Erroneous Assessment of The Effect of Hospital Treatment – The Misleading Creation of 17000 Deaths and its Consequences for Good Medical Practice
Xavier Azalbert, Véronique Baudoux, Alexis Lacout, Valère Lounnas, Martin Zizi
Archives of Microbiology & Immunology, doi:10.26502/ami.936500179
Despite a peer review process prior to being published in Biomedicine & Pharmacotherapy, Pradelle et al, "Deaths induced by compassionate use of hydroxychloroquine (HCQ) during the first COVID-19 wave: an estimate" is cluttered with several scientific integrity issues, one of them being the lack of validation against real life data. Mathematical model-based research should be dealt with an even greater care by reviewers and call upon mathematicians for a review of the logic and appropriateness of the model used. This is illustrated here by the use of an odds ratio (OR) taken as the corner stone of a circular reasoning based on a simple mathematical extrapolation without cross validation against reality and without appraisal regarding the corpus of knowledge amply developed and published on the topic addressed. This resulted in a blind and oversimplistic mathematical treatment of an issue of the foremost importance. A flawed model by design has yield results that can be viewed as a pure fabrication. The OR used is not an accurate representation of the true OR associated with the treatment involved. It was based on the result of a meta-analysis that included only RCT trials with OR exceeding 1. with the two trials with an over-dominating weight having used excessively high doses of HCQ: the Recovery and Who Solidarity trials with weight of 73.7 % and 15.2%, respectively. Recovery was conducted on frail patients hospitalized at a very late disease stage and having received sub-lethal doses of HCQ, very close to the lethal dose, dramatically higher than the safe dosage established by the pharmacokinetics properties of HCQ.
References
Arshad, Kilgore, Chaudhry, Jacobsen, Wang et al., Henry Ford COVID-19 Task Force. Treatment with hydroxychloroquine, azithromycin, and combination in patients hospitalized with COVID-19, Int J Infect Dis
Axfors, Schmitt, Janiaud, Mortality outcomes with hydroxychloroquine and chloroquine in COVID-19 from an international collaborative metaanalysis of randomized trials, Nat Commun
Azalbert, Baudoux, Lacout, Lounnas, Zizi et al., Erroneous Assessment of The Effect of Hospital Treatment -The Misleading Creation of 17000 Deaths and its Consequences for Good Medical Practice, Archives of Microbiology and Immunology
Bartoletti, Marconi, Scudeller, Efficacy of corticosteroid treatment for hospitalized patients with severe COVID-19: a multicentre study, Clin Microbiol Infect
Brouqui, Million, Parola, Mccullough, Raoult, Outcomes after early treatment with hydroxychloroquine and azithromycin: An analysis of a database of 30,423 COVID-19 patients, New Microbes New Infect
Catteau, Dauby, Montourcy, Low-dose hydroxychloroquine therapy and mortality in hospitalised patients with COVID-19: a nationwide observational study of 8075 participants, Int J Antimicrob Agents
Emmerich, Comparisons between the Neighboring States of Amazonas and Pará in Brazil in the Second Wave of COVID-19 Outbreak and a Possible Role of Early Ambulatory Treatment, Int J Environ Res Public Health
Fumagalli, Rozzini, Vannini, Clinical risk score to predict in-hospital mortality in COVID-19 patients: a retrospective cohort study, BMJ Open
Gutiérrez-Abejón, Tamayo, Martín-García, Clinical Profile, Treatment and Predictors during the First COVID-19 Wave: A Population-Based Registry Analysis from Castile and Leon Hospitals, Int J Environ Res Public Health
Lacout, Perronne, Lounnas, Hydroxychloroquine in Hospitalized Patients with Covid-19, N Engl J Med
Lounnas, Gkioulekas, Rendell, Lacout, Azalbert et al., An Independent Analysis of a Retrospective Cohort of 30,423 Covid-19 Patients Treated at IHU-Mediterranean in Marseille, France: Part 1, Efficacy of early Treatment with Hydroxychloroquine and Azithromycin, Archives of Microbiology and Immunology
Lounnas, Lacout, Azalbert, Perronne, Revisiting a Meta-analysis Shows that Hydroxychloroquine with Azithromycin may be Efficient in Covid-19 patients, Archives of Microbiology & Immunology
Lounnas, Lacout, Azalbert, Perronne, Shunt due to Hydroxychloroquine Sub-lethal Dosage Resulted in Excess Transfer to Mechanical Ventilation and Death in Hospitalized Patients with Covid-19, Archives of Microbiology & Immunology
Pradelle, Mainbourg, Provencher, Deaths induced by compassionate use of hydroxychloroquine during the first COVID-19 wave: an estimate, Biomed Pharmacother
{ 'indexed': {'date-parts': [[2024, 8, 12]], 'date-time': '2024-08-12T00:20:53Z', 'timestamp': 1723422053030},
'reference-count': 0,
'publisher': 'Fortune Journals',
'issue': '3',
'content-domain': {'domain': [], 'crossmark-restriction': False},
'published-print': {'date-parts': [[2024]]},
'DOI': '10.26502/ami.936500179',
'type': 'journal-article',
'created': {'date-parts': [[2024, 8, 11]], 'date-time': '2024-08-11T13:46:55Z', 'timestamp': 1723384015000},
'source': 'Crossref',
'is-referenced-by-count': 0,
'title': 'Erroneous Assessment of The Effect of Hospital Treatment – The Misleading Creation of 17000 '
'Deaths and its Consequences for Good Medical Practice',
'prefix': '10.26502',
'volume': '8',
'author': [ {'given': 'Xavier', 'family': 'Azalbert', 'sequence': 'first', 'affiliation': []},
{'given': 'Véronique', 'family': 'Baudoux', 'sequence': 'additional', 'affiliation': []},
{'given': 'Alexis', 'family': 'Lacout', 'sequence': 'additional', 'affiliation': []},
{'given': 'Valère', 'family': 'Lounnas', 'sequence': 'additional', 'affiliation': []},
{'given': 'Martin', 'family': 'Zizi', 'sequence': 'additional', 'affiliation': []}],
'member': '11040',
'published-online': {'date-parts': [[2024]]},
'container-title': 'Archives of Microbiology & Immunology',
'original-title': [],
'deposited': { 'date-parts': [[2024, 8, 11]],
'date-time': '2024-08-11T13:47:01Z',
'timestamp': 1723384021000},
'score': 1,
'resource': { 'primary': { 'URL': 'https://www.fortunejournals.com/articles/erroneous-assessment-of-the-effect-of-hospital-treatment-ndash-the-misleading-creation-of-17000-deaths-and-its-consequences-for-go.html'}},
'subtitle': [],
'short-title': [],
'issued': {'date-parts': [[2024]]},
'references-count': 0,
'journal-issue': { 'issue': '3',
'published-online': {'date-parts': [[2024]]},
'published-print': {'date-parts': [[2024]]}},
'URL': 'http://dx.doi.org/10.26502/ami.936500179',
'relation': {},
'ISSN': ['2572-9365'],
'subject': [],
'container-title-short': 'Arch Microbiol Immunology 2024',
'published': {'date-parts': [[2024]]}}