Paris (AFP)

Banned by some countries, promoted by others: the planet is more than ever divided on the use of hydroxychloroquine to treat the new coronavirus since the publication of a contested study judging the molecule ineffective, even harmful.

The study, published May 22 in the scientific journal The Lancet, concludes that hydroxychloroquine (HCQ), derived from the antimalarial chloroquine, is not effective against Covid-19 and that it even increases the risk of death and arrhythmia.

Its methodology, however, has been called into question by part of the scientific community, as had the methodologies of previous studies praising its effectiveness.

- Banned by certain countries ... -

The study pushed many countries to stop using the molecule, foremost among them France.

Other countries, such as Italy, Egypt, Tunisia, Colombia, Chile, El Salvador, Cape Verde, Albania or Bosnia and Herzegovina, have also suspended prescribing HCQ to patients Covid-19. In Italy, however, its administration remains possible in the context of clinical trials.

For its part, Hungary no longer uses the molecule "for new patients", while continuing the treatment of "those who had already started taking it", according to a government spokesperson.

Some countries had already stopped prescribing HCQ to Covid-19 patients before the study. Sweden, which used it in the hospital to treat severe forms of the disease, stopped in late April after the European Medicines Agency recommended that it only be used in clinical trials.

The German government also believes that "current studies do not currently allow the ordinary treatment of patients with Covid-19 with chloroquine or hydroxychloroquine, outside of clinical trials".

- ... promoted by others -

Many countries, on the contrary, praise the efficacy of hydroxychloroquine and do not wish to do without it.

This is the case of Brazil, Algeria, Morocco, Turkey, Jordan, Thailand, Romania, Portugal, Kenya, Senegal, Chad and Congo-Brazzaville.

"We have treated thousands of cases with this drug with great success to date. And we have not noticed any adverse reactions," said doctor Mohamed Bekkat, member of the Scientific Monitoring Committee of the AFP. evolution of the pandemic in Algeria. According to him, the study published in The Lancet "is confusing" because it "seems to concern serious cases for which hydroxychloroquine is of no help", while the molecule "has proved effective when it is used early ".

Russia, Bahrain, the Sultanate of Oman and the United Arab Emirates have not yet suspended its use. In Iran, messages recently posted on social networks by patients show that the molecule continues to be prescribed there.

India and Venezuela continue to use prophylaxis (preventive) with hydroxychloroquine. Indian health authorities claim to have detected "no major side effects".

For its part, Cuba continues to use the HCQ but will revise its protocols to introduce additional precautions.

In the United States, hydroxychloroquine can in principle be administered to Covid-19 patients only in the hospital, but the drug agency (FDA) warned in April against risks of cardiac arrhythmia. A fervent defender of the molecule, President Donald Trump assured that he was taking it daily as a preventive measure, before announcing shortly after the publication of the Lancet study that he had stopped.

The White House nevertheless announced Sunday the sending to Brazil two million doses of hydroxychloroquine to fight against the cornavirus.

- Suspended clinical trials ... -

The Lancet article caused the suspension of numerous clinical trials, starting with the hydroxychloroquine arm of the Solidarity (WHO) and Discovery (Europe, coordinated by Inserm) programs, which stopped including new patients.

The international trial Copcov administering doses of HCQ to members of the nursing staff in contact with the coronavirus was also suspended, two trials carried out by the university clinic in Tübingen (Germany) and five trials in Denmark. Mali also said it was ready to suspend its clinical trials.

- ... other tests maintained -

But other trials are continuing, such as Recovery (United Kingdom). Based on their own mortality data, officials say there is "no compelling reason to suspend recruitment for security reasons".

Other trials in Canada, Nigeria and Mexico are also continuing.

"There is data to prove that hydroxychloroquine has worked for many patients. This is why we will continue," said Professor Mojisola Adeyeye, who heads the drug agency in Nigeria.

In China, the cradle of the pandemic, the HCQ remains only used in clinical trials, but its effectiveness, judged promising in early February by the University of Wuhan, is now questioned by a renowned hospital in Shanghai.

© 2020 AFP