Coronaviruses (CoV) are positive-sense single-stranded RNA viruses that infect a wide range of hosts producing diseases ranging from the common cold to serious / fatal events. Nitazoxanide (NTZx) is a derivative of 5-nitrothiazole, synthesized in 1974 by Rosignol - Cavier. NTZx has powerful antiviral effects through the phosphorylation of protein kinase activated by double-stranded RNA, which leads to an increase in phosphorylated factor 2-alpha, an intracellular protein with antiviral effects. The purpose of this study is to contrast the beneficial effect of NTZx vs NTZx plus hydroxychloroquine in patients Coronavirus Disease (COVID-19) as well as against other treatments.
Introduction The current pandemic caused by the SARS-COV2 coronavirus (COVID-19) is
life-threatening and is challenging the world's best health systems. Accelerated spread of
this pandemia led physicians to try a variety of treatments without a well established
sequence due to ignorance about this new disease. The case fatality rate has been calculated
at 2.2% but there are differences depending on the country affected.
Perspective When comparing the evolution of cases between Spain and Mexico, an apparently
less pronounced trend is observed in Mexico, but this may be due to underdiagnosis. In
calculations by the Mexican Ministry of Health, around 6% of the patients (approximately
10,500) who contract COVID-19 could be found serious and in need of hospitalization in
intensive care.
NTZx NTZx and its circulating active metabolite, tizoxanide, inhibit the replication of a
wide range of viruses, both RNA and DNA. It has action against 16 strains of Influenza A
virus subtypes H1N1, H3N2, H3N2v, H3N8, H5N9, H7N1 and a strain of influenza B. It also works
against respiratory syncytial virus, norovirus, dengue, yellow fever, Japanese encephalitis
virus, rotavirus , hepatitis B and C, even against the human immunodeficiency virus (Severe
Acute Respiratory Syndrome (SARS) and Middle East respiratory syndrome (MERS).
Problem Mexico is in Phase 2 according to the World Health Organization (WHO) and more local
infections due to coronaviruses are expected. To date, various COVID-19 treatment schemes are
being tested, but the usefulness of none can be assured.
When reviewing the drug schemes that are being carried out in the world, it calls the
attention that developing countries are not included, beyond the fact that the tested
alternatives are economically inaccessible.
This clinical survey aims to test the possible utility of NTZx against COVID-19, alone or in
combination with hydroxychloroquine.
Drug: Nitazoxanide 500 MG
Clinical evaluation of patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) using this option with two drugs
Other Name: hydroxychloroquine
Drug: Hydroxychloroquine
Clinical evaluation of patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) using this option with one drug
Inclusion Criteria:
- COVID-19 positive patients
- Treated at the Health Institute of the State of Mexico (ISEM).
- With risk factors to get complicated: age more than 60 years old, diabetes mellitus or
obesity grade II or more.
Exclusion Criteria:
- Patients who have inherent contraindications to each drug.
Materno-Perinatal Hospital "Mónica Pretelini"
Toluca, Mexico