# Early hydroxychloroquine associated with survival

**URL:** <https://boards.straightdope.com/t/early-hydroxychloroquine-associated-with-survival/853192>\
**Category:** The Quarantine Zone\
**Tags:** covid-quarantine\
**Created:** [May 5, 2020, 4:59pm UTC](https://boards.straightdope.com/t/early-hydroxychloroquine-associated-with-survival/853192 "2020-05-05T16:59:15Z")\
**Posts on this page:** 20\
**Page:** 1

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**Author:** ![Tigers2B1](https://avatars.discourse-cdn.com/v4/letter/t/9fc29f/32.png) [@Tigers2B1](https://boards.straightdope.com/u/Tigers2B1)\
**Post date:** [May 5, 2020, 4:59pm UTC](https://boards.straightdope.com/t/early-hydroxychloroquine-associated-with-survival/853192/1 "2020-05-05T16:59:15Z")

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Publish today. There are no randomized double blind trials published yet. Until then this is what we have. With that, the evidence is mounting for hydroxychloroquine when administered "early\* in the disease. I intentionally emphasized early.

> **[Early Hydroxychloroquine Is Associated with an Increase of Survival in...](https://www.preprints.org/manuscript/202005.0057/v1)**
>
> Background: There is no treatment proven effective against COVID-19. Several drugs with in vitro potential against SARS-CoV-2 virus have been proposed. Hydroxychloroquine has in vitro anti-viral and immunomodulatory activity, but there is no current...

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**Author:** ![Darren\_Garrison](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/darren_garrison/32/92_2.png) [@Darren\_Garrison](https://boards.straightdope.com/u/Darren_Garrison)\
**Post date:** [May 5, 2020, 5:15pm UTC](https://boards.straightdope.com/t/early-hydroxychloroquine-associated-with-survival/853192/2 "2020-05-05T17:15:13Z")

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Using the traditional “quotsterisk” emphasis method, since the board doesn’t have buttons for itallics, underlining, or bold…

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**Author:** ![AK84](https://avatars.discourse-cdn.com/v4/letter/a/85e7bf/32.png) [@AK84](https://boards.straightdope.com/u/AK84)\
**Post date:** [May 5, 2020, 5:43pm UTC](https://boards.straightdope.com/t/early-hydroxychloroquine-associated-with-survival/853192/3 "2020-05-05T17:43:33Z")

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So this confirms that HCQ is errr, not a game changer and not snake oil. No silver bullet, but a useful tool under certain parameters.

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**Author:** ![steronz](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/steronz/32/11765_2.png) [@steronz](https://boards.straightdope.com/u/steronz)\
**Post date:** [May 5, 2020, 6:04pm UTC](https://boards.straightdope.com/t/early-hydroxychloroquine-associated-with-survival/853192/4 "2020-05-05T18:04:03Z")

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> [@AK84](#):
>
> So this confirms that HCQ is errr, not a game changer and not snake oil. No silver bullet, but a useful tool under certain parameters.

“Confirms” is a strong word given the slim and conflicting evidence.

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**Author:** ![Tigers2B1](https://avatars.discourse-cdn.com/v4/letter/t/9fc29f/32.png) [@Tigers2B1](https://boards.straightdope.com/u/Tigers2B1)\
**Post date:** [May 5, 2020, 7:27pm UTC](https://boards.straightdope.com/t/early-hydroxychloroquine-associated-with-survival/853192/5 "2020-05-05T19:27:04Z")

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> [@Darren\_Garrison](#):
>
> Using the traditional “quotsterisk” emphasis method, since the board doesn’t have buttons for itallics, underlining, or bold…

Says the gratuitous asshat who spells italics with 2 L’s.

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**Author:** ![Colibri](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/colibri/32/1841_2.png) [@Colibri](https://boards.straightdope.com/u/Colibri)\
**Post date:** [May 5, 2020, 7:41pm UTC](https://boards.straightdope.com/t/early-hydroxychloroquine-associated-with-survival/853192/6 "2020-05-05T19:41:51Z")

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> [@Darren\_Garrison](#):
>
> Using the traditional “quotsterisk” emphasis method, since the board doesn’t have buttons for itallics, underlining, or bold…

**Moderator Warning**

This appears to be pure snark, and unrelated to the subject of the OP. This is an official warning for being a jerk.

Colibri  
QZ Moderator

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**Author:** ![Colibri](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/colibri/32/1841_2.png) [@Colibri](https://boards.straightdope.com/u/Colibri)\
**Post date:** [May 5, 2020, 7:42pm UTC](https://boards.straightdope.com/t/early-hydroxychloroquine-associated-with-survival/853192/7 "2020-05-05T19:42:43Z")

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> [@Tigers2B1](#):
>
> Says the gratuitous asshat who spells italics with 2 L’s.

**Moderator Warning**

This is an official warning for insults. If you have a problem with a post, report it rather than responding to it.

Colibri  
QZ Moderator

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**Author:** ![Chief\_Pedant](https://avatars.discourse-cdn.com/v4/letter/c/a6a055/32.png) [@Chief\_Pedant](https://boards.straightdope.com/u/Chief_Pedant)\
**Post date:** [May 5, 2020, 9:15pm UTC](https://boards.straightdope.com/t/early-hydroxychloroquine-associated-with-survival/853192/8 "2020-05-05T21:15:53Z")

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I suspect that, if HCQ is helpful at all, it will be for those given it early after onset of symptoms.  
Earlier the better.  
There are hints in may also work for prophylaxis. Even better.

I hope we’ll see a lot more studies in the next few weeks.

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**Author:** ![Squink](https://avatars.discourse-cdn.com/v4/letter/s/b5e925/32.png) [@Squink](https://boards.straightdope.com/u/Squink)\
**Post date:** [May 5, 2020, 9:23pm UTC](https://boards.straightdope.com/t/early-hydroxychloroquine-associated-with-survival/853192/9 "2020-05-05T21:23:26Z")

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How much are they asking for the Brooklyn bridge nowadays?

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**Author:** ![bobot](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/bobot/32/21622_2.png) [@bobot](https://boards.straightdope.com/u/bobot)\
**Post date:** [May 5, 2020, 9:35pm UTC](https://boards.straightdope.com/t/early-hydroxychloroquine-associated-with-survival/853192/10 "2020-05-05T21:35:01Z")

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For those who aren’t clicking the OP’s link, here’s the first sentence:  
"_Background:_ There is no treatment proven effective against COVID-19. Several drugs with in vitro potential against SARS-CoV-2 virus have been proposed. Hydroxychloroquine has in vitro anti-viral and immunomodulatory activity, but there is no current clinical evidence of its effectiveness changing the outcome of the disease._"_

I understand that everyone, their mother, and me want(s) an effective treatment and a vaccine for covid-19. I am big time suspicious and skeptical about why people keep pushing this particular one.

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**Author:** ![dogbutler](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/dogbutler/32/428_2.png) [@dogbutler](https://boards.straightdope.com/u/dogbutler)\
**Post date:** [May 5, 2020, 9:54pm UTC](https://boards.straightdope.com/t/early-hydroxychloroquine-associated-with-survival/853192/11 "2020-05-05T21:54:55Z")

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> [@bobot](#):
>
> I understand that everyone, their mother, and me want(s) an effective treatment and a vaccine for covid-19. I am big time suspicious and skeptical about why people keep pushing this particular one.

Because the Federal Government bought 290 million doses at the direction of the President, and have to do something with it?

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**Author:** ![bobot](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/bobot/32/21622_2.png) [@bobot](https://boards.straightdope.com/u/bobot)\
**Post date:** [May 5, 2020, 10:05pm UTC](https://boards.straightdope.com/t/early-hydroxychloroquine-associated-with-survival/853192/12 "2020-05-05T22:05:45Z")

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I’ve been bitten once discussing politics in the Q-Zone. (Actually, I wasn’t discussing. I was vulgar ranting.)

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**Author:** ![Tigers2B1](https://avatars.discourse-cdn.com/v4/letter/t/9fc29f/32.png) [@Tigers2B1](https://boards.straightdope.com/u/Tigers2B1)\
**Post date:** [May 5, 2020, 10:17pm UTC](https://boards.straightdope.com/t/early-hydroxychloroquine-associated-with-survival/853192/13 "2020-05-05T22:17:20Z")

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> [@Chief\_Pedant](#):
>
> I suspect that, if HCQ is helpful at all, it will be for those given it early after onset of symptoms.  
> Earlier the better.  
> There are hints in may also work for prophylaxis. Even better.
> 
> I hope we’ll see a lot more studies in the next few weeks.

Hydroxychloroquine allows more zinc to enter infected cells which slows down RNA replication. That’s the theory at least. It may create a time-bridge between the activation of your innate and acquired immune system. That is, the viral load isn’t as high and there’s less of a chance of a ‘cytokine storm’ occurring (where your own immune system attacks your body.) If this is how it works then it would be important to give it early has done here. Patients here we’re given hydroxychloroquine within 7 Days of the first symptoms and on the day of being admitted to the hospital. So early yes. And before the onset of severe symptoms.

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**Author:** ![storyteller0910](https://avatars.discourse-cdn.com/v4/letter/s/ecae2f/32.png) [@storyteller0910](https://boards.straightdope.com/u/storyteller0910)\
**Post date:** [May 5, 2020, 10:31pm UTC](https://boards.straightdope.com/t/early-hydroxychloroquine-associated-with-survival/853192/14 "2020-05-05T22:31:43Z")

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Something is… odd… about this study. Unless I am misreading it, they are reporting a mortality of _48 percent_ in the untreated group. By way of contrast, the mortality rate among hospitalized patients (with or without HCQ) in New York City is around 20%. What the hell are they doing at that hospital?

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**Author:** ![Colibri](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/colibri/32/1841_2.png) [@Colibri](https://boards.straightdope.com/u/Colibri)\
**Post date:** [May 5, 2020, 10:40pm UTC](https://boards.straightdope.com/t/early-hydroxychloroquine-associated-with-survival/853192/15 "2020-05-05T22:40:01Z")

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> [@Squink](#):
>
> How much are they asking for the Brooklyn bridge nowadays?

**Moderator Note**

Let’s not threadshit. If you want to comment on the study itself, go ahead.

Colibri  
QZ Moderator

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**Author:** ![Skypist](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/skypist/32/169_2.png) [@Skypist](https://boards.straightdope.com/u/Skypist)\
**Post date:** [May 5, 2020, 11:19pm UTC](https://boards.straightdope.com/t/early-hydroxychloroquine-associated-with-survival/853192/16 "2020-05-05T23:19:16Z")

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I thought we already had the “probably not as effective as originally billed” answer. I assume they’ll continue to study it, but it sounds like remdesivir will now be the standard of care, even though it doesn’t seem to be wildly effective either.

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**Author:** ![Colibri](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/colibri/32/1841_2.png) [@Colibri](https://boards.straightdope.com/u/Colibri)\
**Post date:** [May 5, 2020, 11:25pm UTC](https://boards.straightdope.com/t/early-hydroxychloroquine-associated-with-survival/853192/17 "2020-05-05T23:25:05Z")

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> [@dogbutler](#):
>
> Because the Federal Government bought 290 million doses at the direction of the President, and have to do something with it?

**Moderator Note**

Let’s keep the political jabs out of this forum.

We should be able to impartially discuss scientific studies on treatments in this forum regardless whether they might be being promoted politically. Note that this study was conducted by a Spanish group in a Spanish hospital. Let’s keep discussion in this thread to the actual merits of the study.

Colibri  
QZ Moderator

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**Author:** ![DinoR](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/dinor/32/2821_2.png) [@DinoR](https://boards.straightdope.com/u/DinoR)\
**Post date:** [May 5, 2020, 11:46pm UTC](https://boards.straightdope.com/t/early-hydroxychloroquine-associated-with-survival/853192/18 "2020-05-05T23:46:45Z")

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> [@bobot](#):
>
> For those who aren’t clicking the OP’s link, here’s the first sentence:  
> "_Background:_ There is no treatment proven effective against COVID-19. Several drugs with in vitro potential against SARS-CoV-2 virus have been proposed. Hydroxychloroquine has in vitro anti-viral and immunomodulatory activity, but there is no current clinical evidence of its effectiveness changing the outcome of the disease._"_

That is the **background**. Before doing the study there was no clinical evidence of effectiveness. There were reasons to suspect that this might be effective in clinical testing. That is a pretty normal starting point for early testing. You get clinical evidence by doing testing where none existed. Testing is also ongoing for a number of other drugs and vaccines that had no current clinical evidence as treatments against a disease we did not even know existed 7 months ago.

The abstract also included a summary of what the testing showed.

> [@](#):
>
> Results: We analysed first 220 medical records. 166 patients met the inclusion criteria. 48,8 % of patients not treated with HCQ died, 22% of those treated with hydroxychloroquine (p=0,002). **According to clinical picture at admission, hydroxychloroquine increased the mean cumulative survival in all groups from 1,4 to 1,8 times. This difference was statistically significant in the mild group.** Conclusions: in a cohort of 166 patients from 18 to 85 years hospitalised with COVID-19, **hydroxychloroquine treatment with 800mg added loading dose increased survival when patients were admitted in early stages of the disease.** There was a non-statistically significant trend towards survival in all groups, which will have to be clarified in subsequent studies.

Those bolded parts show a real reason why people would want to continue testing. In this study, hydroxychloroquine use appears to have saved lives.

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**Author:** ![Eva\_Luna](https://avatars.discourse-cdn.com/v4/letter/e/e495f1/32.png) [@Eva\_Luna](https://boards.straightdope.com/u/Eva_Luna)\
**Post date:** [May 5, 2020, 11:59pm UTC](https://boards.straightdope.com/t/early-hydroxychloroquine-associated-with-survival/853192/19 "2020-05-05T23:59:42Z")

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> [@dogbutler](#):
>
> Because the Federal Government bought 290 million doses at the direction of the President, and have to do something with it?

My (now late) stepmother was treated with the hydroxychloroquine/azithromycin combo in the ICU at one of the top hospitals in the United States, BEFORE the President said a damn word about anything. At that point, lacking good options, I imagine the medical staff there thought a Hail Mary pass made sense. And she did improve enough to be released from the ICU to a rehab facility to be weaned from the ventilator.

As I imagine most of you know, most people who end up on a ventilator with COVID-19 do not survive. She was one of the unlucky ones. But until we have better data, we don’t know whether things might have gone differently if she had been treated with a different protocol. She had multiple risk factors, including multiple decades of lupus. But I have full confidence that her treating physicians made an appropriate analysis given the limited information that they had and the lack of any other good alternatives.

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**Author:** ![DinoR](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/dinor/32/2821_2.png) [@DinoR](https://boards.straightdope.com/u/DinoR)\
**Post date:** [May 6, 2020, 12:08am UTC](https://boards.straightdope.com/t/early-hydroxychloroquine-associated-with-survival/853192/20 "2020-05-06T00:08:37Z")

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> [@Skypist](#):
>
> I assume they’ll continue to study it, but it sounds like remdesivir will now be the standard of care, even though it doesn’t seem to be wildly effective either.

The FDA emergency approval for Remdesivir “allows the drug to be given to patients with COVID-19 only if they are severely ill — with blood oxygen levels at 94% or lower, or otherwise requiring supplemental oxygen.” ([Cite](https://www.msn.com/en-us/health/medical/the-drug-remdesivir-got-emergency-use-clearance-from-the-fda-what-will-that-mean-for-treating-covid-19/ar-BB13AU9M)) Since this new test data shows statistically significant benefit where Remdesivir use is not approved, they might both end up being the standard of care. They would just be the standard for different stages in the progression of the disease.

[Next page](https://boards.straightdope.com/t/early-hydroxychloroquine-associated-with-survival/853192.md?page=2)
