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Hydroxychloroquine is Effective and Safe for the Treatment of COVID-19, and May be Universally Effective When Used Early Before Hospitalization: A Systematic Review

See also: FDA Is Hoarding Life-saving Drugs While Americans Die.

This study below is not yet peer reviewed and not a gold standard clinical trial. We should all want to see the TRUTH about hydroxychloroquine revealed with multiple large-scale clinical trials done with the right protocols, because COVID-19 is an equal-opportunity killer. Whatever that truth is.

See: Fraud in the Study of Hydroxychloroquine: can you trust medical experts of any kind any more?

Gold standard clinical trials using hydroxychloroquine with the right protocols were abandoned due to falsified data and political and press pressures. Incompetent and feckless institutions took made-up fake data as real and acted without even the most rudimentary due diligence. These people and institutions have needlessly killed tens of thousands of people by causing the abrupt halt to studies of hydroxychloroquine. At some point, it becomes criminal negligence, not just for the fakers, but for the people who failed to do their jobs properly, not doing even the most basic due diligence.

Most studies on hydroxychloroquine studied the wrong thing with the wrong protocols, making them irrelevant. For example, giving it to people rapidly approaching death. The evidence suggests that giving hydroxychloroquine at that point is a bad idea, but that using it might be a win—but what is the right protocol?

How many people has CNN killed, in effect, by prematurely stifling research (whatever the findings)? The press is complicit in actively misleading the public on the reality of potential benefits, quoting irrelevant trials with the wrong protocols, etc. Given the looming election here in the USA, there will be intense pressure to suppress the truth if that truth trends to safety and effectiveness of hydroxychloroquine. Anything to make President Trump look bad, no matter how many have to die. I don’t care what the truth is either way so long as it really is the truth (of course we all hope for a drug that works!). It’s not a political issue for me, but I’m forced to wade through the muck of trying to discern the truth, given its politicization by the "news", which means ALL the news (brainwashing) networks.

Studies that study the wrong thing, or don’t look for the right things are the norm in medicine and science. History shows that over and over. That’s why I have a lot more confidence in meta analysis than any particular study. But even meta analysis fails if all the studies use differing protocols and all make the same types of errors.

HCQ has become so politicized that it’s hard to believe any study unless the motivations of its authors and funders are scrutinized (in addition to methodology, timing, concurrent administration of other drugs, etc). We’ve already seen falsified data that The Lancet failed to notice (sloppy and incompetent!), and selection bias (intentional or unavoidable) in studies is commonplace for everything. Randomization is ideal, but inappropriate testing protocols (known or not known) repeated only prove that the particular protocol does not work. It’s really hard to prove that a drug works or does not, and to know when and how to use it.

The only thing I care about is a true, unbiased, scientific answer. I don’t want to see anyone hurt by any premature erroneous conclusion about HCQ, either yeah or nay on its efficacy. That wish might be a fantasy prior to the Nov 2020 election.

Update Sept 13: at least one double-blind study concludes that HCQ is not effective as a prophylactic (I do not see it as stating “peer reviewed”). The study omits both zinc and azythromycin, targets a healthier group, has a poor methodology for validating real infections, and it relies on unproven assumptions. Read carefully ("Discussion"), the study itself raises serious doubt about its apparently clear conclusion. Also worth looking into is whether financial contributors include the "Alliance of Chinese Organizations" are pro-CCP or not. Note that the majority of scientific studies are later debunked, so it would not be reasonable to consider the matter anywhere near settled. I quote: “the study itself has significant limitations that prevent it from being a final word on the subject”.

I’m going to do the proper risk management thing: go with the odds—while the odds for HCQ being effective, the odds are not zero. I’m going to go with a 30% chance that it works using some treatment protocol on some good-sized chunk of patients.

Hydroxychloroquine is Effective and Safe for the Treatment of COVID-19, and May be Universally Effective When Used Early Before Hospitalization: A Systematic Review [Excerpts]

Emphasis added.

Introduction

There is a need for effective treatment for COVID-19 infection. Hydroxychloroquine (HCQ), with or without azithromycin, has been found to have efficacy as a treatment for COVID-19 in some studies, while other studies have not shown efficacy.

Some physicians have stated that HCQ has greater efficacy if given earlier in the course of the disease. Several studies showing negative efficacy have been withdrawn due to methodological improprieties [7].

We hypothesized that HCQ clinical studies would show significant efficacy more often than not for COVID-19; and that efficacy would be greater if HCQ were used earlier in the course of the disease. We also hypothesized that some studies that failed to show efficacy would be biased against positive efficacy and that no unbiased studies would show worsening. We also hypothesized that HCQ would be found to be safe.

RESULTS

HCQ was found consistently effective against COVID-19 when used early, in the outpatient setting. It was found overall effective. No credible study found worse outcomes with HCQ use. No mortality or other serious safety issue was found

CONCLUSIONS

HCQ is consistently effective against COVID-19 when used early in the outpatient setting, it is overall effective against COVID-19, it has not produced worsening, it is safe.

...Some studies used HCQ alone, some had the addition of azithromycin or zinc. No outcome difference was seen with the addition of azithromycin (table 4). There were no deaths reported as a result of HCQ, azithromycin or Zinc treatment.

...

TIMING OF HCQ USE: It was striking that 100% of the 11 of the studies which used HCQ early in the disease on an outpatient basis showed positive results.

OVERALL EFFICACY: 23 of the 43 studies (53%) showed a definite positive effect of HCQ vs COVID-19. However if negatively biased studies are removed and the clinically important positive trends from underpowered studies are moved to the positive efficacy group the ratio changes to 28 positive vs 9 no effect: a 75% positivity ratio of positive HCQ studies. Interestingly none of the no-effect studies showed a clear trend toward worsening.

...SIGNIFICANCE: We believe our findings have substantial societal global importance since there have been numerous edicts either preventing HCQ use for COVID-19 or limiting it to the inpatient setting which we believe have resulted in many unnecessary deaths. Our findings showing efficacy and safety of HCQ against COVID-19 indicate that HCQ should be freely available to patients and physicians who choose to use it. And it should especially be freely available to be used on an outpatient basis before hospitalization where it appears to be more effective and where early fears of fatal heart arrhythmias have been shown to be unfounded[45]. This is particularly important because the only drug to show efficacy, Remdesivir, has shown no significant benefit in a recent study [46].It is also expensive and not widely available.... We also do not believe that randomized controlled studies are necessary before HCQ is authorized for general use because the efficacy seen in studies already done indicates that control patients in such studies might die unnecessarily; and because the time delay to do any such study would cause yet more deaths by preventing HCQ use when it is most needed – which is immediately

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