We are back with another Journal club discussion on all things COVID-19… apologies in advance if you are already swamped by info, but it is what has been occupying our minds in recent times.
This episode is long and has a lot of papers… it is a matter of quantity over quality as we know a lot of the data out there is not great and often comes direct from bench science which is not ideal for clinical practice.
Anyway – hopefully back to more clinical stuff next month! Stay tuned.
Since the last edition, there have been a number of studies looking at hydroxychloroquine, but none are really worth going into in detail. The answer is the same: you shouldn’t be using this drug for COVID. All the studies were updated in the main post. As a quick review:
Tang 2020 is a multi-center RCT of hydroxychloroquine in 150 patients that showed no difference in either viral cure or symptoms, but a significant increase in adverse events with hydroxychloroquine.
Magagnoli 2020 is a retrospective look at 368 patients admitted to the Veterans Health Administration hospitals in the United States. The rate of death was higher in patients who were treated with hydroxychloroquine than in those who were not (28% vs 11%, p=0.03). Of course, this is not a randomized trial, and hydroxychloroquine might just have been given to sicker patients, but it is not promising data.
Borba 2020 is a double blind RCT comparing two doses of chloroquine (600 mg BID for 10 days or 450 mg BID on day one then daily for 4 more days). They were supposed to enrol 440 patients, but the trial was stopped early after only 81 patients because mortality was significantly higher in the high dose chloroquine group.
Our first look at remdesivir (if you don’t count press conferences) is negative
I am a GP working in Broome, NW of Western Australia. I work as a hospital DMO (District Med Officer) doing Emergency, Anaesthestics, some Obstetrics and a lot of miscellaneous primary care. Also on the web as @broomedocs | + Casey Parker | Contact