One More Nail

April 21 2020

One more nail in a “coffin” of Hydroxychloroquine was delivered today with publication of Veterans Administration (VA) clinical trial.

The group from Virginia and South Carolina evaluated outcomes of hydroxychloroquine usage in United States veterans hospitalized with Covid-19.

Researchers performed a retrospective analysis of data from patients hospitalized with confirmed SARS- CoV-2 infection in all American VA medical centers until April 11, 2020.

368 patients were categorized into three groups receiving

1. Hydroxychloroquine alone - 97 patients (HC);

2. Hydroxychloroquine with azithromycin - 113 patients (HC+AZ); or

3. No Hydroxychloroquine - 158 patients (no HC).

All patients recieved standard supportive management for Covid-19.

The two primary outcomes were:

1. Death, and

2. The need for mechanical ventilation.

Results:

1. Rates of death in HC, HC+AZ, and no HC groups were 27.8%, 22.1%, 11.4%, respectively;

2. Rates of ventilation in the HC, HC+AZ, and no HC groups were 13.3%, 6.9%, 14.1%, respectively;

3. Compared to the no HC group, the risk of death from any cause was higher in the HC group. Adjusted hazard ratio was 2.61; 95% CI, 1.10 to 6.17; P=0.03, which means patients on HC were 2.61 times more likely to die from any cause;

4. When no HC group was compared to HC+AZ group, there was no significant difference in deaths;

5. The risk of ventilation was the lowest in HC+AZ group with adjusted hazard ratio, 0.43; 95% CI, 0.16 to 1.12; P=0.09. This means that those receiving HC+AZ were more than twice as likely to need ventilation, although it was not statistically significant.

Conclusions:

1. There is no evidence that use of HC, either with or without AZ, reduced the risk of mechanical ventilation in patients hospitalized with Covid-19;

2. An association of increased overall mortality was identified in patients treated with HC alone.

Dr. Why conclusions:

1. Using AZ may lower the need for ventilation;

2. When AZ was added to HC it seemed to counter negative effects of HC on rates of death;

3. AZ shall be used for all patients with Covid-19;

4. HC must never be used because it increases death rate by 2.61;

5. Clinical trials using HC for treatment of viral diseases must stop both to avoid endangering patients lives and to stop wasting time and money.

The 60 year history of failed attempts to use HC for treatment of viral diseases is beyond obvious. Please refer to our blog from March 21st “Can Chloroquine Work for COVID-19?”