The attached study was published a day or two ago by a group of French doctors on the use of hydroxychloroquine and azithromycin to treat hospitalized Covid-19 patients.
The study has a number of problems, most of which the authors acknowledge:
- It was not placebo-controlled or double-blinded.
- The sample size is quite small at 36.
- Six out of 26 patients in the treatment arm were lost to follow-up, three because they had to be put into the ICU and one because they died.
- The outcome measure -- the percent of patients who tested negative by nasopharyngeal PCR for SARS-Cov-2 six days after study entry -- may not correlate that well with a patient's clinical outcome. It is plausible that a patient could clinically deteriorate and die because of a cytokine storm or a secondary bacterial infection after they test negative for the coronavirus.
On the plus side, the outcome measure was at least objective, so maybe less prone to placebo effects and observer bias than a subjective outcome measure. In addition, the patients in the treatment arm were on average older (51) and therefore presumably more prone to severe illness because of their age than controls, who were on average only 37 years old.
The authors found that 70% (14/20) of the treated patients had a negative PCR test 6 days after study inclusion, vs. 12.5% (2/16) for controls.
The authors also found that the combination of hydroxychloroquine and azithromycin appeared to be more effective in clearing the virus -- with 6 out of 6 patients testing negative by PCR on day 6.
Obviously, this is meant as an FYI post, not a recommendation to start taking hydroxychloroquine and azithromycin. The best approach remains to "shelter in place" or to practice social distancing to avoid contracting the coronavirus.
