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Covid 19. Latest news on Hydroxychloroquine Treatment

There has been much controversy over the effectiveness of hydroxychloroquine as a treatment for Covid 19.  The story was confused after two publications that not only showed that HCQ was ineffective, but may even be more dangerous than no treatment at all.  Both of these papers were published in well respected, peer reviewed journals, The Lancet (United Kingdom) and the New England Journal of Medicine (United States).  Based on these studies, the World Health Organization (WHO) and many countries stopped the use of HCQ.  However, since that time, both journals have RETRACTED the publication due to errors and presentation of data that were deemed misleading.

However, more recently another publication has shown convincing and verified data that strongly suggest that HCQ is very effective against covid 19 if prescribed at the right time in the right dose.

Retractions

The two retracted studies were published in the Lancet and the New England Journal of Medicine.

Due concerns regarding the paper after the publications, the editors of the journals requested more detailed information from the authors.  The Lancet editors stated “The study was withdrawn because the company that provided data would not provide full access to the information for a third-party peer review, saying to do so would violate client agreements and confidentiality requirements.”

The reviewers were unable to conduct “an independent and private peer review” and withdrew from the process, The Lancet said.

Similarly, the NEJM stated “because all the authors were not granted access to the raw data and the raw data could not be made available to a third-party auditor, we are unable to validate the primary data sources underlying our article, “Cardiovascular Disease, Drug Therapy, and Mortality in Covid-19.”1 We therefore request that the article be retracted. We apologize to the editors and to readers of the Journal for the difficulties that this has caused.

https://www.nejm.org/doi/full/10.1056/NEJMoa2007621

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)31180-6/fulltext

This means that the articles that lead to the announcement that hydroxychloroquine was ineffective could not be verified making the results highly questionable.

Fortunately, another publication was soon published and has withstood investigation

ACCEPTED PUBLICATION – Positive Results

https://www.ijidonline.com/article/S1201-9712(20)30534-8/fulltext

A team of physicians had their publication accepted by the Journal of Infectious Disease in June.  Their study including 2514 covid 19 infected patients showed that HCQ significantly reduced the mortality rate.  The mortality rate without treatment was 26.4%.  The mortality rate with HCQ was 18.1%  These results were statistically significant.

All patients were in the Henry Ford Health System in Detroit, Michigan.  All patients were hospitalized through the emergency department.  All patients were over the age of 18.  HCQ was given beginning on day 1 of admission.  The majority of patients had body mass index values >30.

There were actually 4 groups of patients.  A group that received no mediation, received HCQ alone, received azithromycin (AZM) alone  or HCQ + AZM.  AZM is antibiotic that is used to treat a variety of infections and has been suggested as a covid 19 treatment.

The following table summarizes the number of patients and their comorbidities fot each treatment group vs NO treatment.

 HCQ vs No TreatmentAZM vs No TreatmentHCQ+AZM vs No Treatment
Hazard Ratio.3401.05.294

Treatment with HCQ reduced the chance of death by 66% and the use of HCQ+AZM reduced the chance of death by 71% compared to no treatment.  AZM alone slightly increased the risk of death.

This is in direct contrast to the two retracted publications and indicate that the early use of HCQ may be an effective method to reduce fatalities, even in patients with comorbidities and high body mass index.

The study needs to be repeated in a larger number of hospitals.  It is not known if HCQ will prevent infection if taken prior to infection or if covid 19 will increase recovery rates in patients that do not die.

There is still research that must be done, but this is an important finding that provides another treatment against covid 19 fatalities.

 

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