4 ms·

I find this paragraph to be too neutral about HCL, and tbh a bit out of date: > Chloroquine and hydroxychloroquine are other potential but controversial drugs

by est31 6y ago

I find this paragraph to be too neutral about HCL, and tbh a bit out of date: > Chloroquine and hydroxychloroquine are other potential but controversial drugs that interfere with the entry of SARS-CoV-2. They have been used in the prevention and treatment of malaria and autoimmune diseases, including systemic lupus erythematosus and rheumatoid arthritis. They can inhibit the glycosylation of cellular receptors and interfere with virus–host receptor binding, as well as increase the endosomal pH and inhibit membrane fusion. Currently, no scientific consensus has been reached for their efficacy in the treatment of COVID-19. Some studies showed they can inhibit SARS-CoV-2 infection in vitro, but the clinical data are insufficient. Two clinical studies indicated no association with death rates in patients receiving chloroquine or hydroxychloroquine compared with those not receiving the drug and even suggest it may increase the risk of dying as a higher risk of cardiac arrest was found in the treated patients130,131. On 15 June 2020, owing to the side effects observed in clinical trials, the US Food and Drug Administration (FDA) revoked the emergency use authorization for chloroquine and hydroxychloroquine for the treatment of COVID-19 The in vitro studies that showed HCL efficacy were using vero lines, basically kidney cells. Those cells don't express the TMPRSS2 receptor, which is expressed on lung cells though. Studies have shown since that if you modify vero lines to express TMPRSS2, or use lung cells instead of kidney cells, HCL has no effect. It's kinda understandable that the earlier studies have used vero lines, because it's a standard cell line. But research has moved on since. The newer study has come out in July and should have been known to the authors of this review. https://www.nature.com/articles/s41586-020-2575-3 https://www.nature.com/articles/s41586-020-2575-3

roenxi 6y ago
The circumstantial evidence of HCQ being positive is substantial, and at least some of the complaints against it are politically motivated. Although how being hopeful about a COVID treatment became a pro-Trump political stance is beyond me. They can wait until the scientific evidence is overwhelming. No hurry, there are a lot of studies starting to come due. Bodies are complex and maybe something is going on that hasn't been thought of yet. EDIT Thanks swebs for the HCL->HCQ correction.
- OnACoffeeBreak 6y ago
  Seems like your wait is over. From the second half of [0]: > Hydroxychloroquine treatment for coronavirus does not work. It is not beneficial, and in fact appears to be actively harmful. As far as I’m concerned, administering it to infected patients now constitutes medical malpractice. Check the linked article for reference to the study. 0: https://blogs.sciencemag.org/pipeline/archives/2020/10/09/hard-data https://blogs.sciencemag.org/pipeline/archives/2020/10/09/ha...
  - roenxi 6y ago
    One of my favourite posts on HN was some gentleman telling me that masks didn't help against COVID, that the science was in, and that I was endangering lives by even suggesting something so stupid when either the WHO or CDC or Fauci had debunked the idea. I think that was back around April. My current policy is to wait until the evidence is older than a week. That is one open label study on patients that were already in hospital - strong evidence, but not a final word. Maybe they missed something, maybe they made a mistake. Science is hard.
    - hn_throwaway_99 6y ago
      I think you're making false equivalences. To be clear, there has never been good scientific evidence that masks are ineffective against respiratory viruses. I think WHO, CDC and Fauci made grave errors at the time by making the argument that mask-wearing by the general public "doesn't work". The clear (and quite understandable) fear was that there would be a run on masks by the general public, so instead of telling the truth ("we need the masks for healthcare workers") they made broader and confusing statements about the effectiveness of masks that were not supported by the underlying science. This had the terrible effect, as your post shows, of making people even more wary of scientific pronouncements. Mine is not an isolated viewpoint. There was a good opinion article in the Washington Post at the time by an influential researcher where she argued the same thing. Contrarily, the good studies that have come out about HCQ have nearly uniformly shown their potential danger. There is simply no equivalence between the scientific data that HCQ is harmful and the data (that never existed mind you) that mask-wearing is ineffective.
gridlockd 6y ago
Any discussion of HCQ that ignores zinc, a key part of the original treatment protocol, is missing the mark. Rationale: https://www.sciencedirect.com/science/article/pii/S0306987720306435 https://www.sciencedirect.com/science/article/pii/S030698772... Trial: https://pubmed.ncbi.nlm.nih.gov/32930657/ https://pubmed.ncbi.nlm.nih.gov/32930657/
- gridlockd 6y ago
  A paper published in Nature is being criticized as "too neutral" for pointing out that the evidence is inconclusive. My comment is getting heavily downvoted, despite being properly sourced. No counter-argument or evidence is presented. Why? Does nobody care to explain themselves?
  - scns 6y ago
    Maybe your negative tone or the low information density. I guess just dropping links is frowned upon. You could have written a short summary or at least paste the TLDR from these papers and then link to the sources.
swebs 6y ago
>HCL It's a bit weird to use that as an acronym for hydroxychloroquine when everybody already uses it for hydrochloric acid (Hydrogen Chloride).
- est31 6y ago
  Thanks for pointing this out. Shows that I'm no chemist :). According to Wikipedia the common abbreviation is HCQ instead of HCL. HN won't let me edit my post any more, otherwise I'd revise my comment.
  - NeutronStar 6y ago
    You should still try to fix your acronym, but his acronym is also wrong. He should have use HCl for Hydrogen Chloride.
- ygra 6y ago
  HCL and HCl would be very different things to a chemist, though, if an element L would actually exist.

by est31 6y ago

roenxi 6y ago

The circumstantial evidence of HCQ being positive is substantial, and at least some of the complaints against it are politically motivated. Although how being hopeful about a COVID treatment became a pro-Trump political stance is beyond me. They can wait until the scientific evidence is overwhelming. No hurry, there are a lot of studies starting to come due. Bodies are complex and maybe something is going on that hasn't been thought of yet. EDIT Thanks swebs for the HCL->HCQ correction.

OnACoffeeBreak 6y ago
Seems like your wait is over. From the second half of [0]: > Hydroxychloroquine treatment for coronavirus does not work. It is not beneficial, and in fact appears to be actively harmful. As far as I’m concerned, administering it to infected patients now constitutes medical malpractice. Check the linked article for reference to the study. 0: https://blogs.sciencemag.org/pipeline/archives/2020/10/09/hard-data https://blogs.sciencemag.org/pipeline/archives/2020/10/09/ha...
- roenxi 6y ago
  One of my favourite posts on HN was some gentleman telling me that masks didn't help against COVID, that the science was in, and that I was endangering lives by even suggesting something so stupid when either the WHO or CDC or Fauci had debunked the idea. I think that was back around April. My current policy is to wait until the evidence is older than a week. That is one open label study on patients that were already in hospital - strong evidence, but not a final word. Maybe they missed something, maybe they made a mistake. Science is hard.
  - hn_throwaway_99 6y ago
    I think you're making false equivalences. To be clear, there has never been good scientific evidence that masks are ineffective against respiratory viruses. I think WHO, CDC and Fauci made grave errors at the time by making the argument that mask-wearing by the general public "doesn't work". The clear (and quite understandable) fear was that there would be a run on masks by the general public, so instead of telling the truth ("we need the masks for healthcare workers") they made broader and confusing statements about the effectiveness of masks that were not supported by the underlying science. This had the terrible effect, as your post shows, of making people even more wary of scientific pronouncements. Mine is not an isolated viewpoint. There was a good opinion article in the Washington Post at the time by an influential researcher where she argued the same thing. Contrarily, the good studies that have come out about HCQ have nearly uniformly shown their potential danger. There is simply no equivalence between the scientific data that HCQ is harmful and the data (that never existed mind you) that mask-wearing is ineffective.

gridlockd 6y ago

Any discussion of HCQ that ignores zinc, a key part of the original treatment protocol, is missing the mark. Rationale: https://www.sciencedirect.com/science/article/pii/S0306987720306435 https://www.sciencedirect.com/science/article/pii/S030698772... Trial: https://pubmed.ncbi.nlm.nih.gov/32930657/ https://pubmed.ncbi.nlm.nih.gov/32930657/

gridlockd 6y ago
A paper published in Nature is being criticized as "too neutral" for pointing out that the evidence is inconclusive. My comment is getting heavily downvoted, despite being properly sourced. No counter-argument or evidence is presented. Why? Does nobody care to explain themselves?
- scns 6y ago
  Maybe your negative tone or the low information density. I guess just dropping links is frowned upon. You could have written a short summary or at least paste the TLDR from these papers and then link to the sources.

swebs 6y ago

>HCL It's a bit weird to use that as an acronym for hydroxychloroquine when everybody already uses it for hydrochloric acid (Hydrogen Chloride).

est31 6y ago
Thanks for pointing this out. Shows that I'm no chemist :). According to Wikipedia the common abbreviation is HCQ instead of HCL. HN won't let me edit my post any more, otherwise I'd revise my comment.
- NeutronStar 6y ago
  You should still try to fix your acronym, but his acronym is also wrong. He should have use HCl for Hydrogen Chloride.
ygra 6y ago
HCL and HCl would be very different things to a chemist, though, if an element L would actually exist.