Study shows hydroxychloroquine has higher death rate than non-treated patients

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A panel of medical experts convened by the U.S. National Institutes of Health recommended against the use of a drug combination touted by President Donald Trump for Covid-19 patients.

The NIH panel, made up of 50 doctors, pharmacy experts and government researchers and officials, specifically recommended against the use of the anti-malaria drug hydroxychloroquine in combination with the antibiotic azithromycin.

The malaria pill can cause heart issues, and the NIH panel warned of the potential for harm from the combination.
In the study, patients who received both hydroxychloroquine alone and the combination of hydroxychloroquine and azithromycin were more likely to have severe Covid-19 disease, compared to people who didn’t get the drugs. But even after statistically adjusting for those differences, patients getting hydroxychloroquine alone still had a higher death rate than those not getting it. There was no clear difference in death rates among those getting the combination compared to those getting no drug.

Results from the unpublished study were first reported by the Associated Press.
In Brazil, part of another clinical trial was suspended because patients getting higher doses of chloroquine, a related drug, appeared to be more likely to die, according to a preprint of the study that had not yet been published in a scientific journal.

Other studies of the drugs in thousand of patients are ongoing around the world to try and determine whether the drug might work as a treatment or a preventive measure.

If hydroxychloroquine or the closely-related drug chloroquine is given alone, patients should be monitored for side effects, including the heart rhythm disturbances that can lead to sudden death, the NIH panel said.



The nationwide study was not a rigorous experiment. But with 368 patients, it's the largest look so far of hydroxychloroquine with or without the antibiotic azithromycin for COVID-19, which has killed more than 171,000 people as of Tuesday.

The study was posted on an online site for researchers and has been submitted to the New England Journal of Medicine, but has not been reviewed by other scientists. Grants from the National Institutes of Health and the University of Virginia paid for the work.

Researchers analyzed medical records of 368 male veterans hospitalized with confirmed coronavirus infection at Veterans Health Administration medical centers who died or were discharged by April 11.
About 28% who were given hydroxychloroquine plus usual care died, versus 11% of those getting routine care alone. About 22% of those getting the drug plus azithromycin died too, but the difference between that group and usual care was not considered large enough to rule out other factors that could have affected survival.

Hydroxychloroquine made no difference in the need for a breathing machine, either.

Researchers did not track side effects, but noted hints that hydroxychloroquine might have damaged other organs. The drug has long been known to have potentially serious side effects, including altering the heartbeat in a way that could lead to sudden death.
 

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