Covid-19 Treatment with Zinc Plus Low Dose Hydroxychloroquine and Azithromycin

https://www.preprints.org/manuscript/202007.0025/v1

by mhdhn • 6 years ago

29 19 6 years ago

From the link:

Conclusions: Risk stratification-based treatment of COVID-19 outpatients as early as possible after symptom onset with the used triple therapy, including the combination of zinc with low dose hydroxychloroquine, was associated with significantly less hospitalizations and 5 times less all-cause deaths.

vore• 6 years ago

There's some discussion on the r/COVID19 subreddit about it: https://www.reddit.com/r/COVID19/comments/hkgj7a/covid19_out...

JohnTHaller2• 6 years ago

Current top comment on reddit by PAJW:

This is a study with authorship by Vladimir Zelenko, MD, a New York physician who has often spoken in favor of HCQ in the popular press. I'm not sure what role the two German authors played.

The study finds a clear decrease in hospitalization and death among those treated with HCQ + AZT + Zinc to an "untreated public reference". Essentially no details are given regarding the control group except whether they sought hospitalization or died as a result of COVID-19.

The study group was clearly younger than the usual COVID-19 death (median age: 58; IQR 40-60), but 70% had one or more medical condition that may serve as a comorbidity (most common: hypertension 28%, obesity 28%, hyperlipidema 23%).

As with many of the studies that aren't RCTs, it is difficult to say whether the treatment worked or not. In this case, since the control group is unknown in composition, the data is really murky. 4 hospitalizations among 141 COVID-positive patients sounds fairly low, but I can't say that definitively.

avs733• 6 years ago

I think the comments are somewhat telling about this paper and preprints as sources of medical decision making overall.

Comment 1: "A subtler point is that the reported age profile of the treatment group is impossible. Group A is aged >60 years, and almost half of the treatment group was in that group. But the IQR was reported as 40-60, so only 25% of the treatment group had an age >60. I hope this was due to excessive rounding, or a similar error that can be corrected."

Comment 2: 'I know nothing of this field but study seems well done'

Comment 3: lauds the authors, makes no comments about the study, and rants about the pharmaceutical industry

Authors include a hand surgeon and a family practitioner (Zelenko) who has been urging hydroxychloroquine as a treatment for a long time now, and was one of Trump's main sources[0].

[0] https://forward.com/news/national/447109/zelenko-hydroxychlo...

ddeck• 6 years ago

As pointed out in the comments on the site, the key issue here is that it is not a blind study, but a case series study where the demographics of the control group are unreported:

The main problem with this work is that the demographics of the control group are not reported, so we have no idea if they are similar. This them means that we have no idea if the differences in outcomes are because of the treatment, or if they would be expected because of the demographies of the groups.
A subtler point is that the reported age profile of the treatment group is impossible. Group A is aged >60 years, and almost half of the treatment group was in that group. But the IQR was reported as 40-60, so only 25% of the treatment group had an age >60. I hope this was due to excessive rounding, or a similar error that can be corrected.

It appears that the researchers selected the treatment group based on a set of quite specific criteria and then compared the outcomes of those patients with outcomes in the general population (see figure 1).

Animats• 6 years ago

This needs more supporting data and independent verification. It's Vladimir Zelenko, again.[1] Without an outside review of the data, again. Also, all the patients are apparently from Kiyras Joel, which is a cult community in New York State with group prayer three times a day. It's a high-density situation, like a nursing home. Zelenko had previously stated that "90% of Kiryas Joel had COVID-19 after 9 of his first 14 tests came back positive — a conclusion the Orange County health commissioner blasted as irresponsible."[2]

Lots of stories from March, few later, probably because NYC had a much bigger epidemic.

[1] http://archive.is/rg1IG

[2] https://www.lohud.com/story/news/coronavirus/2020/03/24/kiry...

mensetmanusman2• 6 years ago

I’m a covid fatalist now, but I hope I live long enough to see a clear timeline of HCQ.

I remember when the media politicized the drug, and it caused places like medium to ban articles saying it was useful:

http://web.archive.org/web/20200405061401/https://medium.com...

Then we find out there was fabricated data about the drug in the world’s top medical journal that had to be retracted.

wtf is going on

TMWNN• 6 years ago

Then we find out there was fabricated data about the drug in the world’s two top medical journals that had to be retracted.

FTFY

Both The Lancet and NEJM!

lucd• 6 years ago

What do you mean by media politizing HCQ ?

I saw some media posting medical disinformation like the claim that in Italy lupus patients treated with HCQ were protected from covid.. https://www.thegatewaypundit.com/2020/04/media-lied-people-d... Denial from the Italia reumatology society: https://www.iltempo.it/cronache/2020/05/02/news/idrossicloro... And claiming that people who do not think HCQ is effective do so because of their anti-Trump feelings.. So that seems to match your claim about media politizing..

What I saw on Twitter is many GOP/Trump militants making dubious claims about HCQ effectiveness and branding everyone who disagree victims of TDS..

And I'm all for medium or others censoring medical disinformation as it was the case with the article you linked to.

Looking at the many studies that were made in the last monthes (including RCTs) and their respective shortcoming it is clear that HCQ isn't effective..

lbeltrame2• 6 years ago

What I saw on Twitter is many GOP/Trump militants making dubious claims about HCQ effectiveness and branding everyone who disagree victims of TDS..

I also saw the opposite, people saying "we knew all along", before some solid evidence was out (RECOVERY, and the UMN study: the latter however has limits due to lack of PCR-confirmed viral tests). Or they believed the flawed Lancet paper unconditionally (count me among them, it was a mistake).

The whole matter was politicized too heavily and the first victim was science, as far as I can see.

I say "some" and not "the" evidence because there are still some large studies going on, like COPCOV.

mensetmanusman2• 6 years ago

What about this one?

https://www.henryford.com/news/2020/07/hydro-treatment-study

CameronNemo• 6 years ago

Why are the researchers combining several different substances at once without understanding the full effects of a single one of the substances in relation to COVID-19? What if zinc (a vitamin that is important to the immune system) is solely responsible for the improved health outcomes?

mhdhn• 6 years ago

Dr. Zelenko stated in a widely circulated letter Mar 23 2020:

    My out-patient treatment regimen is as follows:

    1. Hydroxychloroquine 200mg twice a day for 5 days

    2. Azithromycin 500mg once a day for 5 days

    3. Zinc sulfate 220mg once a day for 5 days

    The rationale for my treatment plan is as follows. I combined the
    data available from China and South Korea with the recent study
    published from France (sites available on request). We know that
    hydroxychloroquine helps Zinc enter the cell. We know that Zinc
    slows viral replication within the cell. Regarding the use of
    azithromycin, I postulate it prevents secondary bacterial
    infections. These three drugs are well known and usually well
    tolerated, hence the risk to the patient is low.

cameldrv• 6 years ago

Tired of hearing about observational studies 5 months after CQ/HCQ was first reported as promising. RCT or GTFO.

forgingahead2• 6 years ago

Why are all articles about HCQ getting flagged? Who is afraid of the discussion? If it works, we should be able to discuss it. If it doesn't work, we should also be able to discuss it. Sunlight and truth is key.

What is going on, HN?

JohnTHaller2• 6 years ago

This is yet another observational study without a proper control.

chaznw• 6 years ago

This study from 2014 details the interaction of Zinc and HCQ. This isn't new knowledge but it is being used as a political cudgel. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4182877/

A study at NYU study showed a 44% reduction in death rate for patients treated with HCQ and ZINC. https://www.medrxiv.org/content/10.1101/2020.05.02.20080036v... A recent study in Michigan at Henry Ford Health System showed a significant cut in death rate using HCQ . https://www.henryford.com/news/2020/07/hydro-treatment-study

Some doctors are able to put 2+2 together, Zinc kills the virus, HCQ helps Zinc into the cell and they are saving lives with this treatment. Other doctors hate Orangeman so much they would rather see people die than give any sort of credit to Orangeman. When this becomes clear to the American people that 44% of those lost to this disease could have been spared, there will be a revolution.

This is the only trial in the US that has a chance of completing a study of HCQ+Zinc. Unfortunately, it is not being fast-tracked while people are dying. Call you representative and demand that this trial be fast-tracked before big pharma and the Orangeman haters destroy it.

https://clinicaltrials.gov/ct2/show/NCT04370782

Covid-19 Treatment with Zinc Plus Low Dose Hydroxychloroquine and Azithromycin

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