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| Настроение: |  sleepy |
| Музыка: | https://youtu.be/lbQzW3D5DZk |
| Entry tags: | china, corona, usa |
COVID: A Long Tale of the Hydroxychloroquine Mess
And this week, a piece in the New York Times described a new trial on hydroxychloroquine in which the results were favorable. It's certainly a better study than the one mentioned above, though that's a pretty low hurdle. But it's not substantially better: it once again enrolled too small a cohort to look directly at mortality, so it relies on surrogate data that make it hard to know whether the benefit is real or an optical illusion; the patient population studied never got very sick, making its relevance in saving lives of unclear significance; and people did suspiciously well in this cohort, potentially suggesting some unseen bias that shaped the numbers. Everyone in my division took a look at the paper: the reaction was swift, and it wasn't anywhere near as favorable as the warm coverage in the article.
The study hasn't been peer reviewed, where these and other troubling issues would be addressed. Perhaps upon peer review, the study might not even be published because it is found to be wanting. The question, then, is why did NYT pick it up? At the Billy Rubin Blog, we're scratching our heads on that one, because the publication of this article just made it harder for every ID doctor everywhere to try to do their jobs, in no small part because we have to continuously explain to stressed and worried families at length why these studies aren't really very good, and that these drugs come with side effects that might actually end their loved ones life, not save it. This blog entry, despite running to thousands of words, hasn't even taken a shot at explaining a heart-stopping effect called the long QT syndrome, which is almost certainly hydroxychloroquine's most deadly acute effect, and is even worse when used in conjunction with azithromycin, and which I've seen once already in a COVID patient.
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