Marcus Aurelius said:
FYI. A study of 63 pts at Henry Ford hospital has been submitted to NEJM. Publication pending. Not a RPCT. 63 pts. 32 received HCQ. 31 did not. These pts were on avg admitted for dyspnea around day 7. Findings. No improvement in survival, N/L ratio. HCQ pts also had statistically significant increased need for respiratory support. Take it FWIW. Anecdotally I have seen similar results once these pts are very sick. Didnt expect negative effects on respiratory outcomes however. Jury still out.
I think with it's proposed primary mechanism of action being inhibiting viral replication. I am expecting no benefit if started after patients are severe enough to require hospitalization since by that time they likely have way too much virus in their system. I think it will have to be used similar to Tamiflu early in the process and hopefully decrease hospitalizations and ICU admissions. While Tamiflu doesn't inhibit viral replication it inhibits budding of the virus so a similar concept. I believe if we in primary care use it on patients with a high index of suspicion and who have risk factors will likely see benefits but very doubtful if implemented late as too much virus is already been made.
I am not seeing them in the hospital so I will defer to your expertise but I believe once they are sick enough to be admitted we are going to need IL-6 inhibitors, plasma transfusions, steroids etc to stop the cytokine storm. I just don't see how slowing viral replication is anywhere near enough to help since it is now your own immune system causing the damage.
I am also surprised to see negative effects also.
No material on this site is intended to be a substitute for professional medical advice, diagnosis or treatment. See full
Medical Disclaimer.