A guy on another forum just posted this. Thought maybe it could bring some hope in the midst of the craziness...
Friends daughter was telling me about a relative of a friend of hers (yeah I know) but anyway she was in a bad way with Covid-19, on a ventilator, doctor asked the family if they wanted to try that malaria drug. They did and 2 days later she's off the ventilator doing a lot better. Might be she would have been without the drug who knows.
Probably not due to the drug which typically must be started early in the course (first 1-3 days or so) as it inhibits viral shedding. Once you are on a ventilator it is because you have developed ARDS (acute respiratory distress syndrome which has a high mortality) or severe pneumonia. The drug will not reverse this. The damage has already been done. If you look at the study with hydroxychloroquine, it is not good as they excluded patients that ended up in the ICU or died. Please read below excerpts from articles from Medscape-
Results from the French study suggest that a combination of azithromycin/hydroxychloroquine in six patients yielded a marked decrease in viral carriage, according to a post-hoc analysis. Results from this uncontrolled small trial of 36 patients suggest that those who received hydroxychloroquine exhibited reduced viral shedding.
The critiques to this study, unfortunately, are many. I realize that this was done in short order. However, I think anyone embracing these drugs must realize that this is a case series subject to some concerns. For example, patients who went to the ICU or died were excluded, so we're not really sure if that would have factored. Also, there was a lack of pairwise statistical analysis. And there is no clinical correlation, although one might think that a reduction in viral shedding might yield clinical changes. But if there are immunologic injuries, perhaps not.
More info-
It seems like everyone is talking about hydroxychloroquine, thanks to one little study appearing in the International Journal of Antimicrobial Agents that is generating a lot of press—thanks to a shout-out from Donald Trump, no less.
What is our pre-study probability that hydroxychloroquine would be effective for COVID-19?
There's a lot of literature here. Hydroxychloroquine has a long history as an antibiotic and antiviral drug and, encouragingly, seems to inhibit coronavirus replication in vitro. It also changes the structure of the receptor that coronavirus binds to.
I'd put the pre-study probability here at around 50/50, but feel free to disagree.
Now let's look at the study. Thirty-six patients in France with COVID-19 were examined. Twenty of them got hydroxychloroquine and 16 were controls. But this was not randomized; treated patients were different from those not receiving treatment. The researchers looked at viral carriage over time in the two groups and found what you see here:
https://img.medscapestatic.com/article/927/342/927342-fig2.jpg?interpolation=lanczos-none&resize=690:*
This appears to be a dramatic reduction in coronavirus carriage in those treated with hydroxychloroquine. Awesome, right? Sure, it's not randomized, but when we need to make decisions fast, "perfect" may be the enemy of "good." Does this study increase my 50/50 prediction that hydroxychloroquine could help?
Well, with data coming at us so fast, we have to be careful. There is a huge fly in the ointment in this study that seems to have been broadly overlooked, or at least underplayed. There was differential loss to follow-up in the two arms of the study; viral positivity was not available for six patients in the treatment group, none in the control group. Why unavailable? I made this table to show you:
https://img.medscapestatic.com/article/927/342/927342-fig3.jpg?interpolation=lanczos-none&resize=690:*
Three patients were transferred to the ICU, one died, and the other two stopped their treatment. By the way, none of the patients in the control group died or went to the ICU. Had these six patients not been dropped, the story we might have is that hydroxychloroquine increases the rate of death and ICU transfer in COVID-19.
Before reading this study, I was 50/50 on hydroxychloroquine. After?
Yeah, I'm right where I started. Because of the problems with the study design—not just its observational nature but that differential loss to follow-up—the data from the French study don't move the needle for me at all.
