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How could hydrooxchloroquine be harmful?
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ora_43




 
 
    
 

Post Mon, Aug 03 2020, 2:45 pm
Mommyg8 wrote:
Dr. Zelenko specifically said he only gave the drug (with zinc) to high risk patients. Those either over 60 or who had other health conditions.

I think you're mistaken. Dr. Zelenko has his own study in the submission process, and the median age of participants was 58. IOW most were under 60. IQR 40-67, so 25% under 40.

Nowhere does it say that participants were high risk, although maybe that will be clarified if/when the full study is publihed.
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ora_43




 
 
    
 

Post Mon, Aug 03 2020, 3:12 pm
I didn't see that the request was for zinc, specifically. So, a new list.

(and bestbubby - of course other doctors are mostly not testing Zelenko's specific proposal. each doctor tests their own ideas. Zelenko (and a few others) who support that specific combo are free to test it, as some of them have. Other people have other ideas, and test those ideas.

Sorry, but I am never going to buy any conspiracy theory that involves researchers deliberately turning down a chance at results that could get them into a top tier journal. Some things just aren't plausible.)

Anyway.

Studies with the hydroxychloroquine + zinc (+ azithromycin combo). Including the one done by Zelenko (et al), although that's still in the prescreen phase:

Triple Drug Combination Hydroxychloroquine, Azithromycin, & Zinc

(they found hydroxychloroquine + zinc was possibly mildly helpful; are hoping for more positive results when adding azithromycin)

Hydroxychloroquine as Prophylaxis for Coronavirus SARS-CoV-2 Infection: Review of the Ongoing Clinical Trials

(scroll down for a list of ongoing trials, a few of which are looking at combos that include hydroxychloroquine and zinc)

COVID-19 Outpatients – Early Risk-Stratified Treatment with Zinc Plus Low Dose Hydroxychloroquine and Azithromycin: A Retrospective Case Series Study

(Zelenko's study)

Criticism of Zelenko's study + one other study

(for fairness' sake)

There have also been several theoretical papers on the possibility of adding zinc when treating with hydroxychloroquine, dating back to January. Not including any of that, since people asked for studies, but if anyone is interested just look for "hydroxychloroquine zinc" (or similar) on Google Scholar, you should get several good results.
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gold21




 
 
    
 

Post Mon, Aug 03 2020, 3:32 pm
the first study you linked:

"CONCLUSION
The combination of HCQ with Zinc sulphate has no effect on duration of hospitalization, time of ventilation or ICU duration. Study shows that Zinc sulphate rises the frequency of corona patient were discharging home safely and no need for ventilation. There is reduction in death rate. The main finding of this study is that after adjusting for the timing of Zinc therapy, we get to know that combination of Zinc sulphate to HCQ and azithromycin was seem to associate with a lower in death rate or transition to hospice in patients who does not need ICU level of care . Basically Zinc showing role in preventing the virus progress. If we are giving effective COVID-19 treatment to reduce hospital stay duration also less need for prolonged mechanical ventilation and but lowing death rate is still to be achieved. We hypothesize that the triple combination of CQ/HCQ withazithromycin and Zinc in treatment of corona virus patients, in an OPD and IPD setting, may help to increase clinical outcomes and to lower the COVID-19 fatality rate. Triple combination of CQ/HCQ with antibiotic azithromycin and Zinc shows safety, efficacy, tolerability. This hypothesis can be rapidly evaluated by amendment of suitable WHO-supported solidary trials or other studies."

The english language skills in this study are terrible, but anyway. Why did you conclude in your post: "(they found hydroxychloroquine + zinc was possibly mildly helpful; are hoping for more positive results when adding azithromycin)"?

That is not the conclusion I am seeing.

This is a study of hospitalized patients, some already on ventilators, some already in ICU, etc. Obviously some of these patients were already quite ill at the time of the study. These researchers found a reduction in death rate when this protocol was administered at the inpatient level. No data given as to what percentage of treated patients survived and what percentage in the control group did. So results are kind of unclear.

They then hypothesize that this protocol would be best served in an outpatient setting. This is not an outpatient study. There is no basis for drawing the conclusion that they found these medications "mildlly helpful", as the actual data wasn't given. "Reduction in death rate" can mean a huge reduction, a small reduction, really anything.
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gold21




 
 
    
 

Post Mon, Aug 03 2020, 3:44 pm
Zelenko's study, while very compelling, is more anecdotal than anything else. We definitely need more studies.
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gold21




 
 
    
 

Post Mon, Aug 03 2020, 3:49 pm
As for the link to the review of multiple ongoing studies, that looks really cool. Thanks for sharing it!

It concludes:

"Chloroquine and its derivatives (e.g., hydroxychloroquine) have been used for malaria and autoimmune rheumatic diseases for almost 80 years, and both the data from the literature and the experience of clinicians show a low incidence of side effects, which are generally mild to moderate. Retinal toxicity, a serious effect, is related to long-term cumulative dose, and is rarely seen in short-term use (I.e. several weeks).

These arguments perhaps tip the balance in favor of using prophylaxis for SARS-CoV-2 virus infection, as long as they are not contraindicated. Nonetheless we are yet to know the results of these clinical trials."

My sentiments exactly!!!

And I would love to see the results of these trials.
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imasoftov




 
 
    
 

Post Wed, Aug 05 2020, 11:13 am
imasoftov wrote:
That says that it was effective against SARS-CoV (at the time the only SARS-CoV, but now known as SARS-CoV-1) in cell cultures (as Cobalt posted while I was writing this), not SARS-CoV-2 in organisms. This paper would have been a reason to test Chloroquine against the more recent virus, and if you click on the link in "This article has been cited by other articles in PMC" you'll find papers that do that.

Furthermore, the experiment used Chloroquine, not Hydroxychloroquine. They are similar but not interchangeable. And the cell lineage on which it was tested came from an African green monkey, not a human. The paper says "Vero E6 cells", see here for what Vero cells are.
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