Hydroxychloroquine / Plaquenil and the Covid-19 / Coronavirus

[ebethc]

It seems it has antiviral activity (not yet proven in vivo, because it's not simple). Some says adding Zinc should give better response to the treatment.

zinc is excellent!

EDIT: also, wondering how it works for arthritis

 

[Hip]

In addition, both poor clinical and virological outcomes were associated to the use of selective beta-blocking agents and angiotensin II receptor blockers (P<0.05).

I wonder if that worsening of the coronavirus infection is due to the drugs themselves, or because those drugs are often prescribed to patients with heart disease, and we know that those with heart conditions are more vulnerable to coronavirus.

 

[pattismith]

@Hip this is one problem raised by this preliminary clinical study, and I feel it still needs further research and analysis.

-16 patients were still in hospital at the time of the publication!
-Even if we consider that they might survive (which is not certain), he found a mortality of 0.47%. You said that German statistic found 0.5% of mortality so no benefit seems obvious, considering all cases has not yet resolved!

I read an article saying the large testing/treatment and education made in his Marseille Hospital for local population may account for the good general statistics in this France part.

The better outcome in this place may be the result of:

-lower viral load in tested and treated patients so the virus spreading is softer and perhaps less harmful
-tested positive people take more measure to isolate themselves and protect others.
It would be still to put to his own credit though..

I would be more interested to know from rheumatologists about their patients taking Hydroxychloroquine on a regular basis to see if it can show any prophylactic effect...

Their mean age was 43.6 years old and 492 were male (46.4%). No cardiac toxicity was observed. A good clinical outcome and virological cure was obtained in 973 patients within 10 days (91.7%).

Prolonged viral carriage at completion of treatment was observed in 47 patients (4.4%) and was associated to a higher viral load at diagnosis (p < 10-2) but viral culture was negative at day 10 and all but one were
PCR-cleared at day 15.
A poor outcome was observed for 46 patients (4.3%); 10 were
transferred to intensive care units, 5 patients died (0.47%) (74-95 years old) and 31 required
10 days of hospitalization or more. Among this group, 25 patients are now cured and 16 are
still hospitalized (98% of patients cured so far).
Poor clinical outcome was significantly associated to older age (OR 1.11), initial higher severity (OR 10.05) and low hydroxychloroquine serum concentration.
In addition, both poor clinical and virological outcomes were associated to the use of selective beta-blocking agents and angiotensin II receptor blockers (P<0.05).

Mortality was significantly lower in patients who had received > 3 days of HCQ-AZ than in patients treated with other regimens both at IHU and in all Marseille public hospitals (p< 10-2)

 

[Wally]

https://amp.washingtontimes.com/news/2020/apr/20/novartis-wins-approval-fda-start-hydroxychloroquin/

Novartis wins approval from FDA to start hydroxychloroquine clinical trial

The Washington Times - Monday, April 20, 2020

Novartis has reached a deal with the Food and Drug Administration to proceed with a clinical trial on the efficacy of hydroxychloroquine, a malaria drug, in treating hospitalized COVID-19 patients, the Swiss drug company announced on Monday.

The trial of about 440 patients is supposed to be conducted at more than a dozen sites across the U.S. . . ,

A recent international poll of more than 6,200 doctors found that it was the most effective therapy for COVID-19 out of a list of more than a dozen options. . . ,

Note - bolding added to quote.

 

[Davsey27]

This could be encouraging news

 

[Wayne]

BREAKING NEWS
Study: No benefit, higher death rate in patients taking hydroxychloroquine for virus

(CNN)Coronavirus patients taking hydroxychloroquine, a treatment touted by President Trump, were no less likely to need mechanical ventilation and had higher deaths rates compared to those who did not take the drug, according to a study of hundreds of patients at US Veterans Health Administration medical centers.​

​

The study, which reviewed veterans' medical charts, was posted Tuesday on medrxiv.org, a pre-print server, meaning it was not peer reviewed or published in a medical journal. The research was funded by the National Institutes of Health and the University of Virginia.​

​

 

[ebethc]

@Davsey27

plus, Italy's in on the hoax, and Dr Fauci is ...ITALIAN! it all adds up....BOOM!

 

[Wayne]

This could be encouraging news

Just a (semi) alert: I started watching this, and soon noticed this guy has a statue of Trump on his desk! lol Now, how many people do you know keep a statue of a U.S. President on their desk? -- Wikipedia apparently considers them to be a "fake news outlet." Another site said their news reliability was "mixed".

 

[pattismith]

BREAKING NEWS
Study: No benefit, higher death rate in patients taking hydroxychloroquine for virus

​

​

it's important to look at the study itself.


"RESULTS: A total of 368 patients were evaluated (HC, n=97; HC+AZ, n=113; no HC, n=158).

Rates of death in the HC, HC+AZ, and no HC groups were 27.8%, 22.1%, 11.4%, respectively.

Rates of ventilation in the HC, HC+AZ, and no HC groups were 13.3%, 6.9%, 14.1%, respectively.

Compared to the no HC group, the risk of death from any cause was higher in the HC group (adjusted hazard ratio, 2.61; 95% CI, 1.10 to 6.17; P=0.03) but not in the HC+AZ group (adjusted hazard ratio, 1.14; 95% CI, 0.56 to 2.32; P=0.72).

The risk of ventilation was similar in the HC group (adjusted hazard ratio, 1.43; 95% CI, 0.53 to 3.79; P=0.48) and in the HC+AZ group (adjusted hazard ratio, 0.43; 95% CI, 0.16 to 1.12; P=0.09), compared to the no HC group.

CONCLUSIONS:
In this study, we found no evidence that use of hydroxychloroquine, either with or without azithromycin, reduced the risk of mechanical ventilation in patients hospitalized with Covid-19.
An association of increased overall mortality was identified in patients treated with hydroxychloroquine alone."

Several things in this paper are not documented and I wonder why...

-are the three groups matching in ages proportions, disease severity when starting the treatment and disease number of days of evolution when starting the treatment?? It matters a lot and several biais can happen that can pose problems when comparing groups.

-the risk for ventilation in the noHC group is not documented

-they say the ventilation risk for HC+Azithro is not better than the no HC group but they say that the rate of ventilation is 6.9% for the HC +Azithro whereas the ratet of ventilation in the no HC group is 14.1%, which seems to me a much better result for the HC+Azythro group than for the no HC groups...

Again more questions than answers!