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Another study on #Hydroxycloroquine efficacy in #COVID19 patients from a Brazilian team has been shared widely this evening. Unfortunately I have to comment it because well it might have some public health implication & this study is atrocious https://www.dropbox.com/s/5qm58cd4fneeci2/2020.04.15%20journal%20manuscript%20final.pdf?dl=0
This study is not a clinical trial but a cohort study on 721 patients, recruited by telemedicine. Incl criteria Flu symptoms, OK to be treated > 18 y/o. Probable diagnosis of #SARSCoV2 but RT-PCR or X ray not compulsory. We don't even know if those patients had #COVID19 
Outcome -> hospitalisation at day 7, that's it.
721 patients unrolled. 85 not followed -> 636 left => 225 refused treatment -> control group & 412 patients Hydroxycholoquine + azithromycine (dose unknown)
All followed daily by telemedicine consultation => huge select biais
721 patients unrolled. 85 not followed -> 636 left => 225 refused treatment -> control group
& 412 patients Hydroxycholoquine + azithromycine (dose unknown) All followed daily by telemedicine consultation => huge select biais
Outcome: HCQ+AZ group 1.9% hospitalisation versus 5.4% -> Chest CT scan for those hospitalized pattern compatible with #COVID19 infection but I don't know what that means given #SARS_CoV2 infection was not confirmed by RT-PCR
In short from this study
1/ We don't know whether these patients were #SARSCoV2 diagnosed
2/ Huge selection bias, cases omitted % not blinded, not randomized and open label
3/ The results are meaningless. I don't know what this means
4/ The study is in short atrocious
1/ We don't know whether these patients were #SARSCoV2 diagnosed
2/ Huge selection bias, cases omitted % not blinded, not randomized and open label
3/ The results are meaningless. I don't know what this means
4/ The study is in short atrocious
Now there are others issues with this study.
1/ Clinical trial was registered 2 days ago and they are not yet recruiting https://clinicaltrials.gov/ct2/show/NCT04348474?term=NCT04348474&draw=2&rank=1
1/ Clinical trial was registered 2 days ago and they are not yet recruiting
https://clinicaltrials.gov/ct2/show/NCT04348474?term=NCT04348474&draw=2&rank=1
2/ The study is performed from an insurance company in Brazil which has promoted its telemedicine application for #COVID19 ! So they have an interest to show efficacy of telemedicine against COVID19. the fact they have declared no COI is a joke
https://preventsenior.com.br/detalhes_noticia.php?id=188
https://preventsenior.com.br/detalhes_noticia.php?id=188
In conclusion, this is really really bad study and awful science, who knows that might have treated flu after all. Ethically it is very wrong. It is really sad.
