Dr Gaetan Burgio, MD, PhD. Profile picture
Apr 18, 2020 9 tweets 5 min read Read on X
Another study on #Hydroxycloroquine efficacy in #COVID19 patients from a Brazilian team has been shared widely this evening. Unfortunately I have to comment it because well it might have some public health implication & this study is atrocious

dropbox.com/s/5qm58cd4fnee…
This study is not a clinical trial but a cohort study on 721 patients, recruited by telemedicine. Incl criteria Flu symptoms, OK to be treated > 18 y/o. Probable diagnosis of #SARSCoV2 but RT-PCR or X ray not compulsory. We don't even know if those patients had #COVID19 😳 😡🤦‍♂️
Outcome -> hospitalisation at day 7, that's it.

721 patients unrolled. 85 not followed -> 636 left => 225 refused treatment -> control group 😳 & 412 patients Hydroxycholoquine + azithromycine (dose unknown)
All followed daily by telemedicine consultation => huge select biais Image
Outcome: HCQ+AZ group 1.9% hospitalisation versus 5.4% -> Chest CT scan for those hospitalized pattern compatible with #COVID19 infection but I don't know what that means given #SARS_CoV2 infection was not confirmed by RT-PCR ImageImageImage
In short from this study
1/ We don't know whether these patients were #SARSCoV2 diagnosed
2/ Huge selection bias, cases omitted % not blinded, not randomized and open label
3/ The results are meaningless. I don't know what this means
4/ The study is in short atrocious
😳 😡🤦‍♂️
Now there are others issues with this study.
1/ Clinical trial was registered 2 days ago and they are not yet recruiting 😳clinicaltrials.gov/ct2/show/NCT04…
2/ The study is performed from an insurance company in Brazil which has promoted its telemedicine application for #COVID19 ! So they have an interest to show efficacy of telemedicine against COVID19. the fact they have declared no COI is a joke

preventsenior.com.br/detalhes_notic… Image
In conclusion, this is really really bad study and awful science, who knows that might have treated flu after all. Ethically it is very wrong. It is really sad. 😳 😡🤦‍♂️

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More from @GaetanBurgio

Apr 29, 2020
Two results came out today on Remdesivir treatment for #COVID19 infection.

The first one is a double blind controlled multi center clinical trial on 237 patients in China

The second one 5 versus 10 days treatment in severe #COVID19 patients

Let's have a look -> thread
The first study is a double blind placebo controlled multi center clinical trial in China in 237 #COVID19 patients. We have now the published result of this trial. Please remember there was a leak on this trial a week ago

158 remdesivi treatment placebo group 79 not 1:1 randomized

incl criteria > 18 y/o #SARSCoV2 + Sao2<94% pneumonia

excl criteria: pregnancy, liver enzymes high...

regimen 200 mg day 1 + 100 mg on days 2–10 IV 1x/day

outcome: clinical improvement aka discharge or ICU admission Image
Read 10 tweets
Apr 10, 2020
A question I often get. Why Lupus patients that have taken Hydroxychloroquine for years have no side effects whereas severe adverse cardiac side effects are described #COVID19 patients under hydroxychloroquine treatment? Let's have a closer look
Let's start with #COVID19. Does #COVID19 causes cardiac effects? The answer is yes from 2 published surveys from Wuhan hospitals. First one reports on 416 hospitalized patients -> 19.7% with myocardial injury + ⬆️cardiac troponin & high mortality rate 51% jamanetwork.com/journals/jamac… Image
The second paper shows similar observation on 187 hospitalized patients -> 27% had cardiac injury with again elevation of cardiac troponin and increase mortality rate at 59%. In short #COVID19 leads to significant cardiac injury but these are severe cases jamanetwork.com/journals/jamac… Image
Read 13 tweets

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