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Re:Severe Outcomes Among U.S. Patients with Covid-19, Feb 12... by chimichangga on Wednesday March 18, 2020 @09:16PM (#22623348)
From Gregory Rigano:

UPDATE:

Full peer reviewed study has been released by Didier Raoult MD, PhD drive.google.com/file/d/186Bel9….

After 6 days 100% of patients treated with HCQ + Azithromycin were virologically cured

p-value <.0001

covidtrial.io

https://twitter.com/riganoesq/status/1240273631604809728?s=2...

Re:Severe Outcomes Among U.S. Patients with Covid-19, Feb 12... by hprotagonist on Wednesday March 18, 2020 @09:45PM (#22623536)
note that Gregory Rigano is a lawyer with no medical training who has been writing about this with a cryptotrader (James M. Todaro).

Distribution of preprint by google drive remains highly suspect, as does the fact that the nominally illustrious first author communicates by a gmail address despite google scholar listing him as having a normal educational email address https://scholar.google.com/citations?hl=en&user=n8EF_6kAAAAJ...

That said, i know plenty of intensely brilliant weirdo researchers -- but i'd take this with big grains of salt. and i have no idea why a z-pak is a booster for an antiviral therapy.

Re:Severe Outcomes Among U.S. Patients with Covid-19, Feb 12... by majos on Wednesday March 18, 2020 @09:50PM (#22623574)
I really want this study to be legit, but there are a few more weird things:

1. the evidence-free claim of “full peer review”, 2. the fact that patients who refused or met “exclusion criteria” for the drug served as a portion of the control group, and were the only members of the control group from the same region as the experimental group, 3. the removal of people from the experiment group because they went to the ICU or died (only three of first and one of second, but a rather bizarre thing to happen before claiming 100% cure), 4. the lack of coverage from any major news source, despite this being reported about a day ago.

Re:Severe Outcomes Among U.S. Patients with Covid-19, Feb 12... by hprotagonist on Wednesday March 18, 2020 @10:01PM (#22623652)
i'm with you, i want this to be onto something but i'm like, constitutionally ill equipped to reject the null on this evidence. Too much time in the lab during normal life, maybe. To your points:

- The twitter guy makes the peer review claim, and i think it's wrong. he is not an author of the paper or affiliated with them, he's just shilling it to elon musk for reasons.

- regionality isn't something i'd considered. I can understand the exclusion group being the control in exeptional cases, like a global pandemic.

- of more concern to me are the either confusing or cargo-culted figures at the end. what in the world is a t- and p value column doing next to age data? why are there nominal p-values per day of administration?

- there might not be coverage, but merck is shipping a boatload of the stuff anyway: https://www.fiercepharma.com/pharma/bayer-preps-u-s-donation...

Re:Severe Outcomes Among U.S. Patients with Covid-19, Feb 12... by intpx on Wednesday March 18, 2020 @10:10PM (#22623709)
Re:Severe Outcomes Among U.S. Patients with Covid-19, Feb 12... by hprotagonist on Thursday March 19, 2020 @12:18PM (#22628919)
https://news.ycombinator.com/item?id=22628302 more thoughts from someone smarter than me.
Re:Severe Outcomes Among U.S. Patients with Covid-19, Feb 12... by intpx on Wednesday March 18, 2020 @10:13PM (#22623728)
There are indications that one of the things that makes it so lethal is that the effect on the respiratory system makes patients susceptible to secondary infections, possibly bacterial. May be wrong, but if it’s true and this pans out it could turn the tides. Your skepticism is healthy but I hope this works out.
Re:Severe Outcomes Among U.S. Patients with Covid-19, Feb 12... by hprotagonist on Wednesday March 18, 2020 @10:47PM (#22623887)
Yep. My training is all biomedical, extreme skepticism is like a brainstem reflex at this point!
Re:Severe Outcomes Among U.S. Patients with Covid-19, Feb 12... by chimichangga on Wednesday March 18, 2020 @11:58PM (#22624303)
https://en.m.wikipedia.org/wiki/Chloroquine

For coronaviruses chloroquine works by increasing endosomal pH and interfere with terminal glycosylation of the cellular receptor.[42][43] In late January 2020 during the 2019–20 coronavirus outbreak, Chinese medical researchers stated that exploratory research into chloroquine and two other medications, remdesivir and lopinavir/ritonavir, seemed to have "fairly good inhibitory effects" on the 2019 novel coronavirus. Requests to start clinical testing were submitted.[44][45][46] Chloroquine phosphate had been also proposed as a treatment for SARS-CoV with in vitro tests successfully inhibiting the virus.[47]

On 19 February 2020, preliminary results found that chloroquine may be effective and safe in treating COVID-19 associated pneumonia.[48][49] There is evidence to indicate the efficacy of chloroquine phosphate against SARS-CoV-2 in vitro, on Vero cells.[50] The Guangdong Provincial Department of Science and Technology and the Guangdong Provincial Health and Health Commission issued a report stating that chloroquine phosphate "improves the success rate of treatment and shortens the length of patient’s hospital stay" and recommended it for patients diagnosed with mild, moderate and severe cases of novel coronavirus pneumonia.[51]

Chloroquine have been recommended by Chinese, South Korean and Italian health authorities for the treatment of COVID-19 [52][53][54], however they have noted the important contraindications for people with certain heart conditions, diabetes, etc.[55][56] In February 2020, both drugs were shown to effectively inhibit COVID-19 in vitro [57], however a further study concluded that hydroxychloroquine was more potent than chloroquine, with a more tolerable safety profile. [58] Preliminary results from a multicentric trial, announced in a press conference suggested that chloroquine is effective and safe in treating COVID-19 associated pneumonia, "improving lung imaging findings, promoting a virus-negative conversion, and shortening the disease course".[59]

On 16 March 2020, advisor to the French Government on COVID-19, Professor Didier Raoult, announced that a trial involving 24 patients from the south east of France supported the claim that chloroquine was an effective treatment for COVID-19.[60] 600mg of hydroxychloroquine was administered to these patients every day for 10 days. The drug appeared to be responsible for a "rapid and effective speeding up of their healing process, and a sharp decrease in the amount of time they remained contagious".[61] The study also suggested that taking chloroquine in combination with the antibiotic azithromycin - which is known to be effective against complications from bacterial lung disease - led to even better outcomes. Professor Raoult said the results showed there was "a spectacular reduction in the number of positive cases" with the combination therapy.[62] At 6 days, among patients given combination therapy, the percentage of cases still carrying SRAS-CoV-2 was no more than 5%.[63]

Re:Severe Outcomes Among U.S. Patients with Covid-19, Feb 12... by teddyvangogh on Wednesday March 18, 2020 @10:33PM (#22623808)
its good to be skeptical. Others have had good results as well. Hope we get more data.

https://www.forbes.com/sites/marybethpfeiffer/2020/03/18/sci...

An old malaria and autoimmune drug is showing promise as a potential treatment for COVID-19 – although health officials are urging caution until clinical trials are done.

The drug, hydroxychloroquine, sold under the brand name Plaquenil, was reported March 9 in Clinical Infectious Diseases journal to be effective at killing the virus in laboratory experiments. In a letter in Cell Discovery Wednesday, the study’s authors, mainly from the Chinese Academy of Sciences in Wuhan, wrote, “(W)e predict that the drug has a good potential to combat the disease.”

https://www.nbcnews.com/health/health-news/here-are-some-exi...

Re:Severe Outcomes Among U.S. Patients with Covid-19, Feb 12... by blaser-waffle on Thursday March 19, 2020 @09:23AM (#22627205)
They're showing caution because Chloroquine can have some ugly side effects. Probably better than dying, but if it only has a marginal efficacy then it may be doing as much harm as it does good.
Re:Severe Outcomes Among U.S. Patients with Covid-19, Feb 12... by smallgovt on Wednesday March 18, 2020 @09:41PM (#22623501)
Given that markets didn't react to this news 11 hours ago, I think it's safe to say that this doesn't have significant prospects of being a real cure.
Re:Severe Outcomes Among U.S. Patients with Covid-19, Feb 12... by war1025 on Wednesday March 18, 2020 @09:44PM (#22623525)
The markets are reacting to the total shutdown of the service sector. That's going to cause a lot of pain whether or not this turns out to be the answer.
Re:Severe Outcomes Among U.S. Patients with Covid-19, Feb 12... by smallgovt on Wednesday March 18, 2020 @09:53PM (#22623599)
You don't think the markets would skyrocket if a real cure that is easily manufactured was discovered today? Sure, there's still a lot of pain to follow but the markets have priced in a lot of really bad scenarios where the virus kills large numbers and shutdowns last a long time.
Re:Severe Outcomes Among U.S. Patients with Covid-19, Feb 12... by majos on Wednesday March 18, 2020 @09:52PM (#22623589)
If it turns out that there’s a cheap, widely available, already-studied treatment that achieves something even close to the 100% cure rate observed in the paper, the timeline for total shutdown looks much shorter, no?
Re:Severe Outcomes Among U.S. Patients with Covid-19, Feb 12... by war1025 on Wednesday March 18, 2020 @10:10PM (#22623702)
> If it turns out

That's the kicker. We are still waiting to see. One guy did it. Now others need to try it and see if it helps.

Re:Severe Outcomes Among U.S. Patients with Covid-19, Feb 12... by troughway on Wednesday March 18, 2020 @09:26PM (#22623402)
What does this mean for the build up of antibodies? Is reinfection likely to occur as a result of this?
Re:Severe Outcomes Among U.S. Patients with Covid-19, Feb 12... by koolba on Wednesday March 18, 2020 @09:41PM (#22623504)
Isn’t Azithromycin antibiotics? (Z-pack?)

How would that help vs a virus? Or does it just help the body from having other unrelated things to also fight?

Re:Severe Outcomes Among U.S. Patients with Covid-19, Feb 12... by treis on Wednesday March 18, 2020 @10:05PM (#22623676)
It has a broad effect on the immune system and inflammation beyond it's anti-bacterial effects. Lots of changes to the production/expression of different factors and cell mechanisms. I don't think it's fully understood how it helps in situations like this but probably related to inflammation and reducing the cytokine storm.
Re:Severe Outcomes Among U.S. Patients with Covid-19, Feb 12... by koolba on Wednesday March 18, 2020 @10:13PM (#22623727)
Interesting. Is there any research on using it in isolation to treat this or other coronavirus? Or only in combination with the other drug?
Re:Severe Outcomes Among U.S. Patients with Covid-19, Feb 12... by war1025 on Wednesday March 18, 2020 @09:27PM (#22623407)
I really hope this turns out to be the magic bullet that saves us from this mess.
Re:Severe Outcomes Among U.S. Patients with Covid-19, Feb 12... by endorphone on Wednesday March 18, 2020 @09:50PM (#22623570)
How is it “full peer reviewed” when it’s explicitly an early release draft? Just saying it’s peer reviewed when it clearly isn’t sounds the scam alarms. A Covid Forsythia.

The study itself is interesting, I’m sure, to people in the field (though reading about the study is a bit odd. Of their test group they simply remove six from consideration for reasons like “they died”), but is irrelevant to a layman.

We are undoubtedly going to have hundreds of “this is the cure” claims that aren’t the cure. The way this is presented has significant indicators of not being credible.

Google Drive, some guy claiming that something that isn't peer reviewed at all is "full peer reviewed", pimped on Twitter. Is HN this gullible? How is this nonsense at the top?

Re:Severe Outcomes Among U.S. Patients with Covid-19, Feb 12... by softwaredoug on Wednesday March 18, 2020 @09:36PM (#22623472)
Is this something that be manufactured at scale to treat 1-4% of the world's population in the next few months?
Re:Severe Outcomes Among U.S. Patients with Covid-19, Feb 12... by voidmain on Wednesday March 18, 2020 @09:49PM (#22623564)
I'm no industrial chemist, but from a glance at the chemical formula [1], I'm going to guess that it could be produced by the trainload (provided that you shoot the FDA first, which we should have done on the first day of the epidemic judging by their track record so far)

[1] https://en.wikipedia.org/wiki/Hydroxychloroquine

Re:Severe Outcomes Among U.S. Patients with Covid-19, Feb 12... by kortex on Wednesday March 18, 2020 @10:11PM (#22623714)
Former process chemist here. Yep, you could produce trainloads of this stuff within the month if you bypass the FDA, and even if you do play by the book, current capacity could easily crank out kilos of GMP HQ a day.
Re:Severe Outcomes Among U.S. Patients with Covid-19, Feb 12... by Engineering-MD on Wednesday March 18, 2020 @11:03PM (#22623987)
Could you expand a bit on the required base materials and possible bottlenecks? Would third world countries be able to produce this, and would export restrictions on reagents/chemicals limit production for some countries?
Re:Severe Outcomes Among U.S. Patients with Covid-19, Feb 12... by gpm on Wednesday March 18, 2020 @09:52PM (#22623592)
There were 5.7 million american prescriptions for Hydroxychloroquine in 2017, and the wholesale price quoted on wikipedia is 5 dollars for a months worth of pills.

I don't know how difficult scaling up production is, but the above numbers make me hopeful.

Re:Severe Outcomes Among U.S. Patients with Covid-19, Feb 12... by kevin_thibedeau on Wednesday March 18, 2020 @09:38PM (#22623482)
How many of the control group were cured?
Re:Severe Outcomes Among U.S. Patients with Covid-19, Feb 12... by smallgovt on Wednesday March 18, 2020 @09:51PM (#22623580)
From the paper, "At day6 post-inclusion, 70% of hydroxychloroquine-treated patients were virologicaly cured comparing with 12.5% in the control group"

Sample size is only 36. 20 treated patients. 16 control.

Re:Severe Outcomes Among U.S. Patients with Covid-19, Feb 12... by war1025 on Wednesday March 18, 2020 @09:42PM (#22623519)
A tweet I saw yesterday said 95% recovered on the medicine. 90% of the control group still contagious. Haven't looked up the post again, but it was something I found either on that same twitter feed or a source he was pulling from.
Re:Severe Outcomes Among U.S. Patients with Covid-19, Feb 12... by mrep on Wednesday March 18, 2020 @09:52PM (#22623595)
From the doc [0]: "At day6 post-inclusion, 100% of patients treated with hydroxychloroquine and azithromycin combination were virologicaly cured comparing with 57.1% in patients treated with hydroxychloroquine only, and 12.5% in the control group (p<0.001)."

[0]: https://drive.google.com/file/d/186Bel9RqfsmEx55FDum4xY_IlWS...

Re:Severe Outcomes Among U.S. Patients with Covid-19, Feb 12... by nostromo on Wednesday March 18, 2020 @09:47PM (#22623548)
Don’t 98%+ recover already?
Re:Severe Outcomes Among U.S. Patients with Covid-19, Feb 12... by war1025 on Wednesday March 18, 2020 @10:14PM (#22623730)
I believe average hospital stay for those that need to be hospitalized can be upwards of 3 weeks though. So something that cuts it down to a week or avoids the need for the ICU bed altogether would be a game changer.
Re:Severe Outcomes Among U.S. Patients with Covid-19, Feb 12... by joe_the_user on Wednesday March 18, 2020 @10:24PM (#22623779)
Wat?

There are widespread report of lung damage for severe Covids patients who recover.

Re:Severe Outcomes Among U.S. Patients with Covid-19, Feb 12... by teddyvangogh on Wednesday March 18, 2020 @09:31PM (#22623436)
looks promising.

"A renowned research professor in France has reported successful results from a new treatment for Covid-19, with early tests suggesting it can stop the virus from being contagious in just six days.

Professor Raoult is an infectious diseases specialist and head of the IHU Méditerranée Infection, who has been tasked by - and consulted by - the French government to research possible treatments of Covid-19."

https://www.connexionfrance.com/French-news/French-researche...