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Well I'll Be Dipped!!!
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That reporting on the VA situation was a bunch of bull****. The took what is actually a positive story for hydroxychloroquine, and turned it into a negative.
 

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I agree that no conclusions can be taken from the VA study for or against HCQ.

But the French study that D. Raoult was senior author of was even worse.
 

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Make It So!!
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Keep in mind that this is the doctor who was banned from his own specialty's journal for falsifying study data, got caught, and played dumb. And his own 30-some-odd patient study is worse than anything he is criticizing.

Yes, I do agree that the VA study in its current form (pre-publishing) is not conclusive. However, it is being internally reviewed by a separate group of researchers. I suspect they will go back to their database and have a hard second look on how it was done. Non-the-less, the study does show that HCQ is not a miracle drug some thought it was.

What I'm more interested is Rutger's RCT on HcQ that is concluding at the end of this month. I'm sure it has gone through an interim analysis by now, and the fact that they are not making a move to terminate the study early makes me think that there is not going to be some epiphany from this study.

Will we continue to use HcQ +/- Zithromax for COVID? Probably. Locally we have. It is just not a game changer some wanted it to be. It will probably continue to be a part of a much larger overall strategy... just like there are many antibiotics to choose from when we treat bacterial pneumonia. We will just need to weight the pro's and con's individually.
 

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Discussion Starter · #5 ·
I agree that no conclusions can be taken from the VA study for or against HCQ.

But the French study that D. Raoult was senior author of was even worse.
Sounds like neither can be relied upon. I'm looking forward to the New York studies. I hope that they aren't politicized.
 

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Make It So!!
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Sounds like neither can be relied upon. I'm looking forward to the New York studies. I hope that they aren't politicized.
You are correct. Many of us are holding our breaths waiting for them to come out. In the meantime, most of us will continue to judiciously use HCQ +/- Zithromax, among other things we are learning every day. The current "favorite," if you will, is convalescent plasma. We've actually been cautiously optimistic with this as we've had a few "saves" with this. Tocilizumab is also getting interesting. Some have been trying the combo of HCQ, followed by Prednisone if HCQ fails. Prednisone is harmful early on, but may be helpful when patients are near ARDS as a rescue medication....

The learning curve is steep in this one. One good thing about today's technology is that we are able to share across the countries. I have zoom meetings and discussions with other doctors across the country just about every day. One of the recent discussions/webnars we had led by a West Coast doctor was aptly named "Sleepless in Seattle."
 

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Discussion Starter · #7 ·
You are correct. Many of us are holding our breaths waiting for them to come out. In the meantime, most of us will continue to judiciously use HCQ +/- Zithromax, among other things we are learning every day. The current "favorite," if you will, is convalescent plasma. We've actually been cautiously optimistic with this as we've had a few "saves" with this. Tocilizumab is also getting interesting. Some have been trying the combo of HCQ, followed by Prednisone if HCQ fails. Prednisone is harmful early on, but may be helpful when patients are near ARDS as a rescue medication....

The learning curve is steep in this one. One good thing about today's technology is that we are able to share across the countries. I have zoom meetings and discussions with other doctors across the country just about every day. One of the recent discussions/webnars we had led by a West Coast doctor was aptly named "Sleepless in Seattle."
Is it safe to assume that "convalescent plasma" is screened for HIV, Hep B & C, etc?

The problem that I have with the VA study is that I didn't hear anything about the reasoning for the use of HCQ. If it was used as a last resort for people on vents, then a low success rate is to be expected, since people on vents are likely to die anyway (50-80%). Conversely, patients who did not need vents may not have been given HCQ as a last resort and survived because they never declined to the point of needing a vent and HCQ.
 

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Sounds like neither can be relied upon. I'm looking forward to the New York studies. I hope that they aren't politicized.
Don, exactly! HCQ is highly politicized for numerous reasons. I think there is a lot of bias concerning the initial 'on the ground' success of the treatment. Anyway, no researcher is without there controversies. Here is Raoult's Wiki info. I'm sure the man is more knowledgeable on the treatment than anyone participating on this thread.
https://en.wikipedia.org/wiki/Didier_Raoult
 

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Make It So!!
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Don, exactly! HCQ is highly politicized for numerous reasons. I think there is a lot of bias concerning the initial 'on the ground' success of the treatment. Anyway, no researcher is without there controversies. Here is Raoult's Wiki info. I'm sure the man is more knowledgeable on the treatment than anyone participating on this thread.
https://en.wikipedia.org/wiki/Didier_Raoult
Stalking me much?
Funny you linked Raoult's wiki page. I guess you didn't bother to read far enough down the page where they talked about how he cheated, falsified research data, got caught, play dumb, and threw his staff under the bus... And the wiki version is the nicer version of what he did. And if you think getting kicked off the editorial board and banned from a major journal is "minor controversies"... well, bless your heart.

Wanna tell folks in this thread how you stole and plagiarized from an article and pretend the knowledge to be your own without actually understanding anything in the article itself and got called out on it in the other thread?
 

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Stalking me much?
Funny you linked Raoult's wiki page. I guess you didn't bother to read far enough down the page where they talked about how he cheated, falsified research data, got caught, play dumb, and threw his staff under the bus... And the wiki version is the nicer version of what he did. And if you think getting kicked off the editorial board and banned from a major journal is "minor controversies"... well, bless your heart.
What do you think about the French and their nicotine vs coronavirus stats?
 

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Make It So!!
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Is it safe to assume that "convalescent plasma" is screened for HIV, Hep B & C, etc?

The problem that I have with the VA study is that I didn't hear anything about the reasoning for the use of HCQ. If it was used as a last resort for people on vents, then a low success rate is to be expected, since people on vents are likely to die anyway (50-80%). Conversely, patients who did not need vents may not have been given HCQ as a last resort and survived because they never declined to the point of needing a vent and HCQ.
Yes convalescent plasma is screened for HIV, hepatitis... etc. It goes through the standard blood donation screening because only certified blood donation centers can collect them.

As for the VA study, yes, you nailed the issues with it. And the issues it has, unfortunately, is also the dilemma with HCQ in hospitalized patients. Most hospitalized COVID patients will score high enough on the QT Prolongation score to make doctors uneasy about using HCQ, much less HCQ + Zithromax. So in real life use, you will only see it use as the last resort when it comes to ICU patients. Some may argue that the study reflects real life use of HCQ, sort of an "intent to treat" model of analysis. I personally am not so sure. My understanding is, the data is being re-analyzed by a separate group of researchers who have access to the entire data set. So we will see how that turns out. They may choose to modify the control group inclusion criteria (I sort of hope for it, but I sort of doubt they will). That's why we are all holding our breaths on the Rutger study.
 
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Make It So!!
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What do you think about the French and their nicotine vs coronavirus stats?
Interesting. Two points I would make on this.

1) I suspect nicotine is a probably a confounder. Let me explain confounder this way. Let's say you are trying to find a cause of lung cancer in a group of lung cancer patients. You ask them a bunch of questions trying to find their common risk factors, but didn't know to ask them about smoking. You ask the same questions to a group of people without lung cancer in order to compare them with the lung cancer patients. Since you didn't know to ask about smoking, you end up finding out that lung cancer patients are much more likely to own lighters and matches, and you erroneously conclude that lighters and matches cause lung cancer. Lighters and matches in this case are what we call "confounders" in medical studies.

2) Nicotine is a potent vasoconstrictor. It has many immediate/short term side effects and are dangerous in hospitalized patients. For example, many hospitalized COVID patients have acute heart muscle injuries from COVID. Before COVID, we wouldn't dream of giving nicotine to acute heart attack patients... it can worsen the heart attack and kill them. So, again, if nicotine has any in vitro value against COVID, its in vivo use can be very problematic.
 
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It ain't over
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Bump for Dr. Picard
Picard: I hope you read this post and can get time to listen to the podcast. It's at warroom.org - show number 136. they interview Vadimir Zelenko and his use of Hydroxychloroquine. Interesting - he claims great success and will publish next week. He bashes some of the current media reporting on the drug as being anti-Trump. I'm not sure what to believe - he claims 95% success with patients if they present early - not stay home and take tylenol. He further claims that some countries are experiencing similar success.

Selenko says he's in the front lines at his hospital. He claims most, if not all, healthcare providers in NYC are using the drug.

It's an interesting interview. I'm posting the link below - hope it works. The interview begins at about the 3 minute mark. It would interesting the hear your opinion of his information.

https://listen.warroom.org/e/ep-136-pandemic-one-god-two-worlds-wdr-vladimir-zelenko/
 

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Make It So!!
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Picard: I hope you read this post and can get time to listen to the podcast. It's at warroom.org - show number 136. they interview Vadimir Zelenko and his use of Hydroxychloroquine. Interesting - he claims great success and will publish next week. He bashes some of the current media reporting on the drug as being anti-Trump. I'm not sure what to believe - he claims 95% success with patients if they present early - not stay home and take tylenol. He further claims that some countries are experiencing similar success.

Selenko says he's in the front lines at his hospital. He claims most, if not all, healthcare providers in NYC are using the drug.

It's an interesting interview. I'm posting the link below - hope it works. The interview begins at about the 3 minute mark. It would interesting the hear your opinion of his information.

https://listen.warroom.org/e/ep-136-pandemic-one-god-two-worlds-wdr-vladimir-zelenko/
I discussed HCQ in much more details in the first few posts of this thread:
The remaining pages will have some updates and some discussions, some heated:

https://www.glocktalk.com/threads/m...rent-covid-treatment-clinical-trials.1824078/

Bottom line. Yes, HCQ has been used safely in some chronic diseases in well screened, ambulatory, otherwise healthy patients. HCQ can be very dangerous in acutely sick patients.

Problem with "using it early" is, you cannot really judge it's "success" rate because overwhelming majority of ambulatory patients (meaning not hospitalized patients) will survive without any specific treatment. Think of it, 99%+ of COVID patients will survive without specific treatments, so if this guy claims a "95% success rate," he is actually doing worse than doing nothing. Using Skittles would have had a higher survival rate than this guys 95% survival rate.
 

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It ain't over
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I discussed HCQ in much more details in the first few posts of this thread:
The remaining pages will have some updates and some discussions, some heated:

https://www.glocktalk.com/threads/m...rent-covid-treatment-clinical-trials.1824078/

Bottom line. Yes, HCQ has been used safely in some chronic diseases in well screened, ambulatory, otherwise healthy patients. HCQ can be very dangerous in acutely sick patients.

Problem with "using it early" is, you cannot really judge it's "success" rate because overwhelming majority of ambulatory patients (meaning not hospitalized patients) will survive without any specific treatment. Think of it, 99%+ of COVID patients will survive without specific treatments, so if this guy claims a "95% success rate," he is actually doing worse than doing nothing. Using Skittles would have had a higher survival rate than this guys 95% survival rate.
Good point - I had not thought of that. It will be interesting to read Dr. Zelenko's paper next week.
 
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