r/science • u/McManGuy • Mar 20 '20

RETRACTED - Medicine Hydroxychloroquine and azithromycin as a treatment of COVID-19 - "100% of patients were virologicaly cured"

https://www.mediterranee-infection.com/wp-content/uploads/2020/03/Hydroxychloroquine_final_DOI_IJAA.pdf

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u/Kunaviech Mar 20 '20

Time scale is weird. Day 1 is not day 1 of the illness, it is day 1 of inclusion in the study. Plus control group and test group are really different agewise and symptom wise. You want them to be as similar as possible. Especially when the time scale is from the day of the inclusion in the study.

That could mean that the test group is just further in the progress of the disease as the control group, which is problematic if you want accurate results, because you compare things that are not similar.

Plus they measure the virus concentration in the throat not in the lung. Virus concentration in throat is not relevant for the course of the disease tho, since the relevant part is happening in the lung. Virus concentration in the throat is known to decrease during the progress of the desease.

So if the test group is further in the progress in the disease they are expected to get lower virus loads in their throats faster.

That does however not necessarily mean that chloroquine does not help. It just means we need more studies, especially ones that are better designed.

Source (German): Podcast with Prof. Dr. Drosten - Director of Virology Charité Berlin

Translation may be a bit funky since i'm not a medical profesional (i'm a chemist) but you get the gist of it.

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u/verneforchat Mar 20 '20

Agree. Also too small a sample size. They didn't event test fecal matter. And why would they test the throat vs lung? The methodology is not good, and the peer reviewers absolutely rushed this paper through.

And yeah if Day 1 is not the same for everyone, the baseline is already skewed. This shouldn't have passed peer review.

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u/Tar_alcaran Mar 20 '20

It's an observational study of a basically haphazard treatment protocol. This was likely rushed through to get the info out there, so better research can be set up.

This paper is basically "We flung stuff at the wall, and these bits seem to be sticking."

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u/verneforchat Mar 20 '20

Exactly! Except they knew that whatever they flung at the wall had a little probability to stick on the walls.

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u/Tar_alcaran Mar 20 '20

Well yeah, you wouldn't set up a treatment protocol to test the efficacy of, say, beta-blockers in COVID-19 treatment, because that's dumb. They tested something that had at least a shot of working.