Best I can tell, the article doesn't even mention the cause of death. :-) Did they die because they were given HCQ or did they die in spite of being given HCQ? We'll never know.
And the paper itself (https://web.archive.org/web/20200413181618/https://www.medrx...) doesn't say that either, and mentions that this study's randomization was flawed in that older patients with heart disease were assigned to the high dosage arm of the experiment.
They saw people were getting heart arrhythmias in the original Brazil study. Anecdotally, a doctor I know has been seeing an increase in arrhythmias on patients treated with HCQ at lower doses if they already have a pre-existing circulatory problem. What is really irking me is that we still don't even know if it's really doing anything.
At the same time, my elderly parent is taking HCQ for arthritis and appears to think she is invincible, going to the store each day in the middle of Queens, the world epicenter. She tried to send me links to Trump's touted Dr. Zelenko about how it's a miracle cure.
Alot of people touting this stuff dismiss or are in denial about their own condition.
I have a friend yakking about this topic and dismissing things like "pre-existing circulatory problems". This particular individual has had high blood pressure since we were in high school, is overweight, pre-diabetic and has some other problems. It doesn't dawn upon him that he is in the bullseye of people who are high risk for both the disease and the experimental, potential treatment option.
We don't even know if eggs and butter are "good for you" so I'm not surprised we know jack squat about HCQ beyond anecdotal evidence, which most studies you will find in the press seem to either ignore, or set their studies up s.t. they fail. In particular, per anecdotal evidence HCQ+Zpak+Zinc is the most effective combination, and only if given at the onset of symptoms. Yet routinely we see either just HQ or HCQ alone, or HCQ (with or without Zpak) given to patients that are so far gone it's unlikely to make any difference. Just read the original study fer chrissakes, it's publicly accessible. Sure it's not "randomized" or "principled", but at the very least _try_ what Raoult did in the first place, maybe? Exactly as he did it?
It looks like Azithromycin is for clearing bacterial pneumonia. Certainly this is a possible and probably common complication of viral pneumonia caused by COVID-19, but I'm sure doctors are well aware of ways to treat secondary bacterial pneumonia.
Just looking at what doctors are saying about Zinc, it seems like there could be something to it, especially if an individual is Zinc deficient, but it's not at all clear it's anything like a silver bullet.
We have no idea what the mechanism of action if for HCQ. My doctor friend tried looking it up and it seemed like there are many possible pathways, many of which are still being researched, that modify immune response. There was one statement that speculated if HCQ could act directly on viral particles by changing pH near a key molecule. My attitude is, great if it works, but we still are very far from knowing that for certain.
One thing that I think is worth keeping in mind is that if a medicine kills 1% of the people we give it to, and we give it to a large number of people relatively indiscriminately, it's about as bad as COVID, which kills 1-5% of victims (though as much as 15% for high risk patients).
tehjoker says>"We have no idea what the mechanism of action if for HCQ. "<
Here's one paper showing that chloroquine allows Zn++ ions to pass into the cell cytoplasm where viral replication takes place. Zinc halts viral replication:
Thanks for the link. I looked around and I saw that 2 uM Zinc inhibited SARS-CoV-1 in vitro, while human cellular concentrations of zinc are typically in the tens to hundreds mM range.
As a non-expert, there are two things that occur to me. That either something weird is going on, or zinc is very tightly controlled by the body and the range is really important. This means that taking extra dietary zinc without an ionophore probably wouldn't do much. So maybe CQ would help promote additional Zinc. According to one review article I was reading, Zinc concentration is naturally increased during immune response unless the virus hijacks the Zinc system.
This information makes me open to the possibility CQ is doing something, but so far the real world results have been unclear. One study showed that CQ had no effect on patients in France. If it's the Zinc that's making the difference and they didn't give Zinc, that would possibly explain the results, but the body also has abundant supplies of Zinc and adjusting intracellular concentration by 2/1000 of the ambient concentration shouldn't be a big deal.
It also says "Several ongoing trials have
been addressing the early use of CQ, in which the anti-inflammatory properties could be more
helpful. That information is urgently needed." and also " Unfortunately, this study’s randomization, probably due to the low sample size, assigned older patients with heart disease to the high dosage arm." Uh-oh.
TL;DR of the paper: if we give as much CQ as the Chinese recommend, people seem to have heart related side effects, so we had to stop treating them with the drug. And if we select older patients with heart disease for the high dosage arm, they tend to experience more side effects.
And the paper itself (https://web.archive.org/web/20200413181618/https://www.medrx...) doesn't say that either, and mentions that this study's randomization was flawed in that older patients with heart disease were assigned to the high dosage arm of the experiment.