11 ms·
It's weak evidence because COVID-19 observational studies are riddled with confounders due to COVID patients generally throwing everything at it they can to try
by koboll 5y ago
It's weak evidence because COVID-19 observational studies are riddled with confounders due to COVID patients generally throwing everything at it they can to try and stay alive.
The exact same pattern occurred with hydroxychloroquine. Lots of small observational studies showed promise. Then it repeatedly failed large RCTs. It turns out that the people with the resources to use HCQ also had the resources to use other things, things that were actually effective.
- chana_masala 5y agoSo what were those other things, then?
- ashtonkem 5y agoDexamethasone, Remdesivir, and monoclonal antibodies are part of the go to treatments for severe Covid cases. They’re the major exotic bits of what they gave trump when he got sick, along with a bunch of over the counter stuff (zinc, vitamin D, melatonin, etc.) My understanding is that the monoclonal antibodies are the really expensive treatments. The Dexamethasone one is an interesting story. It started out as a more controversial “throw everything at the wall and see what sticks” solution by a specialist who knew steroids well. Later studies have shown a strong effect on survival, so it’s become a fairly uncontroversial part of the tool kit for severe Covid.
- makomk 5y agoOf course, what made Dexamethasone such a breakthrough wasn't really the drug itself; I think there's some evidence now that other steroids might actually work better. The big breakthrough was that some UK researchers managed to use the fact that the country got hit hard early on in the pandemic to immediately run a bunch of large randomized controlled trials on all the most promising throw-things-at-the-wall treatments to get evidence on which actually worked as soon as possible.