3 ms·
Something I personally would find helpful is if someone with the appropriate background could talk through these results and some of the acronyms. This passage
by AaronFriel 6y ago
Something I personally would find helpful is if someone with the appropriate background could talk through these results and some of the acronyms.
This passage is quite dense, and I think I and - hopefully I'm underestimating the audience on HN - others would have difficulty parsing it:
> After exclusion of studies with critical bias, the pooled RR for COVID-19 mortality was 1.27 (95%CI: 1.04-1.54, n=7) indicating an increased mortality linked to the use of hydroxychloroquine with azithromycin. With a baseline hospital mortality of 26%, we identified a significant absolute risk difference of +7%. We found an increased risk of mortality in patients treated with hydroxychloroquine and azithromycin compared to standard of care (RR: 1.29 (95%CI: 1.06-1.58, n=6)) among non-randomized studies but this relationship was not found in the single Brazilian RCT, with no heterogeneity observed across the study design (Pheterogeneity between = 0.28) (Figure 3). There was a low heterogeneity across the included studies (I2 =38%, p=0.14). Egger's test (p= 0.70) and Begg's test (p=0.65) were not significant but the asymmetry in the funnel plot indicates that a publication bias could be present (Figure S7). However, the number of included studies was small. Subgroup analyses are described in supplementary material (Table S4, Figure S8). The Bayesian meta-analysis led to similar results with a pooled RR for mortality of 1.32 (95%CI: 0.97-1.68, n=7 studies) (Table S5, Figure S9). The increase in mortality was also significant with influence analysis (Figure S10).
RR is relative risk, HR is hazard ratio, OR is odds ratio. Are there any red flags in reading this, and how relevant is it that studies were excluded for critical bias, that the single randomized controlled trial did not show this relationship.
The number of studies of HCQ with AZI was also quite small - is that a problem, and how likely is it that we could expect further studies to point in the opposite direction? 5% likely? More or less?
Lastly, many HCQ proponents advocate zinc in this mixture. That wasn't included in this meta-analysis. Is there a clinical basis for believing zinc changes the therapeutic effect of HCQ and AZI?