I'm disappointed that there are no RCT's of the old, cheap, safe, supplements rutin & procyanidin for #COVID.
They're active in so many in-silico models, including a prescient study from the start of the pandemic which found activity for ivermectin. Little 5 tweet thread.👇
This article from March accurately predicted antiviral activity of such notables as ivermectin, which hit 2 of the 3 #SARSCoV2 targets evaluated.
Both rutin and procyanidin each hit 2 targets as well.
"Molecular dynamics simulation revealed changes in the dynamics of receptors like ACE2, Mpro and spike... structural changes induced by the procyanidin are sufficient to inhibit the proteins to prevent the progression of the disease." ncbi.nlm.nih.gov/pmc/articles/P…
I really think these should be studied for #COVID19.
If this tweet ever finds a home with someone who has an interest & the means to research these cheap, safe, readily available, potential remedies for COVID, please seriously consider rutin and procyanidin.
Designing valid retrospective reviews is like putting lipstick on a pig. But RCT's have no porcine roots. They start out with racehorse potential, which made it even more sad when the major design flaws in this study rendered this horse lame. Analysis:👇 acpjournals.org/doi/10.7326/M2…
To test whether #HCQ works for #COVID19, subjects must have had proof that they actually had it, not just clinical suspicion. Without this evidence, we can't draw reliable conclusions. But only 1/3 had positive COVID tests. And maybe that's why the following didn't add up:👇
Case fatality rate (CFR) for the placebo group was about 0.5%, but the observed US COVID19 CFR at the time of study enrollment was 5.58%. Could this discrepancy have been in part due to many in the study never having had COVID19 in the first place?👇cebm.net/covid-19/globa…
They're using an inactivated virus for their #COVID19 vaccine. Some things puzzle me about the studies to date for this vaccine candidate.👇 statnews.com/2020/06/14/sin…
There has been a known potential problem with such a vaccine design when they tried it for SARS: An abnormal worsening of disease in the face of immunization, known as antibody dependent enhancement (ADE), or referred to more broadly as immune enhancement.👇
This didn't happen with the Sinovac vaccine candidate, but safety was assessed only 7 days after vaccination. ADE occurs as antibody levels go lower over time. Researchers state, "ADE after antibody titers wane could not be ruled out in this study."👇science.sciencemag.org/content/early/…
My Dad's recent #COVID19. Not an academic document-just sharing a human experience of outrage & triumph.
My Dad is almost 90, frail as can be, in a nursing home. I went to visit him 3 months ago & wore a mask before it was fashionable to protect him just in case I had it.
I sent an email to 5 people at the nursing home the next day saying that I was shocked that none of the staff or visitors were wearing PPE. I warned them that the now infamous Seattle nursing home which had massive deaths early on in the #COVID pandemic was a sentinel event.
I warned them that they needed to "act now" to prevent a "major tragedy," but not a single one of the recipients responded to my email, silence. I reached out to my Dad's doctor to discuss the situation. She felt that he was a sitting duck and that prophylaxis was appropriate.
I think the authors put forth a good effort, but there are significant issues with this study, which was intended to evaluate #COVIDー19 post-exposure prophylaxis with #HCQ. My two cents:👇nejm.org/doi/full/10.10…
Planned enrollment threshold was within 3 days of exposure due to the average incubation period of 5.5 days. But then the threshold was changed to 4 days. Cutting it close. One can argue that the study nearly misses its basic premise of being a PEP trial. And then this: 👇
Authors wrote that the "vast majority of the participants" couldn't get diagnostic testing for #Covid. Instead, they looked at symptoms and labeled some cases as "probable," about which they admit, "predictive power of this case definition is unknown." Is this OK?👇
This 65 year-old drug, which has been prescribed safely hundreds of millions of times, has been reduced to media villain over the span of a few short weeks. Here's how:👇
To say that this drug has been politicized has been an understatement. It's been an embarrassment. A permanent stain to whatever last remnants of objectivity had remained in medical science and media. Let's look at the hypocrisies: 👇 abc3340.com/news/nation-wo…
A trove of data supporting the efficacy & safety of #HCQ for #COVID19 has been curated by @JamesTodaroMD, but that hasn't stopped the media from running with "results" from two poorly designed retrospective data reviews. Problems are summarized here:👇 medicineuncensored.com
Subconscious biases are ubiquitous and powerful. We all have them, so what are going to do about it? "Confirmation bias—probably the most pervasive and damaging bias of them all—leads us to look for evidence that confirms what we already think." theatlantic.com/magazine/archi…
Physicians are vulnerable to bias just like other humans and it can lead to diagnostic errors. "The culture of medicine has never been one that encourages discussion of physician vulnerability." beckershospitalreview.com/hospital-physi…
This article details how researchers are blind to their own bias but can easily point it out in others, including when it comes to how receiving gifts from pharmaceutical companies affects decision making. cmu.edu/news/stories/a…