4 ms·

Hydroxychloroquine Associated with an Increase of Survival in Covid-19 Patients

22 points by jaboutboul 6y ago

product50 6y ago
So Trump was right after all. Guess no newspaper will report that..
- hansdieter1337 6y ago
  Please educate yourself on statics and read the paper. Obvious points: - It’s a pre-print - Not reviewed - Way too small group sizes to be meaningful
  - jshevek 6y ago
    >Please educate yourself on statics and read the paper. I think you mean "statistics"? Statics is the study of constant forces acting on unmoving bodies (as opposed to dynamics).
- abiogenesis 6y ago
  Even if Trump finally turns out to be right, he announced his claims before seeing this (or any other) study. If you claim a thousand things eventually one or two will be true.
  - sfj 6y ago
    Trump often makes claims about things he wants to draw attention to. Given that HCQ is such a cheap, off patent drug, it stands to reason that he wanted to get it into the public consciousness so it would be looked at with more scrutiny. Without him mentioning it, there isn't much incentive to study it.
- loopz 6y ago
  All the times this person is wrong he lies about it and puts someone else under the bus. Good luck!
- me_me_me 6y ago
  This comment brings nothing to discussion, plus making any kind of definitive statement based on 'none statistically significant study' is plain rubbish. Go complain to fb or twitter.
jlj 6y ago
> There was a non-statistically significant trend towards survival in all groups, which will have to be clarified in subsequent studies.
sunkenvicar 6y ago
The earlier the better. Give us our Trump pills!
InTheArena 6y ago
I’m so ready to get past observational studies to real proper double-blind research, The first should go to pre-print next week. This is hopeful though.
- nshepperd 6y ago
  Agreed. It's disappointing to see observational study after observational study pumped out and still little-to-no actual causal evidence after three months.
  - lbeltrame 6y ago
    The U of Minnesota trial (which is a true vs-placebo trial) reported on April 22nd that they needed at least 200 more people to get enough power for their study. According to their web page[1] the interim meeting of the safety board is expected for today. [1] https://covidpep.umn.edu/updates https://covidpep.umn.edu/updates
sunkenvicar 6y ago
Abstract: Background: There is no treatment proven effective against COVID-19. Several drugs with in vitro potential against SARS-CoV-2 virus have been proposed. Hydroxychloroquine has in vitro anti-viral and immunomodulatory activity, but there is no current clinical evidence of its effectiveness changing the outcome of the disease. Methods: We enrolled all 18-85 years old inpatients from Central Defense Hospital “Gómez Ulla”, Madrid, Spain, who were hospitalised for COVID-19 and had a definitive outcome (dead or discharged). We used a statistical survival analysis to detect treatment differences associated with in-hospital death. Results: We analysed first 220 medical records. 166 patients met the inclusion criteria. 48,8 % of patients not treated with HCQ died, 22% of those treated with hydroxychloroquine (p=0,002). According to clinical picture at admission, hydroxychloroquine increased the mean cumulative survival in all groups from 1,4 to 1,8 times. This difference was statistically significant in the mild group. Conclusions: in a cohort of 166 patients from 18 to 85 years hospitalised with COVID-19, hydroxychloroquine treatment with 800mg added loading dose increased survival when patients were admitted in early stages of the disease. There was a non-statistically significant trend towards survival in all groups, which will have to be clarified in subsequent studies.
hansdieter1337 6y ago
“ Age distribution according to the severity at admission was homogeneous between HCQ and non- HCQ treatment groups when the clinical picture was mild (57,6 years HCQ – 58,4 years non-HCQ, p=0,865) or moderate (63,8 years HCQ – 70 years non-HCQ, p=0,269). ” Those are some high p-values. Makes sense with a small control group of 43 people. This paper can be put in the bin labeled “no statically significance”
- nshepperd 6y ago
  They're meant to be high. This means "we didn't find a detectable difference in age distribution between the groups" and therefore that the results are (hopefully) not confounded by age.
abalone 6y ago
“This version is not peer-reviewed” Here’s the problem with preprints like this: In an earlier era, issues with the Santa Clara study would have been addressed during peer review—the process in which scientific work is assessed by other researchers before being published in a journal. But like many COVID-19 studies, this one was uploaded as a preprint—a paper that hasn’t yet run the peer-review gauntlet. Preprints allow scientists to share data quickly, and speed is vital in a pandemic: Several important studies were uploaded and discussed a full month before being published. Preprints also allow questionable work to directly enter public discourse, but that problem is not unique to them. The first flawed paper on hydroxychloroquine and COVID-19 was published in a peer-reviewed journal, whose editor in chief is one of the study’s co-authors.[1] [1] https://www.theatlantic.com/health/archive/2020/04/pandemic-confusing-uncertainty/610819/ https://www.theatlantic.com/health/archive/2020/04/pandemic-...
- lbeltrame 6y ago
  That doesn't mean one can't read the preprint and critically evaluate it (I've done so for a few posted here on HN). On this specific paper, I think tracking survival is not the right metric. Studies which evaluate the time to recovery, like the NIAID trial with remedisivir, are far more important in the current situation.
  - abalone 6y ago
    Sure. You can critically evaluate random Internet posts. They are still problematic when they enter public non-specialist discourse without peer review by those that possess the experience and context to properly evaluate them.
jshevek 6y ago
I take every study with a massive grain of salt, [especially one this size], until solid meta-analysis is done, but this is more promising than I expected for hydroxychloroquine without zinc: >Conclusion: in a cohort of 166 patients from 18 to 85 years hospitalised with COVID-19, hydroxychloroquine treatment with an 800mg added loading dose increased the cumulative mean survival according to the diagnosis of severity at the beginning by 1.4 to 1.8 times. This difference was statistically significant when the clinical picture at admission was mild.
imustbeevil 6y ago
> In the study of 368 patients, 97 patients who took hydroxychloroquine had a 27.8% death rate. The 158 patients who did not take the drug had an 11.4% death rate. https://www.cnn.com/2020/04/21/health/hydroxychloroquine-veterans-study/index.html https://www.cnn.com/2020/04/21/health/hydroxychloroquine-vet... Personally, when I find two studies report opposite conclusions, I take a neutral position. Neutral meaning: lets give drugs to people who need them instead of using a lupus drug to treat flu symptoms. Might as well try Benadryl and Tylenol first.
- akvadrako 6y ago
  They aren’t nessesarially opposite conclusions. Maybe they used different dosages, for example. https://www.randombio.com/hcq2.html https://www.randombio.com/hcq2.html

22 points by jaboutboul 6y ago

product50 6y ago

So Trump was right after all. Guess no newspaper will report that..

hansdieter1337 6y ago
Please educate yourself on statics and read the paper. Obvious points: - It’s a pre-print - Not reviewed - Way too small group sizes to be meaningful
- jshevek 6y ago
  >Please educate yourself on statics and read the paper. I think you mean "statistics"? Statics is the study of constant forces acting on unmoving bodies (as opposed to dynamics).
abiogenesis 6y ago
Even if Trump finally turns out to be right, he announced his claims before seeing this (or any other) study. If you claim a thousand things eventually one or two will be true.
- sfj 6y ago
  Trump often makes claims about things he wants to draw attention to. Given that HCQ is such a cheap, off patent drug, it stands to reason that he wanted to get it into the public consciousness so it would be looked at with more scrutiny. Without him mentioning it, there isn't much incentive to study it.
loopz 6y ago
All the times this person is wrong he lies about it and puts someone else under the bus. Good luck!
me_me_me 6y ago
This comment brings nothing to discussion, plus making any kind of definitive statement based on 'none statistically significant study' is plain rubbish. Go complain to fb or twitter.

jlj 6y ago

> There was a non-statistically significant trend towards survival in all groups, which will have to be clarified in subsequent studies.

sunkenvicar 6y ago

The earlier the better. Give us our Trump pills!

InTheArena 6y ago

I’m so ready to get past observational studies to real proper double-blind research, The first should go to pre-print next week. This is hopeful though.

nshepperd 6y ago
Agreed. It's disappointing to see observational study after observational study pumped out and still little-to-no actual causal evidence after three months.
- lbeltrame 6y ago
  The U of Minnesota trial (which is a true vs-placebo trial) reported on April 22nd that they needed at least 200 more people to get enough power for their study. According to their web page[1] the interim meeting of the safety board is expected for today. [1] https://covidpep.umn.edu/updates https://covidpep.umn.edu/updates

sunkenvicar 6y ago

Abstract: Background: There is no treatment proven effective against COVID-19. Several drugs with in vitro potential against SARS-CoV-2 virus have been proposed. Hydroxychloroquine has in vitro anti-viral and immunomodulatory activity, but there is no current clinical evidence of its effectiveness changing the outcome of the disease. Methods: We enrolled all 18-85 years old inpatients from Central Defense Hospital “Gómez Ulla”, Madrid, Spain, who were hospitalised for COVID-19 and had a definitive outcome (dead or discharged). We used a statistical survival analysis to detect treatment differences associated with in-hospital death. Results: We analysed first 220 medical records. 166 patients met the inclusion criteria. 48,8 % of patients not treated with HCQ died, 22% of those treated with hydroxychloroquine (p=0,002). According to clinical picture at admission, hydroxychloroquine increased the mean cumulative survival in all groups from 1,4 to 1,8 times. This difference was statistically significant in the mild group. Conclusions: in a cohort of 166 patients from 18 to 85 years hospitalised with COVID-19, hydroxychloroquine treatment with 800mg added loading dose increased survival when patients were admitted in early stages of the disease. There was a non-statistically significant trend towards survival in all groups, which will have to be clarified in subsequent studies.

hansdieter1337 6y ago

“ Age distribution according to the severity at admission was homogeneous between HCQ and non- HCQ treatment groups when the clinical picture was mild (57,6 years HCQ – 58,4 years non-HCQ, p=0,865) or moderate (63,8 years HCQ – 70 years non-HCQ, p=0,269). ” Those are some high p-values. Makes sense with a small control group of 43 people. This paper can be put in the bin labeled “no statically significance”

nshepperd 6y ago
They're meant to be high. This means "we didn't find a detectable difference in age distribution between the groups" and therefore that the results are (hopefully) not confounded by age.

abalone 6y ago

“This version is not peer-reviewed” Here’s the problem with preprints like this: In an earlier era, issues with the Santa Clara study would have been addressed during peer review—the process in which scientific work is assessed by other researchers before being published in a journal. But like many COVID-19 studies, this one was uploaded as a preprint—a paper that hasn’t yet run the peer-review gauntlet. Preprints allow scientists to share data quickly, and speed is vital in a pandemic: Several important studies were uploaded and discussed a full month before being published. Preprints also allow questionable work to directly enter public discourse, but that problem is not unique to them. The first flawed paper on hydroxychloroquine and COVID-19 was published in a peer-reviewed journal, whose editor in chief is one of the study’s co-authors.[1] [1] https://www.theatlantic.com/health/archive/2020/04/pandemic-confusing-uncertainty/610819/ https://www.theatlantic.com/health/archive/2020/04/pandemic-...

lbeltrame 6y ago
That doesn't mean one can't read the preprint and critically evaluate it (I've done so for a few posted here on HN). On this specific paper, I think tracking survival is not the right metric. Studies which evaluate the time to recovery, like the NIAID trial with remedisivir, are far more important in the current situation.
- abalone 6y ago
  Sure. You can critically evaluate random Internet posts. They are still problematic when they enter public non-specialist discourse without peer review by those that possess the experience and context to properly evaluate them.

jshevek 6y ago

I take every study with a massive grain of salt, [especially one this size], until solid meta-analysis is done, but this is more promising than I expected for hydroxychloroquine without zinc: >Conclusion: in a cohort of 166 patients from 18 to 85 years hospitalised with COVID-19, hydroxychloroquine treatment with an 800mg added loading dose increased the cumulative mean survival according to the diagnosis of severity at the beginning by 1.4 to 1.8 times. This difference was statistically significant when the clinical picture at admission was mild.

imustbeevil 6y ago

> In the study of 368 patients, 97 patients who took hydroxychloroquine had a 27.8% death rate. The 158 patients who did not take the drug had an 11.4% death rate. https://www.cnn.com/2020/04/21/health/hydroxychloroquine-veterans-study/index.html https://www.cnn.com/2020/04/21/health/hydroxychloroquine-vet... Personally, when I find two studies report opposite conclusions, I take a neutral position. Neutral meaning: lets give drugs to people who need them instead of using a lupus drug to treat flu symptoms. Might as well try Benadryl and Tylenol first.

akvadrako 6y ago
They aren’t nessesarially opposite conclusions. Maybe they used different dosages, for example. https://www.randombio.com/hcq2.html https://www.randombio.com/hcq2.html