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News Study Suggests Hydroxychloroquine May Help After All

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News Study Suggests Hydroxychloroquine May Help After All

2020-07-03 17:23:49

By Laura Tucker, Staff writer; Image: Doctors treating COVID-19 patient (Image source: Public domain)

A study showed there was a higher rate of death among coronavirus patients who took the anti-malaria drug hydroxychloroquine. Donald Trump was insistent on taking it and pushing it, however. Another study is insisting that its evidence shows the drug can be helpful, but other researchers are disputing the results.

A team in Michigan's Henry Ford Health System said Thursday that their study covered 2,541 hospitalized patients. Those who were given hydroxychloroquine were less likely to die than those who were not given the drug.

Dr. Marcus Zervos, the division head of infectious disease for Henry Ford Health System, explained that 26 percent of those not given hydroxychloroquine died, while 13 percent of those who got the drug did not. They studied everyone who died in the hospital system since the first one to do so in March.

"Overall crude mortality rates were 18.1 percent in the entire cohort, 13.5 percent in the hydroxychloroquine alone group, 20.1 percent among those receiving hydroxychloroquine plus azithromycin, 22.4 percent among the azithromycin alone group, and 26.4 percent for neither drug," wrote the team in its report in the International Journal of Infectious Diseases.

However, several other studies have not found a benefit of giving hydroxychloroquine to patients, despite Donald Trump relentlessly touting it, to the point of even claiming he himself took it, though he has never admitted to having symptoms. Studies, though, found the patients who took it did not do better and that if they received the drug, they were more likely to suffer cardiac side effects.

Initially, the Food and Drug Administration issued an emergency use authorization for the drug, only to withdraw it earlier this month.

Researchers who were not involved in the Henry Ford study noted the study wasn't of the same quality as the others. They said other treatments, such as the use of the steroid dexamethasone, could have led to the better survival rate of some patients.

"Our results do differ from some other studies," acknowledged Zervos at a news conference. "What we think was important in ours ... is that patients were treated early. For hydroxychloroquine to have a benefit, it needs to begin before the patients begin to suffer some of the severe immune reactions that patients can have with COVID."

He added that the team monitored the patients carefully for heart difficulties. "The combination of hydroxychloroquine plus azithromycin was reserved for selected patients with severe COVID-19 and with minimal cardiac risk factors," wrote the team.

The team believes their findings show that hydroxychloroquine could be useful as a possible treatment for COVID-19. "It's important to note that in the right settings, this potentially could be a lifesaver for patients," said Dr. Steven Kalkanis, CEO of the Henry Ford Medical Group, at the news conference.

Kalkanis doesn't believe his team's findings necessarily contradict the earlier studies. He stated that they "also want to make the point that just because our results differ from some others that may have been published, it doesn't make those studies wrong or definitely a conflict. What it simply means is that by looking at the nuanced data of which patients actually benefited and when, we might be able to further unlock the code of how this disease works."

"Much more work needs to be done to elucidate what the final treatment plan should be for COVID-19," Kalkinas continued. "But we feel ... that these are critically important results to add to the mix of how we move forward if there's a second surge, and in relevant other parts of the world. Now we can help people combat this disease and to reduce the mortality rate."

Zervos contends that the controversial drug can help interfere with COVID-19 directly and that it also reduces inflammation.

Researchers who were not involved with the Henry Ford study were critical of it. They pointed to the team not randomly treating patients but selecting them for treatments based on specific criteria.

"As the Henry Ford Health System became more experienced in treating patients with COVID-19, survival may have improved, regardless of the use of specific therapies," wrote Dr. Todd Lee of the Royal Victoria Hospital in Montreal, Canada, and his colleagues in a commentary in the same journal that published the Henry Ford study.

"Finally, concomitant steroid use in patients receiving hydroxychloroquine was more than double the non-treated group. This is relevant considering the recent RECOVERY trial that showed a mortality benefit with dexamethasone," added the critics, showing that the hydroxychloroquine wasn't necessarily beneficial, as many of the patients also received the steroid that has been shown to be beneficial among some patients.

The Henry Ford team wrote that 82 percent of the patients they studied received hydroxychloroquine within the first 24 hours of admission, and 91 percent received it within the first 48 hours. In comparison, a study at 25 New York hospitals started taking the drug "at any time during their hospitalization."

Yet, the New York study patients began taking the hydroxychloroquine on average one day after admission. "Maybe there's a little bit of a difference, but it's not like patients in New York were being started on day seven. That's not what happened," clarified Eli Rosenberg, the lead author of the New York study and an associate professor of epidemiology at the University at Albany School of Public Health.

He added that the Henry Ford study excluded 267 patients, which is nearly 10 percent of the total study group, who had not yet been discharged from the hospital. He believes that could have altered the results to make hydroxychloroquine look more beneficial. 

"There's a little bit of loosey-goosiness here in all this," he said.

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