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Hydroxychloroquine Helped Coronavirus Patients Survive, Study Finds

2020-07-03T20:00:57.181Z


A study by the Henry Ford Health System in Michigan said that a group of more than 2,500 covid-19 patients who received hydroxychloroquine were much less likely to die than ...


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(CNN) - A surprising new study found that the controversial antimalarial drug hydroxychloroquine helped patients survive in the hospital.

A team from the Henry Ford Health System in Southeast Michigan said Thursday that their study of 2,541 hospitalized patients found that those who received hydroxychloroquine were much less likely to die.

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Dr. Marcus Zervos, chief infectious disease division for the Henry Ford Health System, said 26% of those who did not receive hydroxychloroquine died, compared to 13% of those who received the drug. The team reviewed all those treated in the hospital system since the first patient in March.

"Overall crude mortality rates were 18.1% across the cohort, 13.5% in the hydroxychloroquine alone group, 20.1% among those receiving hydroxychloroquine plus azithromycin, 22.4% among the azithromycin alone group and 26.4% for none of the medications, ”the team wrote in a report published in the International Journal of Infectious Diseases.

It is a surprising finding because several other studies have found no benefit from hydroxychloroquine, a medication originally developed to treat and prevent malaria. President Donald Trump heavily promoted the drug, but later studies found that patients not only did not improve if they received the drug, but were more likely to experience cardiac side effects.

The U.S. Food and Drug Administration (FDA) withdrew its emergency use authorization for the drug earlier this month, and trials worldwide, including trials sponsored by the World Health Organization and the World Health Organization, were suspended. National Institutes of Health.

"Our results differ from other studies," said Zervos at a press conference. "What we think was important in ours ... is that the patients were treated before. For hydroxychloroquine to have a benefit, it must start before patients begin to experience some of the serious immune reactions that patients may have with covid-19. ”

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Henry Ford's team also carefully monitored patients for heart problems, he said.

"The combination of hydroxychloroquine plus azithromycin was reserved for selected patients with severe covid-19 and minimal cardiac risk factors," the team wrote.

Henry Ford's team said they believe their findings show that hydroxychloroquine could potentially be useful as a treatment for coronavirus.

"It is important to note that in the right settings, this could be a lifesaver for patients," said Dr. Steven Kalkanis, CEO of the Henry Ford Medical Group, at the press conference.

Kalkanis said his findings do not necessarily contradict those of previous studies. "We also want to point out that just because our results differ from some others that may have been published, it doesn't make those studies wrong or definitely conflict. What it simply means is that by looking at the nuanced data that patients really benefited from and when we could further unlock the code for how this disease works, ”he said.

"Much more work is needed to figure out what the final treatment plan should be for covid-19," added Kalkanis. "But we feel ... that these are critically important results to add to the mix of how we move forward if there is a second wave (of contagion), and in other relevant parts of the world. Now we can help people fight this disease and reduce the death rate. "

Zervos said that hydroxychloroquine can help directly interfere with the virus and also reduce inflammation.

Investigators who were not involved in the study were critical. They noted that Henry Ford's team did not randomly treat patients, but instead selected them for various treatments based on certain 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 colleagues in a comment in the same newspaper.

"Finally, the concomitant use of steroids in patients receiving hydroxychloroquine was more than double that of the untreated group. This is relevant considering the recent RECOVERY trial that showed a mortality benefit with dexamethasone. ” The steroid dexamethasone can reduce inflammation in seriously ill patients.

Henry Ford's team wrote that 82% of their patients received hydroxychloroquine within the first 24 hours of admission, and 91% within the first 48 hours of admission.

By comparison, they wrote, a study of patients in 25 New York hospitals began taking the drug "any time during their hospital stay."

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But patients in that New York study, published in the Journal of the American Medical Association in May, started taking hydroxychloroquine on average a day after being hospitalized.

"Maybe there is a little difference, but it's not like patients in New York start on day seven. That was not what happened, ”said Eli Rosenberg, lead author of the New York study and an associate professor of epidemiology at the University of Albany School of Public Health.

Rosenberg also noted that the Detroit newspaper excluded 267 patients, nearly 10% of the study population, who had not yet been discharged from the hospital.

He said this could have skewed the results to make hydroxychloroquine look better than it really was. Those patients could still have been in the hospital because they were very sick, and if they died, by excluding them from the study, hydroxychloroquine seemed more like a lifesaver than it really was.

"There's a little laziness here in all of this," Rosenberg told CNN.

Both the Detroit and New York studies were observational: They looked at how patients worked when doctors prescribed hydroxychloroquine.

Although useful, observational studies are not as valuable as controlled clinical trials. Considered the gold standard in medicine, patients in a clinical trial are randomly assigned to take the medicine or a placebo, which is a treatment that does nothing. Doctors then follow patients to see how they are doing.

Two clinical trials of hydroxychloroquine for covid-19, one in the United States and one in the United Kingdom, were stopped early because their data suggested that hydroxychloroquine was not helpful.

The United States trial, led by the National Institutes of Health, enrolled more than 470 patients.

The UK trial, led by the University of Oxford, enrolled more than 11,000 patients.

"We have concluded that there is no beneficial effect of hydroxychloroquine in hospitalized patients with covid-19," concluded the Oxford physicians.

But a White House official praised the Henry Ford team's study.

Peter Navarro, the White House business adviser, said the study shows that hydroxychloroquine works if given early enough.

"This is a big problem," he told CNN. "This drug can literally save tens of thousands, perhaps hundreds of thousands of American lives and perhaps millions of people worldwide."

covid-19 hydroxychloroquine

Source: cnnespanol

All news articles on 2020-07-03

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