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I don't work in this field, but the authors seem to be suggesting that hydroxychloroquine makes some things significantly worse. Patients who took hydroxychloroquine were much more likely to "need" supplementary oxygen. However, the two groups of patients were in two different hospitals. The paper doesn't discuss whether each hospital used exactly the same definition of "need" and had staff policies/practices that assessed this need with exactly the same amount of diligence.
I agree. From the article:

> This created a unique situation in which natural randomization occurred depending on which hospital they were admitted to.

As someone that goes to every thread about the French study to highlight that it has no real control group, I'm morary obliged to point here that this study has no real control group (in spite it has somewhat the oposite conclussion).