A New Covid Study

Henry Ford Hospital Group (Michigan)  released its peer reviewed observational study on using HCQ, HCQ+AZT, and AZT in the treatment of Covid 19. At 4:30 AM (can’t sleep sometimes), I read it and this is difficult reading while yawning. The stats are within the text of the limited study. I am not going to put them in this brief recital of the study. My version is not all inclusive and I may have missed some issues or facts of importance. I invite you to read it and form your own conclusions.

Treatment with Hydroxychloroquine, Azithromycin, and Combination in Patients Hospitalized with COVID-19″, Henry Ford Covid-19 Task Force, International Journal of Infectious Diseases, July 1, 2020

Cohort, Application, and Dosage:

All patients evaluated were 18 years of age and older and were treated as inpatients for at least 48 hours unless they expired within the time period. The primary objective was to assess treatment experience with hydroxychloroquine versus hydroxychloroquine + azithromycin, azithromycin alone, and other treatments for COVID-19. Treatments were protocol driven, uniform in all hospitals and established by a system-wide interdisciplinary COVID-19 Task Force. Hydroxychloroquine was dosed as 400 mg twice daily for 2 doses on day 1, followed by 200 mg twice daily on days 2-5. Azithromycin was dosed as 500 mg once daily on day 1 followed by 250 mg once daily for the next 4 days. The combination of hydroxychloroquine + azithromycin was reserved for selected patients with severe COVID-19 and with minimal cardiac risk factors.

The methodology of application and dosage appears to be similar to what was used in France and as detailed in others less exact reports. This is not a full-fledged study as one might find in an FDA report. It did involve ~2400 patients.

Limitations:

Include the retrospective, non-randomized, non-blinded study design. Also, information on duration of symptoms prior to hospitalization was not available for analysis. However, our study is notable for use of a cohort of consecutive patients from a multi-hospital institution, regularly updated and standardized institutional clinical treatment guidelines and a QTc interval-based algorithm specifically designed to ensure the safe use of hydroxychloroquine. To mitigate potential limitations associated with missing or inaccurate documentation in electronic medical records, we manually reviewed all deaths to confirm the primary mortality outcome and ascertain the cause of death. A review of our COVID-19 mortality data demonstrated no major cardiac arrhythmias; specifically, no torsades de pointes that has been observed with hydroxychloroquine treatment. This finding may be explained in two ways. First, our patient population received aggressive early medical intervention, and were less prone to development of myocarditis, and cardiac inflammation commonly seen in later stages of COVID-19 disease. Second, and importantly, inpatient telemetry with established electrolyte protocols were stringently applied to our population and monitoring for cardiac dysrhythmias was effective in controlling for adverse events. Additional strengths were the inclusion of a multi-racial patient composition, confirmation of all patients for infection with PCR, and control for various confounding factors including patient characteristics such as severity of illness by propensity matching.

The First (bolded) point made is important as all other commentary made concerning HCQ stressed early intervention in the treatment of Covid to prevent replication of the virus. Subsequent studies such as the VA study involved later intervention of treatment when using hydroxychloroquine.

A Suggestion for further study and a role in treatment:

Our results also require further confirmation in prospective, randomized controlled trials that rigorously evaluate the safety, and efficacy of hydroxychloroquine therapy for COVID-19 in hospitalized patients. Considered in the context of current studies on the use of hydroxychloroquine for COVID-19, our results suggest that hydroxychloroquine may have an important role to play in reducing COVID-19 mortality.

This document is open to the general public. There is “nothing” blocking you from reading it.

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