• Welcome to OGBoards 10.0, keep in mind that we will be making LOTS of changes to smooth out the experience here and make it as close as possible functionally to the old software, but feel free to drop suggestions or requests in the Tech Support subforum!

Non-Political Coronavirus Thread

dartsndeacs said:
It seems easy enough to just do a well designed study to answer the question once and for all, isnt it? I mean it does make some sense that you’d take an anti inflammatory drug before things get inflamed.

Posting a study of the effects of a drug 2 weeks after symptoms appear and with half of each group already on the drug seems rather disingenuous.
Click to expand...

It's easy to conceptualize it, but much, much more difficult to carry out. This study ran from mid March until May - they needed to write the protocol, get institutional consent, and hire study coordinators really quickly. Then, they needed to identify those with COVID accurately (that's still a challenge now), contact them, enroll them, randomize them, get them treatment (many were in the hospital), and then follow them accurately for 15 days.

Also, I think you may have some of the data wrong. In this study, the median time from symptom onset to enrollment in the study was 7 days, which is pretty fast enrollment and treatment. About 10% of the participants, in all groups, were already on hydroxychlonoquine.
 
Rafi said:
It's easy to conceptualize it, but much, much more difficult to carry out. This study ran from mid March until May - they needed to write the protocol, get institutional consent, and hire study coordinators really quickly. Then, they needed to identify those with COVID accurately (that's still a challenge now), contact them, enroll them, randomize them, get them treatment (many were in the hospital), and then follow them accurately for 15 days.

Also, I think you may have some of the data wrong. In this study, the median time from symptom onset to enrollment in the study was 7 days, which is pretty fast enrollment and treatment. About 10% of the participants, in all groups, were already on hydroxychlonoquine.
Click to expand...

Looks like 14 days to me. Oh, ya said median, nm

a11e68314cc5594555e89b6353624b55.jpg
 
Last edited:
dartsndeacs said:
Looks like 14 days to me. Oh, ya said median, nm

a11e68314cc5594555e89b6353624b55.jpg
Click to expand...

Yes, median. So half the participants were treated within the first 7 days. The researchers could potentially look at their participants that were treated earliest, to see if there was any signal of benefit. I would guess they did, and didn't see anything (which is why it's not reported).

A few other points to consider. Brazil has been using HCQ routinely for mild cases since May 20th, and during that time their death rate has quickly climbed to #10 in the world. Belgium used HCQ liberally in the beginning of the pandemic, yet they have the worst COVID death rate in the entire world.
 
That isn't the only randomized trial.

The UK Recovery trial found no benefit in hospitalized patients (in fact, the HCQ group had longer hospital stays and were a little bit more likely to die/require mechanical ventilation.

A US/Canadian randomized study and a randomized study from Spain found no benefit (but increase side effects) when giving HCQ as prophylaxis in people who were exposed. In addition, the Solidarity Trial, the big WHO randomized study looking at various treatments, closed the HCQ arm at interim analysis for futility, which they only do if it is essentially statistically impossible for there to be a benefit.

There are a lot of other studies ongoing, but at this point I think they are a waste of resources. It is theoretically possible that we could find some subgroup who derives some small benefit, but I think even that is pretty unlikely at this point. . If you really believe in the drug, do the study and prove it. But given the complete lack of efficacy (and evidence of harm) in all the randomized studies so far, no one should be prescribing this off of a clinical trial.
 
tiltdeac said:
That isn't the only randomized trial.

The UK Recovery trial found no benefit in hospitalized patients (in fact, the HCQ group had longer hospital stays and were a little bit more likely to die/require mechanical ventilation.

A US/Canadian randomized study and a randomized study from Spain found no benefit (but increase side effects) when giving HCQ as prophylaxis in people who were exposed. In addition, the Solidarity Trial, the big WHO randomized study looking at various treatments, closed the HCQ arm at interim analysis for futility, which they only do if it is essentially statistically impossible for there to be a benefit.

There are a lot of other studies ongoing, but at this point I think they are a waste of resources. It is theoretically possible that we could find some subgroup who derives some small benefit, but I think even that is pretty unlikely at this point. . If you really believe in the drug, do the study and prove it. But given the complete lack of efficacy (and evidence of harm) in all the randomized studies so far, no one should be prescribing this off of a clinical trial.
Click to expand...

Correct, and there is no good quality evidence for HCQ.
 
yeah, they share a bed and both have been home full-time with each other for over a week leading up to the test

one possibility is that they both already had it and that explains my brother's negative test and my SIL's mild symptoms

both had a mystery illness for four or five days back in January or February that could have been COVID


the whole ordeal plays with your head
 
JuiceCrewAllStar said:
yeah, they share a bed and both have been home full-time with each other for over a week leading up to the test

one possibility is that they both already had it and that explains my brother's negative test and my SIL's mild symptoms

both had a mystery illness for four or five days back in January or February that could have been COVID


the whole ordeal plays with your head
Click to expand...

Yeah, that's pretty wild...None of this makes any sense. I'm ready for life to make some kind of sense again.
 
Louis Gossett Jr said:
I don't even think Palma's cousin is real, its like a split personality of Palma where Palma is sending emails to himself and then responding to said emails.
Click to expand...

That alternate personality has it pretty sweet too, owns a brewery that's sitting on 5* on yelp
 
A study in JAMA today shows that statewide school closures in the US from March to May was associated with a 62% reduction in cases and 58% reduction in deaths. School closures reduced deaths by 1.5 per 100,000 people every 16 days.
 
Rafi said:
That is correct. None of the well-designed trials have shown a benefit of hydroxychloroquine.
Click to expand...

PhDeac said:
A guy I know recovered from COVID about two months ago. He posted about the "frontline doctors" and talked about how his doctors gave him hydroxychloroquine and he was grateful. I understand that people who took it and recovered believe they recovered because of it, but that's what the research is for. It's frustrating the people don't get that.
Click to expand...

tiltdeac said:
That isn't the only randomized trial.

The UK Recovery trial found no benefit in hospitalized patients (in fact, the HCQ group had longer hospital stays and were a little bit more likely to die/require mechanical ventilation.

A US/Canadian randomized study and a randomized study from Spain found no benefit (but increase side effects) when giving HCQ as prophylaxis in people who were exposed. In addition, the Solidarity Trial, the big WHO randomized study looking at various treatments, closed the HCQ arm at interim analysis for futility, which they only do if it is essentially statistically impossible for there to be a benefit.

There are a lot of other studies ongoing, but at this point I think they are a waste of resources. It is theoretically possible that we could find some subgroup who derives some small benefit, but I think even that is pretty unlikely at this point. . If you really believe in the drug, do the study and prove it. But given the complete lack of efficacy (and evidence of harm) in all the randomized studies so far, no one should be prescribing this off of a clinical trial.
Click to expand...

What are the issues with the 10 or so studies referenced by Risch that do show a benefit?

I mean this is fairly convincing. Most of the trials you link above are in hospitalized patients, and if the data is accurate the significant differences in outpatient use early can't really be explained as "random" when the benefits in some cases are 50 fold. All with fairly minor side effects (Morbidity in 9/100,000 patients) which even if understated still doesn't compare to even the potential benefit for covid patients.

https://watermark.silverchair.com/k...oWfnvrvxInGSn6JfGH2kS9c4BGQ_nbXpIVQljAxC50Y1g
 
Last edited:
stugotz said:
What are the issues with the 10 or so studies referenced by Risch that do show a benefit?

I mean this is fairly convincing. Most of the trials you link above are in hospitalized patients, and if the data is accurate the significant differences in outpatient use early can't really be explained as "random" when the benefits in some cases are 50 fold. All with fairly minor side effects (Morbidity in 9/100,000 patients) which even if understated still doesn't compare to even the potential benefit for covid patients.

https://watermark.silverchair.com/k...oWfnvrvxInGSn6JfGH2kS9c4BGQ_nbXpIVQljAxC50Y1g
Click to expand...

Your link doesn’t work.

I think he referenced either 5 or 7 studies (I read his editorial a few days ago). They are all case series, which is basically just someone reporting their experience. Imagine if the “demon sperm lady” who was retweeted by Trump (nonpolitically) reported her HCQ experience with 350 patients - it too would have looked really favorable for HCQ. That’s the problem with non randomized trials - they can be filled with major biases.

There is no good study showing benefit for HCQ, which makes sense because it is an antimalarial drug with no clear mechanism of action against viruses. But if you find a study that you think shows benefit, I would be happy to read it.
 
DistrictDeacon said:
False negative or he gave it to her and had no symptoms.
Click to expand...

Possibly, but not necessarily. I know a physician that saw a hospitalized COVID patient early in the pandemic but didn’t wear full PPE because she thought his fever was from another cause. Two days later the physician awoke in the middle of the night with a high fever and the next day tested positive. Her husband, who she slept next to for two nights while she was infected, never developed COVID (no symptoms and antibody negative multiple times).

Similar reports are not uncommon.
 
Rafi said:
Your link doesn’t work.

I think he referenced either 5 or 7 studies (I read his editorial a few days ago). They are all case series, which is basically just someone reporting their experience. Imagine if the “demon sperm lady” who was retweeted by Trump (nonpolitically) reported her HCQ experience with 350 patients - it too would have looked really favorable for HCQ. That’s the problem with non randomized trials - they can be filled with major biases.

There is no good study showing benefit for HCQ, which makes sense because it is an antimalarial drug with no clear mechanism of action against viruses. But if you find a study that you think shows benefit, I would be happy to read it.
Click to expand...

It's the PDF link on this page. I believe he does a pretty good job of addressing your critiques

https://academic.oup.com/aje/article/doi/10.1093/aje/kwaa093/5847586
 
tiltdeac said:
That isn't the only randomized trial.

The UK Recovery trial found no benefit in hospitalized patients (in fact, the HCQ group had longer hospital stays and were a little bit more likely to die/require mechanical ventilation.

A US/Canadian randomized study and a randomized study from Spain found no benefit (but increase side effects) when giving HCQ as prophylaxis in people who were exposed. In addition, the Solidarity Trial, the big WHO randomized study looking at various treatments, closed the HCQ arm at interim analysis for futility, which they only do if it is essentially statistically impossible for there to be a benefit.

There are a lot of other studies ongoing, but at this point I think they are a waste of resources. It is theoretically possible that we could find some subgroup who derives some small benefit, but I think even that is pretty unlikely at this point. . If you really believe in the drug, do the study and prove it. But given the complete lack of efficacy (and evidence of harm) in all the randomized studies so far, no one should be prescribing this off of a clinical trial.
Click to expand...


Yep
 
You must log in or register to reply here.
Back
Top