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0 0.5 1 1.5 2+ Death/intubation -125% Improvement Relative Risk HCQ for COVID-19  Saib et al.  LATE TREATMENT Is late treatment with HCQ beneficial for COVID-19? PSM prospective study of 104 patients in France Higher death/intubation with HCQ (not stat. sig., p=0.23) Saib et al., PLOS ONE, June 2021 Favors HCQ Favors control

Lack of efficacy of hydroxychloroquine and azithromycin in patients hospitalized for COVID-19 pneumonia: A retrospective study

Saib et al., PLOS ONE, doi:10.1371/journal.pone.0252388
Jun 2021  
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HCQ for COVID-19
1st treatment shown to reduce risk in March 2020
*, now known with p < 0.00000000001 from 421 studies, recognized in 42 countries.
No treatment is 100% effective. Protocols combine complementary and synergistic treatments. * >10% efficacy in meta analysis with ≥3 clinical studies.
3,800+ studies for 60+ treatments.
203 hospitalized patients in France, not showing significant differences with treatment. Confounding by indication is likely. Authors do not discuss confounding.
This study is excluded in the after exclusion results of meta analysis: substantial unadjusted confounding by indication likely.
risk of death/intubation, 125.0% higher, RR 2.25, p = 0.23, treatment 9 of 52 (17.3%), control 4 of 52 (7.7%), PSM.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Saib et al., 9 Jun 2021, prospective, propensity score matching, France, peer-reviewed, 9 authors, average treatment delay 7.2 days.
This PaperHCQAll
Lack of efficacy of hydroxychloroquine and azithromycin in patients hospitalized for COVID-19 pneumonia: A retrospective study
Anis Saib, Walid Amara, Pascal Wang, Simon Cattan, Azeddine Dellal, Kais Regaieg, Stephane Nahon, Olivier Nallet, Lee S Nguyen
PLOS ONE, doi:10.1371/journal.pone.0252388
Background Hydroxychloroquine combined with azithromycin (HCQ/AZI) has initially been used against coronavirus disease-2019 . In this retrospective study, we assessed the clinical effects of HCQ/AZI, with a 28-days follow-up. Methods In a registry-study which included patients hospitalized for COVID-19 between March 15 and April 2, 2020, we compared patients who received HCQ/AZI to those who did not, regarding a composite outcome of mortality and mechanical ventilation with a 28-days follow-up. QT was monitored for patients treated with HCQ/AZI. Were excluded patients in intensive care units, palliative care and ventilated within 24 hours of admission. Three analyses were performed to adjust for selection bias: propensity score matching, multivariable survival, and inverse probability score weighting (IPSW) analyses. Results Overall, 203 patients were included: 60 patients treated by HCQ/AZI and 143 control patients. During the 28-days follow-up, 32 (16.3%) patients presented the primary outcome and 23 (12.3%) patients died. Propensity-score matching identified 52 unique pairs of patients with similar characteristics. In the matched cohort (n = 104), HCQ/AZI was not associated with the primary composite outcome (log-rank p-value = 0.16). In the overall cohort (n = 203), survival and IPSW analyses also found no benefit from HCQ/AZI. In the HCQ/AZI group, 11 (18.3%) patients prolonged QT interval duration, requiring treatment cessation.
Supporting information S1 File. (XLSX) Author Contributions Conceptualization: Anis Saib, Lee S. Nguyen. Data curation: Anis Saib. Investigation: Walid Amara, Pascal Wang, Simon Cattan, Azeddine Dellal, Kais Regaieg, Stephane Nahon, Olivier Nallet, Lee S. Nguyen. Resources: Pascal Wang. Supervision: Lee S. Nguyen. Validation: Walid Amara, Simon Cattan, Azeddine Dellal, Kais Regaieg, Stephane Nahon, Olivier Nallet. Visualization: Lee S. Nguyen. Writing -original draft: Anis Saib. Writing -review & editing: Olivier Nallet, Lee S. Nguyen.
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Late treatment
is less effective
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