Quantifying treatment effects of hydroxychloroquine and azithromycin for COVID-19: a secondary analysis of an open label non-randomized clinical trial (Gautret et al., 2020)

Lover, medRxiv, doi:10.1101/2020.03.22.20040949

Apr 2020

Source PDF All Studies Meta AnalysisMeta

Secondary analysis of Gautret et al. showing "modest to no impact of HCQ treatment, with more significant effects from [HCQ+AZ]".

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 72% lower mortality [59‑81%], 67% lower ventilation [-710‑99%], 28% lower ICU admission [-17‑55%], 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.

Important missing comments or errors? Let us know.

Lover et al., 10 Apr 2020, preprint, 1 author.

All Studies Meta Analysis Submit Updates or Corrections

This Paper HCQ All

Quantifying treatment effects of hydroxychloroquine and azithromycin for COVID-19: a secondary analysis of an open label non-randomized clinical trial

Andrew A Lover

doi:10.1101/2020.03.22.20040949

The author stands by all analytical and statistical aspects of this preprint. However, subsequent to this analysis, further details of the original study have been released-with major uncertainties in study design, reporting, choice of endpoints, and most importantly, data integrity [1, 2] . Therefore, all results from the original study should be viewed with considerable skepticism.

References

Bik, Thoughts on the Gautret et al. paper about Hydroxychloroquine and Azithromycin treatment of COVID-19 infections

Coveney, Firthlogit: Stata module to calculate bias reduction in logistic regression

Gautret, Lagier, Parola, Van Thuan, Hoang et al., Hydroxychloroquine and Azithromycin as a treatment of COVID-19: preliminary results of an open-label non-randomized clinical trial, medRxiv

Ian R White, Horton, Carpenter, Pocock, Strategy for intention to treat analysis in randomised trials with missing outcome data, Bmj

Lorenc, Oliver, Adverse effects of public health interventions: a conceptual framework, J Epidemiol Community Health

Mcnutt, Wu, Xue, Hafner, Estimating the relative risk in cohort studies and clinical trials of common outcomes, American journal of epidemiology

Michael A Johansson, Reich, Meyers, Lipsitch, Preprints: An underutilized mechanism to accelerate outbreak science, PLoS medicine

Nakagawa, Innes, Cuthill, Effect size, confidence interval and statistical significance: a practical guide for biologists, Biological reviews

Pubpeer, Pubpeer: Hydroxychloroquine and Azithromycin as a treatment of COVID-19: preliminary results of an open-label non-randomized clinical trial

Rivers, Chretien, Riley, Pavlin, Woodward et al., Using "outbreak science" to strengthen the use of models during epidemics, Nature Communications

Royston, Parmar, Flexible parametric proportional-hazards and proportional-odds models for censored survival data, with application to prognostic modelling and estimation of treatment effects, Statistics in medicine

Sandeep, Gupta, Intention-to-treat concept: a review, Perspectives in clinical research

Tjur, Coefficients of determination in logistic regression models-a new proposal: The coefficient of discrimination, The American Statistician

Late treatment
is less effective

Please send us corrections, updates, or comments. Vaccines and treatments are complementary. All practical, effective, and safe means should be used based on risk/benefit analysis. No treatment, vaccine, or intervention is 100% available and effective for all current and future variants. We do not provide medical advice. Before taking any medication, consult a qualified physician who can provide personalized advice and details of risks and benefits based on your medical history and situation. FLCCC and WCH provide treatment protocols.

Submit

@CovidAnalysis

FAQ

Public domain CC0 1.0