Treatment with Hydroxychloroquine Cut Death Rate Significantly in COVID-19 Patients

[jojo777]

My mother is 88 years old. She has AFIB, kidney stents a pace maker and high blood pressure. She contracted COVID-19 around April 1st. She took hydroxychloroquine for 5 days. What did she have to lose at 88. It took weeks, but she fully recovered. If I had to do it again, I certainly would and I would take it myself, if needed.

 

[Cornell]

My mother is 88 years old. She has AFIB, kidney stents a pace maker and high blood pressure. She contracted COVID-19 around April 1st. She took hydroxychloroquine for 5 days. What did she have to lose at 88. It took weeks, but she fully recovered. If I had to do it again, I certainly would and I would take it myself, if needed.

Awesome news for your family. Really awesome.

 

[DannyTS]

yeah .... it backfires .......... we will soon find out the WHO is part of the New World Order of Illuminati

View attachment 23031

https://www.bbc.com/news/technology-52833706

were we talking about Bill Gates? What kind of diversion is this?

 

[Mroze]

My mother is 88 years old. She has AFIB, kidney stents a pace maker and high blood pressure. She contracted COVID-19 around April 1st. She took hydroxychloroquine for 5 days. What did she have to lose at 88. It took weeks, but she fully recovered. If I had to do it again, I certainly would and I would take it myself, if needed.

So happy for you and may God bless your mother.

 

[Panina]

My mother is 88 years old. She has AFIB, kidney stents a pace maker and high blood pressure. She contracted COVID-19 around April 1st. She took hydroxychloroquine for 5 days. What did she have to lose at 88. It took weeks, but she fully recovered. If I had to do it again, I certainly would and I would take it myself, if needed.

So glad she is well. I would take it if needed too.

 

[bogey21]

My mother is 88 years old. She has AFIB, kidney stents a pace maker and high blood pressure. She contracted COVID-19 around April 1st. She took hydroxychloroquine for 5 days. What did she have to lose at 88. It took weeks, but she fully recovered. If I had to do it again, I certainly would and I would take it myself, if needed.

My guess is that using hydroxy is kind of a crap shoot. It may benefit some and do nothing for others. Someday science will catch up and we will have a definitive answer. Until then whether one uses it or not should be between them and their Doctor...

George

 

[T_R_Oglodyte]

Jumping back into this thread briefly.

My thought is that evaluation of protocols and responses should be based on reasoned analysis of available. That means applying high acceptance thresholds to anecdotal and uncontrolled evidence, with use of that information as suggestive of controlled observations, and excluding entirely ad hominem dismissals of information.

 

[easyrider]

Brazil's President used hydroxychloroquine to cure his covid 19 infection.

Bill

Brazil's president, infected with virus, touts malaria drug

Brazilian President Jair Bolsonaro, who said he is infected with the coronavirus, on Wednesday defended his government's handling of the pandemic that has killed tens of thousands of Brazilians and touted his use of a contentious anti-malaria drug

www.ctvnews.ca

“No country in the world did it like Brazil,” Bolsonaro said. “For those who root against hydroxychloroquine, but don't present alternatives, I regret to inform you that I'm very well with its use and, with God's grace, I will live for a long time still.”

 

[isisdave]

Some of my reading suggests that HCQ might be of some benefit, sometimes, for some people. But none of the reporting of positive outcomes that I've seen has ever mentioned the dose protocol or timing, or prescreening for long QTc.

The possible benefit I see most often is as a zinc ionophore. [Zinc in cells inhibits virus replication, but zinc doesn't go through cell walls easily. An "ionophore" helps the zinc ion get through.] And incidentally it doesn't seem to take much zinc. But this suggests to me that you'd have to give the ionophore (there are others too) and zinc before infection, or at least before viral replication gets seriously underway. This is harder when symptoms may not appear until days later.

The usual dosing for malaria prevention for adults is 400 mg once a week. For malaria treatment, it's 2000 mg over the first 48 hours only. For autoimmune diseases, it's often 200-400 mg per day. The initial reporting of some early studies (the ones with poor reported results) had much higher dose rates for at least one group.

If anyone's seen reporting that's more scientific or maybe even a pre-publication site on this, I'd like to hear about it. Thanks.

 

[csodjd]

I think the answer might be the mean age of those that were given only Hydroxychloroquine. That group had a mean age several years younger than the other groups;

only with Hydroxychloroquine:13% Mean age 53
with Hydroxychloroquine and azithromycin : 20.1% Mean age 64
only with azithromycin: 22.4% Mean age 68
not treated with either: 26.4% Mean age 71

We know that the mortality rate for those under 60 is substantially lower than those above 60 anyway. But the variation in the age of the groupings gives me pause.

Here's the link to the actual study https://www.ijidonline.com/article/S1201-9712(20)30534-8/fulltext

Absolutely correct. Also, patients were chosen to be placed into their respective treatment groups, the antithesis of randomized and creating a significant potential for selection bias. Of about 2400 patients, only a bit more than 100 were in the no-treatment group, so the cohorts were very unbalanced. In addition, HCQ patients were treated with steroids. Well, now we know, from a placebo controlled double blind randomized ("gold standard") study, that steroids reduced mortality. Thus, this Henry Ford study may have done nothing more than show us that older people die more, and people receiving steroids die less. HCQ may well have played no role whatsoever -- which is what two gold standard studies have concluded.

 

[DannyTS]

Absolutely correct. Also, patients were chosen to be placed into their respective treatment groups, the antithesis of randomized and creating a significant potential for selection bias. Of about 2400 patients, only a bit more than 100 were in the no-treatment group, so the cohorts were very unbalanced. In addition, HCQ patients were treated with steroids. Well, now we know, from a placebo controlled double blind randomized ("gold standard") study, that steroids reduced mortality. Thus, this Henry Ford study may have done nothing more than show us that older people die more, and people receiving steroids die less. HCQ may well have played no role whatsoever -- which is what two gold standard studies have concluded.

Absolutely incorrect, according to the study they used regression analysis to separate several factors and isolated the influence of HCQ :

"From Cox regression modeling, predictors of mortality were age>65 years (HR:2.6 [95% CI:1.9-3.3]), white race (HR:1.7 [95% CI:1.4-2.1]), CKD (HR:1.7 [95%CI:1.4-2.1]), reduced O2 saturation level on admission (HR:1.5 [95%CI:1.1-2.1]), and ventilator use during admission (HR: 2.2 [95%CI:1.4-3.3]). Hydroxychloroquine provided a 66% hazard ratio reduction, and hydroxychloroquine + azithromycin 71% compared to neither treatment (p < 0.001). "

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

Can you please point out what were the two "gold standard studies" you are referring to?

 

[csodjd]

Absolutely incorrect, according to the study they used regression analysis to separate several factors and isolated the influence of HCQ :

"From Cox regression modeling, predictors of mortality were age>65 years (HR:2.6 [95% CI:1.9-3.3]), white race (HR:1.7 [95% CI:1.4-2.1]), CKD (HR:1.7 [95%CI:1.4-2.1]), reduced O2 saturation level on admission (HR:1.5 [95%CI:1.1-2.1]), and ventilator use during admission (HR: 2.2 [95%CI:1.4-3.3]). Hydroxychloroquine provided a 66% hazard ratio reduction, and hydroxychloroquine + azithromycin 71% compared to neither treatment (p < 0.001). "

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

Can you please point out what were the two "gold standard studies" you are referring to?

The hazard ration reduction fails to take the other treatments given into account in this study. If you give the patients in the HCQ arm steroids, the study below shows it WILL reduce mortality. That poisons the conclusions of the study. In addition, because the treatment group was 20x the size of the "placebo" (no treatment) group, the hazard ratio calculations are not reliable. The no treatment group was too small.

And see this: https://www.statnews.com/2020/07/08...uses-attention-and-the-fda-may-pay-the-price/, stating, "The study that sparked the latest controversy was anything but randomized. Not only was it not randomized, outside experts noted, but patients who received hydroxychloroquine were also more likely to get steroids, which appear to help very sick patients with Covid-19. That is likely to have influenced the central finding of the Henry Ford study: that death rates were 50% lower among patients in hospitals treated with hydroxychloroquine."

In addition, the Henry Ford study results excluded more than 10% of the cohort because they were still in the hospital. Why were they still in the hospital? Because they were very sick but had not (yet) died? You cannot cut off a study and exclude the remaining "bad outcomes" before they occur and come to a valid conclusion.

Here are the two studies:

Remdesivir:
https://www.nejm.org/doi/full/10.1056/NEJMoa2007764

Dexamethasone:
https://www.medrxiv.org/content/10.1101/2020.06.22.20137273v1

In addition, every gold standard completed study on the effectiveness of HCQ has shown no difference between it and placebo. No gold standard study of HCQ has yet to be published or prepublished showing any efficacy for treatment or prevention. So, you can "absolutely incorrect" me all you want, but clinically and scientifically HCQ does not work according to all known credible science.

 

[DannyTS]

The hazard ration reduction fails to take the other treatments given into account in this study. If you give the patients in the HCQ arm steroids, the study below shows it WILL reduce mortality. That poisons the conclusions of the study. In addition, because the treatment group was 20x the size of the "placebo" (no treatment) group, the hazard ratio calculations are not reliable. The no treatment group was too small.

And see this: https://www.statnews.com/2020/07/08...uses-attention-and-the-fda-may-pay-the-price/, stating, "The study that sparked the latest controversy was anything but randomized. Not only was it not randomized, outside experts noted, but patients who received hydroxychloroquine were also more likely to get steroids, which appear to help very sick patients with Covid-19. That is likely to have influenced the central finding of the Henry Ford study: that death rates were 50% lower among patients in hospitals treated with hydroxychloroquine."

In addition, the Henry Ford study results excluded more than 10% of the cohort because they were still in the hospital. Why were they still in the hospital? Because they were very sick but had not (yet) died? You cannot cut off a study and exclude the remaining "bad outcomes" before they occur and come to a valid conclusion.

Here are the two studies:

Remdesivir:
https://www.nejm.org/doi/full/10.1056/NEJMoa2007764

Dexamethasone:
https://www.medrxiv.org/content/10.1101/2020.06.22.20137273v1

In addition, every gold standard completed study on the effectiveness of HCQ has shown no difference between it and placebo. No gold standard study of HCQ has yet to be published or prepublished showing any efficacy for treatment or prevention. So, you can "absolutely incorrect" me all you want, but clinically and scientifically HCQ does not work according to all known credible science.

It appears you are not very familiar with the regression analysis.
Try to read more from journalists that do not mention political figures in their articles several times if you want to get closer to the truth. The guy from Statnews (never heard of them before) does not even mention why Lancet withdrew the study, he makes it look like it is the same thing. This is journalism!

About the two "gold" standard studies you mention, they are not about hydroxychloroquine but about Dexamethasone and Remdesivir , you will probably want to reconsider that statement.

 

[csodjd]

It appears you are not very familiar with the regression analysis.
Try to read more from journalists that do not mention political figures in their articles several times if you want to get closer to the truth. The guy from Statnews (never heard of them before) does not even mention why Lancet withdrew the study, he makes it look like it is the same thing. This is journalism!

About the two "gold" standard studies you mention, they are not about hydroxychloroquine but about Dexamethasone and Remdesivir , you will probably want to reconsider that statement.

I really could care less about political figures. Whether Trump advocated for a drug or not doesn't affect the outcome of a quality clinical trial. Being 62 and at risk, nothing I'd love more than an effective treatment. I don't consider false hope an effective treatment, however.

Sorry. Try these. I gave you two studies showing things that DO work. Below are links to two that show something --HCQ -- that so far does not. Of course, you can have 100 studies showing something does NOT work and that's not proof it will never work under some as yet untested set of circumstances. But each clinical trial that fails to show efficacy, which so far is all of them, lends further credence to the hypothesis that HCQ is not effective against COVID-19 when bias is removed. The broader point is that the Henry Ford study is plainly flawed by the introduction of significant selection bias (no attempt at all to randomize and profoundly unbalanced cohorts) and, more importantly, the use of steroids in the HCQ patients and the elimination from the results of 10% of the sickest trial participants MOST likely to die (as evidenced by still being in the hospital).

https://www.nejm.org/doi/full/10.1056/NEJMoa2016638

No clinical benefit from use of hydroxychloroquine in hospitalised patients with COVID-19 — RECOVERY Trial

Statement from the Chief Investigators of the Randomised Evaluation of COVid-19 thERapY (RECOVERY) Trial on hydroxychloroquine, 5 June 2020

www.recoverytrial.net

See also https://www.recoverytrial.net/results

There is also this: https://www.nih.gov/news-events/news-releases/nih-halts-clinical-trial-hydroxychloroquine

And, yes, I understand regression analysis. I also know now to read a study critically, because I make clinical decisions that actually have an impact on real people based on those studies. I got something out of two doctorates, a bachelors in biology, and my 13 years of post-high school education.

 

[DannyTS]

You say that you do not care about the political figures but you quote from the article rather than the study itself . The journalist says that some patients were more likely to have received corticosteroids but that is nowhere in the study, it is just his conjecture.

So you are saying that the corticosteroids given to some patients (to reduce pain and inflammation) along with HCQ helped reduced the deaths by 71% or that the corticosteroids alone reduced them by 71%? Because ANY is great news if that is true. I am reading a study though about corticosteroids and it does not seem to hold too much water, not conclusive at all.

Efficacy and safety of corticosteroids in COVID-19 based on evidence for COVID-19, other coronavirus infections, influenza, community-acquired pneumonia and acute respiratory distress syndrome: a systematic review and meta-analysis

BACKGROUND: Very little direct evidence exists on use of corticosteroids in patients with coronavirus disease 2019 (COVID-19). Indirect evidence from related conditions must therefore inform inferences regarding benefits and harms. To support a guideline for managing COVID-19, we conducted...

www.cmaj.ca

Concerning your two doctorates, probably they also taught you not to talk about the efficiency of a drug when you look at two "gold standard" studies that have nothing to do with that drug. If I were you, I would have not mentioned them in this context. You said:

HCQ may well have played no role whatsoever -- which is what two gold standard studies have concluded.

then later:

Here are the two studies:

Remdesivir:
https://www.nejm.org/doi/full/10.1056/NEJMoa2007764

Dexamethasone:
https://www.medrxiv.org/content/10.1101/2020.06.22.20137273v1

 

[DannyTS]

interesting article about HCQ

Zerohedge

ZeroHedge - On a long enough timeline, the survival rate for everyone drops to zero

www.zerohedge.com

 

[Ralph Sir Edward]

Best treatment? Who knows, Ivermectin may be better. . . (And who know about the mix of both HCQ/Zinc and Ivermectin.

 

[MommaBear]

There are many reasons that hydrochloroquine is not a safe drug in the treatment of Covid 19 and until there are randomized double blinded peer reviewed studies that show differently, no one should use this off label. Many study arms wee stopped abruptly because it increased the rate of death.

Yes, interpreting medical studies and participating in clinical trials was part of my job for 40 years.

A flawed Covid-19 study gets the White House’s attention — and the FDA may pay the price

A new debate over whether to use hydroxychloroquine as a Covid-19 treatment is threatening to undermine the FDA's credibility when it needs it most.

www.statnews.com

https://www.google.com/url?sa=t&sou...FjAAegQIAxAB&usg=AOvVaw113igZOx_aVksBCV6fgQgh

[/URL]

 

[DannyTS]

There are many reasons that hydrochloroquine is not a safe drug in the treatment of Covid 19 and until there are randomized double blinded peer reviewed studies that show differently, no one should use this off label. Many study arms wee stopped abruptly because it increased the rate of death.

Yes, interpreting medical studies and participating in clinical trials was part of my job for 40 years.

A flawed Covid-19 study gets the White House’s attention — and the FDA may pay the price

A new debate over whether to use hydroxychloroquine as a Covid-19 treatment is threatening to undermine the FDA's credibility when it needs it most.

www.statnews.com

https://www.google.com/url?sa=t&sou...FjAAegQIAxAB&usg=AOvVaw113igZOx_aVksBCV6fgQgh

[/URL]

If you have read this study and given your expertise, why do you think the study is not good? And what are those many reasons why HCQ is not a safe drug for C19?
To be clear, I am not saying anyone should take it, I just want to understand your comment better.

 

[easyrider]

In 2005, headed by Dr. Fauci, the National Institute of Health published a Virology Journal with an article named “Chloroquine is a potent inhibitor of SARS coronavirus infection and spread ". This drug was considered very safe in 2005 and was expected to be used in the treatment of corona virus / sars.

Bill

Chloroquine is a potent inhibitor of SARS coronavirus infection and spread

Severe acute respiratory syndrome (SARS) is caused by a newly discovered coronavirus (SARS-CoV). No effective prophylactic or post-exposure therapy is currently available.We report, however, that chloroquine has strong antiviral effects on SARS-CoV infection ...

www.ncbi.nlm.nih.gov

Results
We report, however, that chloroquine has strong antiviral effects on SARS-CoV infection of primate cells. These inhibitory effects are observed when the cells are treated with the drug either before or after exposure to the virus, suggesting both prophylactic and therapeutic advantage. In addition to the well-known functions of chloroquine such as elevations of endosomal pH, the drug appears to interfere with terminal glycosylation of the cellular receptor, angiotensin-converting enzyme 2. This may negatively influence the virus-receptor binding and abrogate the infection, with further ramifications by the elevation of vesicular pH, resulting in the inhibition of infection and spread of SARS CoV at clinically admissible concentrations.

 

[bluehende]

In 2005, headed by Dr. Fauci, the National Institute of Health published a Virology Journal with an article nam. This drug was considered very safe in 2005 and was expected to be used in the treatment of corona virus / sars.

Bill

Chloroquine is a potent inhibitor of SARS coronavirus infection and spread

Severe acute respiratory syndrome (SARS) is caused by a newly discovered coronavirus (SARS-CoV). No effective prophylactic or post-exposure therapy is currently available.We report, however, that chloroquine has strong antiviral effects on SARS-CoV infection ...

www.ncbi.nlm.nih.gov

Results
We report, however, that chloroquine has strong antiviral effects on SARS-CoV infection of primate cells. These inhibitory effects are observed when the cells are treated with the drug either before or after exposure to the virus, suggesting both prophylactic and therapeutic advantage. In addition to the well-known functions of chloroquine such as elevations of endosomal pH, the drug appears to interfere with terminal glycosylation of the cellular receptor, angiotensin-converting enzyme 2. This may negatively influence the virus-receptor binding and abrogate the infection, with further ramifications by the elevation of vesicular pH, resulting in the inhibition of infection and spread of SARS CoV at clinically admissible concentrations.

That is an invitro study....not invivo. There is a very big leap between the two. The reason it was tried early is due to this study and should have been. All the early studies showed no effect invivo. This data from the study being discussed here is very interesting. I have not studied these studies enough to know if other studies contradict this one only in the respect of earlier treatment. The results from this one are far from definitive even if there is little data on early treatment from other studies, but would certainly suggest that a good double blind study should be done. I would be shocked if they are not in fact being done now due to the early optimism of this treatment.

Also am surprised with the title you bolded

“Chloroquine is a potent inhibitor of SARS coronavirus infection and spread "

here is an actual sentence from the study

Chloroquine is effective in preventing the spread of SARS CoV in cell culture.

Also the implication that Fauci had anything to do with this study is not true. He is not one of the authors.

 

[csodjd]

So you are saying that the corticosteroids given to some patients (to reduce pain and inflammation) along with HCQ helped reduced the deaths by 71% or that the corticosteroids alone reduced them by 71%? Because both are great news if that is true. I am reading a study though about corticosteroids and it does not seem to hold too much water.

Efficacy and safety of corticosteroids in COVID-19 based on evidence for COVID-19, other coronavirus infections, influenza, community-acquired pneumonia and acute respiratory distress syndrome: a systematic review and meta-analysis

BACKGROUND: Very little direct evidence exists on use of corticosteroids in patients with coronavirus disease 2019 (COVID-19). Indirect evidence from related conditions must therefore inform inferences regarding benefits and harms. To support a guideline for managing COVID-19, we conducted...

www.cmaj.ca

Also, from what I understand the corticosteroids where given to some patients on all groups, whether on HCQ or not. Are you not reading it the same way?

First, there were only a bit over 100 patients in the no treatment group, compared with about 2000 that got HCQ. That alone is a problem because the normal variations will have a much larger impact in the small group of no treatment patients. The steroids were given at a higher frequency to the HCQ patients, which (according to the study above) would ALONE have resulted in a reduction in mortality in that group. Of course the age differences.

But my point is a broader one. We have two "(maybe three) gold standard" clinical studies that found no benefit. The NIH and the large Recovery Trial both ended the HCQ arms early because the data showed no benefits. On the flip side we have a handful of observational studies of varying degrees of quality with varying results. While those observational studies are useful to guide the development of good prospective studies, once the prospective studies publish THOSE are what we need to look at.

 

[csodjd]

That is an invitro study....not invivo. There is a very big leap between the two. The reason it was tried early is due to this study and should have been. All the early studies showed no effect invivo. This data from the study being discussed here is very interesting. I have not studied these studies enough to know if other studies contradict this one only in the respect of earlier treatment. The results from this one are far from definitive even if there is little data on early treatment from other studies, but would certainly suggest that a good double blind study should be done. I would be shocked if they are not in fact being done now due to the early optimism of this treatment.

Also am surprised with the title you bolded

“Chloroquine is a potent inhibitor of SARS coronavirus infection and spread "

here is an actual sentence from the study

Chloroquine is effective in preventing the spread of SARS CoV in cell culture.

Also the implication that Fauci had anything to do with this study is not true. He is not one of the authors.

A seemingly very solid gold-standard study was begun.

ClinicalTrials.gov

clinicaltrials.gov

However, for reasons unknown to me, a week ago they changed it from 2000 participants to 20, and ended the study as of Monday this week.

 

[csodjd]

If you have read this study and given your expertise, why do you think the study is not good? And what are those many reasons why HCQ is not a safe drug for C19?
To be clear, I am not saying anyone should take it, I just want to understand your comment better.

#MommaBear has linked for you the same piece I did earlier this evening which explains, as I have, reasons it is not good. You have a randomized double blind placebo controlled study showing that steroids reduce mortality at statistically significant rates. Then you have this observational study where the "studied" arm -- those receiving HCQ -- were also treated with steroids at a higher rate than the "control" group -- those not receiving HCQ or AZ. Why would it be anything but expected then that the studied arm had a lower mortality? On top of that, the study was ended with more than 10% of the study participants that received HCQ still in the hospital and not counted. But they are in the hospital because they have not improved and some may/will die. So the data is not complete. If many of those apparently very sick HCQ recipients die, it could wipe out the conclusion entirely.

 

[DannyTS]

A seemingly very solid gold-standard study was begun.

ClinicalTrials.gov

clinicaltrials.gov

However, for reasons unknown to me, a week ago they changed it from 2000 participants to 20, and ended the study as of Monday this week.

Are you saying they have seen such horrible results after 20 patients that they had to stop? I think this is what you are suggesting, if so please substantiate it.

Maybe after the fake study in the Lancet magazine people did not want to participate in the study? Maybe activists made the study impossible to continue?
Davey Smith, MD, University of California explained a bit the atmosphere created and how difficult is to actually study this drug in the United States.

Smith, rightfully being careful in what language he used, suggested hydroxychloroquine in use with antibiotic azithromycin was thought to be most useful in the earliest stages of COVID-19 infection. He went on that since nothing else had been available and there was thought to be some efficacy in vitro (in the test tube), it was being used in the clinic for later states of the disease because there was nothing else to work with.

This unfortunately, reported Dr. Smith, led to a whole series of “mixed messages” and “different things in the literature,” including results that led to potential harm in the context of a pandemic situation. The clinical trials continued but in the context of all the “mixed messages”, some negative comments in the literature and “politics” have led to a situation where it is “untenable” to keep clinical trials going.

Well Respected UCSD Virologist & Clinical Investigator on Hydroxychloroquine Use for COVID-19

Dr. Davey Smith leads University of California, San Diego (UCSD) Infectious disease research and serves as a principal investigator on antivirus clinical trials. He was recently interviewed by local news outlet KTAL 5 Morning News. They sought more information about COVID-19 clinical trials...

www.trialsitenews.com