The press continues to multiply information on studies that would prove the ineffectiveness of the Raoult protocol (hydroxychloroquine and azithromycin). We counted five and studied them all.
A closer look at the effectiveness of the protocol comes out reinforced … Check yourself and become conspirators …
https://www.lci.fr/sante/covid-19-deux-etudes-recentes-demontrent-l-inefficacite-de-l-hydroxychloroquine-contre-le-coronavirus-2153867.html
First study: France Mahevas Paris
It concerns 181 patients from different hospitals, none of whom are at the beginning of the disease, all of them have pneumonia requiring an oxygen supply
https://www.bmj.com/content/369/bmj.m1844
Attention the subtleties are in the appendices, we discover that:
number of cases including intensive care including death
Raoult Protocol
hk and azi 15 0 0
Outside Raoult protocol 166 41 17
of which hk alone 77 19 9 of which group without hk 89 22 8
Only the severely ill of the two groups would have received azithromycin in addition, which gives 100% healing for the group who received the full protocol with hydroxychloroquine and 90% for the others.
At day 21, 79% of patients in the treatment group had been weaned from oxygen compared with 74% in the control group (relative risk 1.1, 95% confidence interval 0.9 to 1.3). Furthermore, 80% of patients in both groups had been discharged to home or rehabilitation (1.0, 0.9 to 1.2; table 2). None of the 15 patients who received a combination of hydroxychloroquine and azithromycin was transferred to intensive care and none died. Additionally, these patients had fewer severe signs at admission compared with patients who received hydroxychloroquine without azithromycin (oxygen flow: 2 L / min, interquartile range 1.25-4 v 3 L / min, 2-6; respiratory frequency: 25 per min, interquartile range 22-33 v 28 per min, 24-32; percentage of lung affected> 50%: 13% v 17%). Finally, 26 patients received azithromycin without hydroxychloroquine. Among these patients, six were admitted to the intensive care unit and five died.
Didier raoult
Why did the study methodologist (Pr Philippe Ravaud) refuse to analyze the data which shows that azithromycin and hydroxychloroquine (0 shifts, 0 deaths, out of 15 patients) work better than standard treatment (16 shifts, 3 dead, out of 63)?
Second China study
This study concerns patients with moderate stages, all of them survived. The study does not prove anything one way or the other.
There was a group with HCQ and a group without but in the two groups we find an identical percentage who receives the antibiotic. Concomitant treatments, including antivirals, antibiotics, and systemic glucocorticoid therapy, were similar in the two groups.
We have no details on the results of those who benefited from the Raoult protocol (hcq and azithromycin)
https://www.bmj.com/content/369/bmj.m1849
After the “Discovery” fiasco the lab rats are unable to demonstrate that Raoult was wrong. So they publish statistical series that do not stand up to analysis.
These are not studies but figures taken from hospitals. We must never forget that the patient who arrives in a hospital especially in the United States is no longer at the first symptoms of the disease but at a very degraded stage. The Raoult protocol precisely avoids this situation.
Systematically, doctors try everything for everything and place the intubated patients … under hydroxychloroquine.
What they say:
https://fr.news.yahoo.com/coronavirus-nouvelle-etude-efficacite-chloroquine-soigner-covid-19-090409574.html
Here is a common thread on how the @nejm New York observational study was biased to mask the significant benefits of hydroxychloroquine (HCQ) for hospital patients. nothing in common between patients treated with hcq and the others: half suffer from hypertension (6%) for the others … The oxygen saturation is less good.
But above all: both groups benefit from antibiotics …
Yet COVID patients who developed respiratory failure at the NY hospital were found to be 4 times more likely to survive when treated with HCQ!
In worse condition at the start of treatment, patients treated with hcq are intubated for 154 out of 811 (19%), the rest are 26 out of 274 (9%).
32% of intubated patients treated with hydroxychloroquine die, two thirds of patients without hcq
https://threadreaderapp.com/thread/1259154540630364162.html?fbclid=IwAR1MMQkO4qSz0JjSfF24-Z4figTBfPjzzovrijinaxl68BOLQWfTDrUyPLw
Same problem for another statistical series from the United States
https://jamanetwork.com/journals/jama/fullarticle/2766117?appId=scweb
The study’s authors acknowledge that many patients went on HCK and azi because their condition was worsening. So by going on an artificial respirator they received hck and azi. The “drug-free” group deflates serious cases which will die in the other groups.
We thus discover that the group treated with hck + azi has 608 patients who did not go through intensive care or not more than a day. In addition, 100 patients entered intensive care for more than one day, for a total of 708 people. However, this group ultimately counts 735 patients when it comes to counting deaths…
Treatment with hydroxychloroquine and azithromycin only started very late for very serious patients and in half of the cases after mechanical ventilation.
The speed with which patients entered intensive care and underwent mechanical ventilation, often at the same time as the initiation of hydroxychloroquine and azithromycin, made these results unsuitable for efficacy analyzes. Of the patients with mechanical ventilation receiving hydroxychloroquine + azithromycin, hydroxychloroquine alone or azithromycin alone, 49.6% were ventilated before or at the same time as the start of these treatments.
Study shows effectiveness of azithromycin
For the subsample of 211 patients receiving azithromycin alone, the HR point mortality estimate was 0.56, but the confidence interval exceeded 1.0. This suggests the possibility of a true protective association.
They rejoice: an American study warns of the dangers of chloroquine. very few French journalists understand English and can read.
The famous study is just a statistical statement intended to demolish Trump who authorized the Raoult protocol. A simple reading of the report reveals that cases have been analyzed a posteriori, that is to say after the illness.
Raoult’s response
Response-to-Magagnoli
These are only very sick men with many co-morbidities and treated late.
The group without hydroxychloroquine (hc) that would have obtained the best results was treated with the antibiotic (azithromycin) in 50 cases, the others received another antibiotic. Co-morbidities are less numerous than in the other groups. . Table 1 shows the group without HC falling from 177 patients to 158 at the time of ventilation. The study thus removed the 19 most seriously ill patients in the group without HC …
The group with hydrocloroquine and without azythromycin which obtains the worst results was swollen at the last moment of patients after failure of ventilation removed from the previous group
The group combining Hydroxychloroquine and Azithromycin obtains the best results even if it was “also swollen with 11 moribund patients: one would have suspected it, it is the Raoult protocol
After reintegration into their group of origin of the dying we obtain:
Hoxydrochloroquine alone: 22% of deaths
HC and az 13%
Az alone or not az 21%
A cursory browse through Table 2 of the paper shows that the patients that would eventually understand the HC group were the sickest upon admission, the HC + AZ patients were intermediate and the patients that would elect no HC group were the least sick. This is prior to intervention.
This sort of sampling bias highlights the importance of double blind randomization to determine efficacy. Such an a priori correlation might be due to sicker patients opting for experimental treatments at a higher rate. In any case, it would not be wise to interpret these data as indicating that the interventions cause the worse outcomes. The underlying health state is probably responsible.
Some examples follow, then a criticism of what the authors have written into their Results and Discussion.
Known risk factors include age, weight and blood pressure; and signs of severe disease include kidney damage.
Browsing through table 2 looking for parameters with lowish p-values:
Mean systolic blood pressure differences between groups showed a p-value of just under 0.05 (statistically significant), with values of 136, 132, and 129 across the groups (HC, HC + AZ, no HC), but more significantly, the HC group had 34% of patients with BP information showing up in the very highest pressure group (27.8 / 0.804, the denominator being the fraction with information on BP in that group), while HC + AZ had 30% and no HC had 25%.
A brief overview of Table 2 of the document shows that the patients who would eventually form the HC group were the sickest on admission, the HC + AZ patients were intermediate and the patients chosen for the group without HC were the least ill.
In any event, it would be unwise to interpret this data as indicating that the interventions cause the worst results. The underlying health condition is probably responsible.
Jean Bernard Cadier
https://www.bfmtv.com/international/etats-unis-une-etude-preliminaire-sur-l-hydroxychloroquine-livre-des-resultats-peu-probants-1898508.html
A Joseph Stalin prize for Cnews which mixes the pseudo study above and the therapeutic guide of the National Institutes of Health very hostile to Trump who advises against dual therapy for severe cases…
https://www.nih.gov/news-events/news-releases
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