: Offsetting Powers Secure Our Rights


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