Conclusions: Risk stratification-based treatment of COVID-19 outpatients as early as possible after symptom onset with the used triple therapy, including the combination of zinc with low dose hydroxychloroquine, was associated with significantly less hospitalizations and 5 times less all-cause deaths.
This is a study with authorship by Vladimir Zelenko, MD, a New York physician who has often spoken in favor of HCQ in the popular press. I'm not sure what role the two German authors played.
The study finds a clear decrease in hospitalization and death among those treated with HCQ + AZT + Zinc to an "untreated public reference". Essentially no details are given regarding the control group except whether they sought hospitalization or died as a result of COVID-19.
The study group was clearly younger than the usual COVID-19 death (median age: 58; IQR 40-60), but 70% had one or more medical condition that may serve as a comorbidity (most common: hypertension 28%, obesity 28%, hyperlipidema 23%).
As with many of the studies that aren't RCTs, it is difficult to say whether the treatment worked or not. In this case, since the control group is unknown in composition, the data is really murky. 4 hospitalizations among 141 COVID-positive patients sounds fairly low, but I can't say that definitively.
This can't be right. First, this therapy was advocated by Trump, and everything he touches is wrong and must be burned to the ground, just like the media says. Second, the media has been telling me this literally kills people. So I'm going to ignore this and be thankful to Big Pharma and Gilead for providing me with the remdesivir miracle cure. Obviously this is HN, who always follows facts, so this satirical comment will fade, because clearly the good rational people of HN all knew HCQ/AZ/Zn worked all along, and they were never ever deluded by the media. Right? right? Plus, there's no moral liability issue the the media has in possible causing more death by discouraging and misrepresenting a useful therapy, so let's just ignore any culpability and get back to being grateful we have a Free Press, unlike those commies. Happy 4th!!!!
I think the comments are somewhat telling about this paper and preprints as sources of medical decision making overall.
Comment 1: "A subtler point is that the reported age profile of the treatment group is impossible. Group A is aged >60 years, and almost half of the treatment group was in that group. But the IQR was reported as 40-60, so only 25% of the treatment group had an age >60. I hope this was due to excessive rounding, or a similar error that can be corrected."
Comment 2: 'I know nothing of this field but study seems well done'
Comment 3: lauds the authors, makes no comments about the study, and rants about the pharmaceutical industry
Authors include a hand surgeon and a family practitioner (Zelenko) who has been urging hydroxychloroquine as a treatment for a long time now, and was one of Trump's main sources[0].
As pointed out in the comments on the site, the key issue here is that it is not a blind study, but a case series study where the demographics of the control group are unreported:
>The main problem with this work is that the demographics of the control group are not reported, so we have no idea if they are similar. This them means that we have no idea if the differences in outcomes are because of the treatment, or if they would be expected because of the demographies of the groups.
>A subtler point is that the reported age profile of the treatment group is impossible. Group A is aged >60 years, and almost half of the treatment group was in that group. But the IQR was reported as 40-60, so only 25% of the treatment group had an age >60. I hope this was due to excessive rounding, or a similar error that can be corrected.
It appears that the researchers selected the treatment group based on a set of quite specific criteria and then compared the outcomes of those patients with outcomes in the general population (see figure 1).
This needs more supporting data and independent verification. It's Vladimir Zelenko, again.[1] Without an outside review of the data, again. Also, all the patients are apparently from Kiyras Joel, which is a cult community in New York State with group prayer three times a day. It's a high-density situation, like a nursing home.
Zelenko had previously stated that "90% of Kiryas Joel had COVID-19 after 9 of his first 14 tests came back positive — a conclusion the Orange County health commissioner blasted as irresponsible."[2]
Lots of stories from March, few later, probably because NYC had a much bigger epidemic.
What I saw on Twitter is many GOP/Trump militants making dubious claims about HCQ effectiveness and branding everyone who disagree victims of TDS..
And I'm all for medium or others censoring medical disinformation as it was the case with the article you linked to.
Looking at the many studies that were made in the last monthes (including RCTs) and their respective shortcoming it is clear that HCQ isn't effective..
> What I saw on Twitter is many GOP/Trump militants making dubious claims about HCQ effectiveness and branding everyone who disagree victims of TDS..
I also saw the opposite, people saying "we knew all along", before some solid evidence was out (RECOVERY, and the UMN study: the latter however has limits due to lack of PCR-confirmed viral tests). Or they believed the flawed Lancet paper unconditionally (count me among them, it was a mistake).
The whole matter was politicized too heavily and the first victim was science, as far as I can see.
I say "some" and not "the" evidence because there are still some large studies going on, like COPCOV.
This is one of the reasons many experienced politicians choose not to comment on things that they know will only politicize a thing. As soon as Trump decided to tie his political fortunes to something, it created negative motivations for others to see it fail. And with Trump's record, as soon as he mentions something, a lot of people are going to instantly assume the truth must be elsewhere.
Why are the researchers combining several different substances at once without understanding the full effects of a single one of the substances in relation to COVID-19? What if zinc (a vitamin that is important to the immune system) is solely responsible for the improved health outcomes?
Dr. Zelenko stated in a widely circulated letter Mar 23 2020:
My out-patient treatment regimen is as follows:
1. Hydroxychloroquine 200mg twice a day for 5 days
2. Azithromycin 500mg once a day for 5 days
3. Zinc sulfate 220mg once a day for 5 days
The rationale for my treatment plan is as follows. I combined the
data available from China and South Korea with the recent study
published from France (sites available on request). We know that
hydroxychloroquine helps Zinc enter the cell. We know that Zinc
slows viral replication within the cell. Regarding the use of
azithromycin, I postulate it prevents secondary bacterial
infections. These three drugs are well known and usually well
tolerated, hence the risk to the patient is low.
Sometimes observational studies are all you have (especially early). 5 months out is very early. A good observational study can tell you more than many poorly-executed randomized double blind placebo controlled studies. You may see RCT come out in at best another year. OTOH you may never see good RCT's because...
Pharmaceutical companies and their custodians, FDA CDC and WHO, don't prefer a cheap available solution. Yet the earliest hope, Gilead's remdesevir, has proven ineffective, less effective than HCQ+ZINC+ZPAK.
The public is confused by the politicizing of this but all they need to do is "follow the money". There are not millions, not billions, but trillions of dollars to be made here. Everybody involved in vaccine research who is not a saint is trying to get rich off Covid-19 and if they can make a case to the press/congress/executive of the US goverrnment then they will be offered money to do so by interested parties.
EXAMPLE:
"The COVID-19 Treatment Panel of NIH evaded disclosure of the massive financial links of its members to Gilead Sciences, the manufacturer of a competing drug remdesivir. Among those who failed to disclose such links are 2 out of 3 of its co-chairs."
Why are all articles about HCQ getting flagged? Who is afraid of the discussion? If it works, we should be able to discuss it. If it doesn't work, we should also be able to discuss it. Sunlight and truth is key.
Some doctors are able to put 2+2 together, Zinc kills the virus, HCQ helps Zinc into the cell and they are saving lives with this treatment. Other doctors hate Orangeman so much they would rather see people die than give any sort of credit to Orangeman. When this becomes clear to the American people that 44% of those lost to this disease could have been spared, there will be a revolution.
This is the only trial in the US that has a chance of completing a study of HCQ+Zinc. Unfortunately, it is not being fast-tracked while people are dying. Call you representative and demand that this trial be fast-tracked before big pharma and the Orangeman haters destroy it.
21 comments
[ 4.1 ms ] story [ 55.1 ms ] threadConclusions: Risk stratification-based treatment of COVID-19 outpatients as early as possible after symptom onset with the used triple therapy, including the combination of zinc with low dose hydroxychloroquine, was associated with significantly less hospitalizations and 5 times less all-cause deaths.
This is a study with authorship by Vladimir Zelenko, MD, a New York physician who has often spoken in favor of HCQ in the popular press. I'm not sure what role the two German authors played.
The study finds a clear decrease in hospitalization and death among those treated with HCQ + AZT + Zinc to an "untreated public reference". Essentially no details are given regarding the control group except whether they sought hospitalization or died as a result of COVID-19.
The study group was clearly younger than the usual COVID-19 death (median age: 58; IQR 40-60), but 70% had one or more medical condition that may serve as a comorbidity (most common: hypertension 28%, obesity 28%, hyperlipidema 23%).
As with many of the studies that aren't RCTs, it is difficult to say whether the treatment worked or not. In this case, since the control group is unknown in composition, the data is really murky. 4 hospitalizations among 141 COVID-positive patients sounds fairly low, but I can't say that definitively.
Comment 1: "A subtler point is that the reported age profile of the treatment group is impossible. Group A is aged >60 years, and almost half of the treatment group was in that group. But the IQR was reported as 40-60, so only 25% of the treatment group had an age >60. I hope this was due to excessive rounding, or a similar error that can be corrected."
Comment 2: 'I know nothing of this field but study seems well done'
Comment 3: lauds the authors, makes no comments about the study, and rants about the pharmaceutical industry
Authors include a hand surgeon and a family practitioner (Zelenko) who has been urging hydroxychloroquine as a treatment for a long time now, and was one of Trump's main sources[0].
[0] https://forward.com/news/national/447109/zelenko-hydroxychlo...
>The main problem with this work is that the demographics of the control group are not reported, so we have no idea if they are similar. This them means that we have no idea if the differences in outcomes are because of the treatment, or if they would be expected because of the demographies of the groups.
>A subtler point is that the reported age profile of the treatment group is impossible. Group A is aged >60 years, and almost half of the treatment group was in that group. But the IQR was reported as 40-60, so only 25% of the treatment group had an age >60. I hope this was due to excessive rounding, or a similar error that can be corrected.
It appears that the researchers selected the treatment group based on a set of quite specific criteria and then compared the outcomes of those patients with outcomes in the general population (see figure 1).
Lots of stories from March, few later, probably because NYC had a much bigger epidemic.
[1] http://archive.is/rg1IG
[2] https://www.lohud.com/story/news/coronavirus/2020/03/24/kiry...
I remember when the media politicized the drug, and it caused places like medium to ban articles saying it was useful:
http://web.archive.org/web/20200405061401/https://medium.com...
Then we find out there was fabricated data about the drug in the world’s top medical journal that had to be retracted.
wtf is going on
FTFY
Both The Lancet and NEJM!
I saw some media posting medical disinformation like the claim that in Italy lupus patients treated with HCQ were protected from covid.. https://www.thegatewaypundit.com/2020/04/media-lied-people-d... Denial from the Italia reumatology society: https://www.iltempo.it/cronache/2020/05/02/news/idrossicloro... And claiming that people who do not think HCQ is effective do so because of their anti-Trump feelings.. So that seems to match your claim about media politizing..
What I saw on Twitter is many GOP/Trump militants making dubious claims about HCQ effectiveness and branding everyone who disagree victims of TDS..
And I'm all for medium or others censoring medical disinformation as it was the case with the article you linked to.
Looking at the many studies that were made in the last monthes (including RCTs) and their respective shortcoming it is clear that HCQ isn't effective..
I also saw the opposite, people saying "we knew all along", before some solid evidence was out (RECOVERY, and the UMN study: the latter however has limits due to lack of PCR-confirmed viral tests). Or they believed the flawed Lancet paper unconditionally (count me among them, it was a mistake).
The whole matter was politicized too heavily and the first victim was science, as far as I can see.
I say "some" and not "the" evidence because there are still some large studies going on, like COPCOV.
I'd go further, and say that actually a lot regarding this disease is still heavily polarized, without any room for more nuanced positions.
https://www.henryford.com/news/2020/07/hydro-treatment-study
Pharmaceutical companies and their custodians, FDA CDC and WHO, don't prefer a cheap available solution. Yet the earliest hope, Gilead's remdesevir, has proven ineffective, less effective than HCQ+ZINC+ZPAK.
The public is confused by the politicizing of this but all they need to do is "follow the money". There are not millions, not billions, but trillions of dollars to be made here. Everybody involved in vaccine research who is not a saint is trying to get rich off Covid-19 and if they can make a case to the press/congress/executive of the US goverrnment then they will be offered money to do so by interested parties.
EXAMPLE:
"The COVID-19 Treatment Panel of NIH evaded disclosure of the massive financial links of its members to Gilead Sciences, the manufacturer of a competing drug remdesivir. Among those who failed to disclose such links are 2 out of 3 of its co-chairs."
the above quote is from:
https://wattsupwiththat.com/2020/05/02/pseudo-science-behind...
for details visit:
https://defyccc.com/covid-19-panel-gilead-ties/
What is going on, HN?
A study at NYU study showed a 44% reduction in death rate for patients treated with HCQ and ZINC. https://www.medrxiv.org/content/10.1101/2020.05.02.20080036v... A recent study in Michigan at Henry Ford Health System showed a significant cut in death rate using HCQ . https://www.henryford.com/news/2020/07/hydro-treatment-study
Some doctors are able to put 2+2 together, Zinc kills the virus, HCQ helps Zinc into the cell and they are saving lives with this treatment. Other doctors hate Orangeman so much they would rather see people die than give any sort of credit to Orangeman. When this becomes clear to the American people that 44% of those lost to this disease could have been spared, there will be a revolution.
This is the only trial in the US that has a chance of completing a study of HCQ+Zinc. Unfortunately, it is not being fast-tracked while people are dying. Call you representative and demand that this trial be fast-tracked before big pharma and the Orangeman haters destroy it.
https://clinicaltrials.gov/ct2/show/NCT04370782