Joined: 10-21-2000 Posts: 55,394 |
Burner02 wrote:Not wishing for political solutions, just hoping lives were not lost unnecessarily due to bogus data.
Don't blame me, it wasn't me that had the responsible party on the air during the past couple of weeks toughing his data as the gospel.. Research in context
Evidence before this studyWe searched MEDLINE (via PubMed) for articles published up to April 21, 2020, using the key words “novel coronavirus”, “2019-nCoV”, “COVID-19”, “SARS-CoV-2”, “therapy”, “hydroxychloroquine”, “chloroquine”, and “macrolide”. Moreover, we screened preprint servers, such as Medrxiv, for relevant articles and consulted the web pages of organisations such as the US National Institutes of Health and WHO. Hydroxychloroquine and chloroquine (used with or without a macrolide) are widely advocated for treatment of COVID-19 based on in-vitro evidence of an antiviral effect against severe acute respiratory syndrome coronavirus 2. Their use is based on small uncontrolled studies and in the absence of evidence from randomised controlled trials. Concerns have been raised that these drugs or their combination with macrolides could result in electrical instability and predispose patients to ventricular arrhythmias. Whether these drugs improve outcomes or are associated with harm in COVID-19 remains unknown.Added value of this studyIn the absence of reported randomised trials, there is an urgent need to evaluate real-world evidence related to outcomes with the use of hydroxychloroquine or chloroquine (used with or without macrolides) in COVID-19. Using an international, observational registry across six continents, we assessed 96 032 patients with COVID-19, of whom 14 888 were treated with hydroxychloroquine, chloroquine, or their combination with a macrolide. After controlling for age, sex, race or ethnicity, underlying comorbidities, and disease severity at baseline, the use of all four regimens was associated with an increased hazard for de-novo ventricular arrythmia and death in hospital. This study provides real-world evidence on the use of these therapeutic regimens by including a large number of patients from across the world. Thus, to our knowledge, these findings provide the most comprehensive evidence of the use of hydroxychloroquine and chloroquine (with or without a macrolide) for treatment of COVID-19.Implications of all the available evidenceWe found no evidence of benefit of hydroxychloroquine or chloroquine when used either alone or with a macrolide. Previous evidence was derived from either small anecdotal studies or inconclusive small randomised trials. Our study included a large number of patients across multiple geographic regions and provides the most robust real-world evidence to date on the usefulness of these treatment regimens. Although observational studies cannot fully account for unmeasured confounding factors, our findings suggest not only an absence of therapeutic benefit but also potential harm with the use of hydroxychloroquine or chloroquine drug regimens (with or without a macrolide) in hospitalised patients with COVID-19.
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)31180-6/fulltext
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