Revisiting a Meta-analysis Shows that Hydroxychloroquine with Azithromycin may be Efficient in Covid-19 patients

Lounnas e al., Archives of Microbiology & Immunology, doi:

Feb 2021

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Analysis of the Fiolet meta analysis and correction of bias evaluation, showing HCQ RR 0.45 [0.31-0.59], and HCQ+AZ RR 0.34 [0.06-0.61].

7 meta analyses show significant improvements with hydroxychloroquine for mortality Landsteiner de Sampaio Amêndola, Risch, Risch (B), Stricker, hospitalization Landsteiner de Sampaio Amêndola, recovery Prodromos, combined death/hospitalization/cases Ladapo, and cases García-Albéniz.

Currently there are 38 HCQ for COVID-19 early treatment studies, showing 76% lower mortality [60‑86%], 67% lower ventilation [-710‑99%], 31% lower ICU admission [1‑53%], and 41% lower hospitalization [28‑51%].

1. García-Albéniz et al., Systematic review and meta-analysis of randomized trials of hydroxychloroquine for the prevention of COVID-19, European Journal of Epidemiology, doi:10.1007/s10654-022-00891-4.springer.com, doi.org.

2. Ladapo et al., Randomized Controlled Trials of Early Ambulatory Hydroxychloroquine in the Prevention of COVID-19 Infection, Hospitalization, and Death: Meta-Analysis, medRxiv, doi:10.1101/2020.09.30.20204693.medrxiv.org, doi.org.

3. Landsteiner de Sampaio Amêndola et al., COVID-19 Infection in Rheumatic Patients on Chronic Antimalarial Drugs: A Systematic Review and Meta-Analysis, Journal of Clinical Medicine, doi:10.3390/jcm11226865.mdpi.com, doi.org.

4. Prodromos et al., Hydroxychloroquine is effective, and consistently so used early, for Covid-19: A systematic review, New Microbes and New Infections, doi:10.1016/j.nmni.2020.100776.sciencedirect.com, doi.org.

5. Risch, H., Early Outpatient Treatment of Symptomatic, High-Risk Covid-19 Patients that Should be Ramped-Up Immediately as Key to the Pandemic Crisis, American Journal of Epidemiology, kwaa093, 27 May 2020, doi:10.1093/aje/kwaa093.oup.com, doi.org.

6. Risch (B), H., Response to: “Early Outpatient Treatment of Symptomatic, High-Risk Covid-19 Patients” and “Re: Early Outpatient Treatment of Symptomatic, High-Risk Covid-19 Patients that Should be Ramped-Up Immediately as Key to the Pandemic Crisis”, American Journal of Epidemiology, July 20, 2020, doi:10.1093/aje/kwaa152.oup.com, doi.org.

7. Stricker et al., Hydroxychloroquine Pre-Exposure Prophylaxis for COVID-19 in Healthcare Workers from India: A Meta-Analysis, Journal of Infection and Public Health, doi:10.1016/j.jiph.2021.08.001.sciencedirect.com, doi.org.

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Lounnas et al., 9 Feb 2021, peer-reviewed, 4 authors.

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Revisiting a Meta-analysis Shows that Hydroxychloroquine with Azithromycin may be Efficient in Covid-19 patients

Valère Lounnas, Alexis Lacout, Xavier Azalbert, Christian Perronne

Archives of Microbiology & Immunology, doi:10.26502/ami.93650055

Objective: To analyze the impact of study selection on the results of a recently published meta-analysis of the efficacy of hydroxychloroquine (HCQ) and hydroxychloroquine plus azithromycin (AZI) in Covid-19 patients. Methods: 31 studies were reviewed looking for critical bias. Combined hazard ratios and confidence intervals were calculated for both treatments using a fixed effects size model and a random effects model. Quantitative analysis regarding the toxicity of the association HCQ plus AZI is made. Results: Meta-analyses performed on the 11 studies we deem critically unbiased show a mortality reduction of 55% for HCQ and 66% for HCQ plus AZI. For both treatments, our meta-analysis indicates a significant efficacy in reducing mortality in hospitalized Covid-19 patients.

Competing interests The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. Ethical Approval Approval was not required for this work. Acknowledgments Thanks to all members of the France Soir -Citizen Circle (scientists, medical practitioners, lecturers and jurists) for the many public audience articles they wrote or help publish in France Soir, with

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