Read the actual paper: "Hydroxychloroquine-treated patients were more severely ill at baseline than those who did not receive hydroxychloroquine (median ratio of partial pressure of arterial oxygen to the fraction of inspired oxygen, 223 vs. 360)."
So the sickest patients had worse outcomes, when you give them an antiviral drug that does not help very sick patients. Duh. We already knew that. That's exactly what the VA study told us. HCQ is not a miracle drug that can save people as a last resort.
They also were giving some patients remdesivir, azithromycin, or some other antiviral drug. It's pretty messy, but they say they fixed up all of that with some whiz-band stats.
>What is the evidence that zinc helps? Any studies?
Easy to Google. Lots of papers about hydroxychloroquine as a zinc ionophore. Lots of papers on zinc blocking corona virus replication in vitro. Some government health authorities recommending the combination. Some studies underway, ie:
HCQ and Zinc Trial Actually, the whole "compassionat use" system is totally ineffective for antivirals. You have to ask the FDA for a drug for your dying patient, when the drug does not work for dying patients. I suspect that has happened a lot with remdesivir.
Do you have a link to the VA study? The quote you mentioned is apparently not from the VA study. It is from a Columbia-Presbyterian study.
Again, a point you seem to be persistently not taking into consideration; I heard (not sure of its accuracy as I haven't read the VA study) that even AFTER correcting the statistical treatment to account for the higher acuity of the patients who received HCQ, the disadvantage *persisted.* I'd like to read the study to, one, confirm that it was the case, and two, see the statistical treatment of the data, in order to form an opinion.
Several studies have arms that differ in one or more aspects but you *can* adjust the data for it.
Re: Zinc, we'll see, when the study concludes. Too bad it's open label. Hopefully the researchers will be unbiased, but after all the shenanigans pulled off by Professor Raoult of Marseille, I'd much prefer a double-blind study.
Again, in-vitro activity and in-vivo activity are two *vastly* different domains, and Medicine is shock-full of potential drugs that had in-vitro activity against infectious agents and didn't pay off in-vivo. I'll reserve judgment.
And again, there is no proof that HCQ helps less severe patients, either. That's another point you're persistently not taking into account.
What evidence do you have that HCQ would help for less severe patient? The theoretical activity in-vitro to inhibit replication? That's NOT proof of clinical usefulness.
*Regardless* of a drug's promising characteristics in-vitro, theoretically, or due to mechanism of action, it *can* fail miserably in a real-life in-vivo clinical situations, and again, the History of Medicine is shock-full of those. Actually this is way more the rule than the exception. Most in-vitro-active drugs fail to show a clinical benefit.
When RCTs come in with the prophylaxis element (one would hope that if it helps in earlier phases, it would help with prophylaxis) or with just mild cases being studied, in paired and randomized, double blind, controlled trials, THEN I will believe. Not before. Not a second before. Everything else is anecdotal.
