Hacker News new | past | comments | ask | show | jobs | submit login
Hydroxychloroquine Tied to Deaths, Heart Risk in Covid Study (bloomberg.com)
27 points by pseudolus 15 days ago | hide | past | web | favorite | 26 comments

Expression of concern: Hydroxychloroquine or chloroquine with or without a macrolide for treatment of COVID-19: a multinational registry analysis


Absolute garbage. The study confirms that sicker patients get hydroxychloroquine more frequently than less-sick patients. When sicker patients get drugs, "Treatment with any combination of the four drugs was associated with a higher risk of death than seen in 81,000 patients who didn’t receive them."

And...why don't the study authors control for zinc use as well? "Hydroxychloroquine is a zinc ionophore", explains one paper.

> The study confirms that sicker patients get hydroxychloroquine more frequently than less-sick patients.

Wait, where does it say that in the study? The study specifically says it controls for disease severity (amongst other things), and that it only uses data for people given the drugs within 48 hours of diagnosis.

"Within 48 hours of diagnosis" indicates nothing about disease severity, nor how long patients were sick prior to diagnosis.

> Wait, where does it say that in the study? The study _supports_ the idea that sicker patients get hydroxychloroquine more frequently than less-sick patients. The study's raw figures show that sicker patients get hydroxychloroquine more than healthier patients.

The study states that besides age and BMI, "all other [control] data were treated as categorical variables in the model."

It's clear the study's authors don't sensitively control for patients' angiotensin-renin-aldosterone system health.

There's strong subject selection bias in "initial disease severity" as well when some subjects die at home and others go to the ER mistaking mild Covid for heart attack symptoms.

You seem to have a post history of dragging any study that calls into question the use of Hydroxychloroquine so it's not hard to see the clear bias in play here. Medical consensus is increasingly becoming apparent that it's either ineffective in healthy patients or dangerous for patients with more severe complications due to the side effects.

I agree with data from studies questioning the efficacy of hydroxychloroquine without health zinc and nitric oxide & vitamin D levels. I agree with data from studies questioning the efficacy of hydroxychloroquine when patients are too sick.

I don't agree with overly-broad conclusions and I certainly don't agree with wasted time spent approving and writing up underscoped studied.

Medical consensus on Covid treatment amongst professionals is overwhelmingly "we're not confident enough to develop changes in our practices based on current science and research. We need to see other professionals we trust, beyond journal editors, use the current science and research before we'll use it."

Medical research on HQC is laughable at best. The first reports from Wuhan talked about the efficiency of it as prescription drug. Then it appeared for a short while in their treatment plan, up to their 7th revision, at around Mid February. In extremely high dosis. At around April Europeans started trying it as treatment. Several studies appeared, the first French one being positive but the study itself was flawed. All other subsequent studies produced failures. But not a single study tried HCQ as prevention drug. Because that's how it works. That's btw also how those disliked presidents use it.

The first such study just appeared today, from India. Of course it works as advertised and is now recommended prevention in India. https://www.icmr.gov.in/pdf/covid/techdoc/V5_Revised_advisor...

There were multiple posters here on HN advocating for Hydroxychloroquine saying that it's safe, that you have nothing to lose otherwise and that it's better to try something than do nothing.

So unfortunately what we have here is a textbook example of people falling for a cargo cult surrounding a drug whose efficacy wasn't confirmed at all. Even if a drug seems safe and has few side effects, you should never self-dose or listen to people without medical consensus.

> medical consensus

I think I can understand where these sentiments come from.

People are dissatisfied with medical consensus because medicine doesn’t really speak with a unified voice. A doctor in one hospital might treat a condition differently from another — sometimes radically differently — and your family doctor might say something different from either of them. And anyone who’s been paying attention has seen authoritative recommendations from one decade be retracted a decade or two later.

The discipline is still waiting for a lot of discoveries that would dramatically change both mundane and more rare scenarios. A lot of competing theories show up in practice, which is natural for innovation.

Unfortunately, there are a number of cargo cults that have been medical consensus for many years.

> People are dissatisfied with medical consensus because medicine doesn’t really speak with a unified voice.

It's hard for me not to empathize with this mindset in others when I see agencies like WHO spreading dis/misinformation on the pandemic to control some political narrative.

Hydroxychloroquine's efficacy against coronavirus-family viruses has been actually shown for 15+ years, since SARS.

And by definition, innovative medicine doesn't have medical consensus yet.

As prevention yes, as treatment not. Because then it's too late already. It needs 2-3 weeks to build up enough zinc in the cells.

> you should never self-dose

It isn't like you can just pick this stuff up at the grocery story, you would still need a prescription from a doctor.

You can tell the doctor that you need Plaquenil for your upcoming business trip to Africa. Thats how people started doing it back in March.

If you are in the risk group. Otherwise the chances are extremely low.

There are many drugs that aren't "safe", but are yet better than any alternative (including doing nothing).

Call me crazy, but there is something interesting I observed. Before Trump started advocating for it, there were some articles touting Hydroxychloroquine as a potential Covid-19 treatment, and that it was worth trying. Immediately after Trump started advocating for it, Hydroxychloroquine became like a poison, that will kill everyone. Isn't that great? I wish more things would receive this level of scrutiny before being inflicted on vulnerable and desperate people.

This is an artifact of the way the news was presented where you read it: this is an old drug with well-understood side-effects and actual experts (pharmacists, doctors, patients) pointed those out almost immediately.

The problem is that the people hyping it through either desperation or greed have a lot more time to spend promoting an idea than, say, medical professionals during a pandemic — a dynamic which got much worse when the full weight of Fox News and the President of the United States jumped on board the hype train.

I believe it's the same phenomenon that we saw with the stock market crash after Trump gave his first coronavirus address.

Confirming what we've known all along

It’s probably too early to draw conclusions. Many doctors seem to think it is the best treatment available: http://nypost.com/2020/04/02/hydroxychloroquine-most-effecti...

I think people should resist politicizing this because they are for our against Trump. It is normal for both medicine and the scientific process in general to have a multitude of voices with diverse opinions.

It's practically obscene that anyone thinks that Trump's mention should in any way affect their thinking about a drug. People are dying--let science run its course unhindered.

I am hoping come the November elections that Trump will be gone. He has made the US look incredibly stupid in the rest of the world's eyes.

Guidelines | FAQ | Support | API | Security | Lists | Bookmarklet | Legal | Apply to YC | Contact