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Science & Technology
The Rise and Fall of Hydroxychloroquine for the Treatment and Prevention of COVID-19
2021-09-03
[PMC] - The efficacy and safety of hydroxychloroquine (HCQ) for the prevention and treatment of COVID-19 has received great attention, and most notably, the enthusiasm for HCQ has been one of politicization rather than science. Laboratory studies and case series published early in the pandemic supported its efficacy. The scientific community raced to conduct observational and randomized evaluations of the drug in all stages of the disease, including prophylaxis, early treatment, and advanced disease. Yet a divisive media response affected recruitment, funding, and subsequent enthusiasm for continuing scientific investigations.
Not just the media has been divisive. All those politicians, and the science professionals who have supported them, shouting about “settled science” will one day have a place in science textbooks next to Piltdown Man and Trofim Lysenko.
Of the more than 300 HCQ trials registered, fewer than 50% report having recruited any patients, and most trials might fail to achieve any useful portions of their intended sample size. Multiple observational studies and two large randomized trials have demonstrated HCQ does not offer efficacy against COVID-19 in hospitalized patients.
As expected. HCQ was originally presented as part of a treatment protocol to be used as a prophylactic upon exposure and immediately upon the onset of symptoms to reduce the progress of the disease so that hospitalization would not become needed. HCQ is one of several ionophores that pull zinc ions into the cell, where the zinc inhibits reproduction of RNA viruses like Covid-19. The original treatment package included HCQ, zinc, azithromycin for its anti-inflammatory effect, and vitamins D and C which strengthen the immune system. Aspirin was later added to reduce the formation of damaging tiny blood clots. Once the immune response has progressed to the point of cytokine storm, the actual infection no longer matters.
Prophylaxis studies and early treatment studies provided heterogeneous results and are plagued by low event rates and poor study outcome monitoring. Emerging high-quality evaluations of prophylaxis and early treatment do not support a role for HCQ in these populations.
“Emerging”? That sounds like a premature conclusion.
The story of HCQ for COVID-19 has followed a pattern of initial enthusiasm supported by poor quality evidence, followed by disappointment based on more rigorous evaluations. The experience of HCQ in the COVID-19 era calls for the depoliticization of science away from media glare.
Depoliticization would be really nice. Especially at the NIH, CDC, FDA, and WHO.
Posted by:g(r)omgoru

#17  If, dear readers, you do not mind my indulgence, I would like to quote as sorts one of the storytelling epics available.

The Marvel Comics series.

Bear with me. It is an epic, it is modern, and it is topical.

In Avengers: Endgame, Tony Stark/Iron Man goes on a tirade against Steve Rodgers/Captain America towards the beginning of the film. "What we needed, was an Iron Suit, damned the peoples' rights" or some such. It was framed that Starks was right, and that a iron clapdown would have avoided that whole Thanos situation. Because Starks is infallable.

Wrong.

Had there not have been Ultron, and the Iron Suit Around the World have taken place, then no Avengers would be around and that idea of Independent Thought would have been squashed and come Thanos' goons would have rolled over Earth, close credits, please throw away your movie trash.

https://youtu.be/4FXHnmO2qK8
Posted by: swksvolFF   2021-09-03 21:07  

#16  The novel pathogenic coronavirus SARS-CoV-2 causes COVID-19 and remains a threat to global public health. Chloroquine and hydroxychloroquine have been shown to prevent viral infection in cell-culture systems, but human clinical trials did not observe a significant improvement in COVID-19 patients treated with these compounds. Here we show that hydroxychloroquine interferes with only one of two somewhat redundant pathways by which the SARS-CoV-2 spike (S) protein is activated to mediate infection. The first pathway is dependent on the endosomal protease cathepsin L and sensitive to hydroxychloroquine, whereas the second pathway is dependent on TMPRSS2, which is unaffected by this compound. We further show that SARS-CoV-2 is more reliant than SARS coronavirus (SARS-CoV-1) on the TMPRSS2 pathway, and that this difference is due to a furin cleavage site present in the SARS-CoV-2 S protein. Finally, we show that combinations of hydroxychloroquine and a clinically tested TMPRSS2 inhibitor work together to effectively inhibit SARS-CoV-2 entry. Thus TMPRSS2 expression on physiologically relevant SARS-CoV-2 target cells may bypass the antiviral activities of hydroxychloroquine, and explain its lack of in vivo efficacy.
Posted by: John Frum   2021-09-03 20:55  

#15  See

Hydroxychloroquine-mediated inhibition of SARS-CoV-2 entry is attenuated by TMPRSS2
Posted by: John Frum   2021-09-03 20:52  

#14  To crib from a sister thread today concerning Dune, Fear is the Mind Killer. I abhor both wings of the question, and only wish us humans here come to their own conclusions and the population of Rantburg allowed to their own conclusions based upon their own situations without the strain of peer pressure.
Posted by: swksvolFF   2021-09-03 20:44  

#13  Apologies; I submit to your honor in fairness and retract the absolution, guilty of my breaking my own rule of Unchangeable Opinion Based On Incomplete Data.

For 12 months now, I have been witness to ignorant decision making and outright propaganda and have relied mainly on observation evidence.

I submit two more data points, or more accurately for everyone reading, anecdotes.

One: a known known, who does not go to hospital except when no other option allows to squirm out, submitted oneself for lack of breathing. After a Z-Pack, if you will, patient was home in 48 hours.

Two: the long term health effects and damage from Covid Regulations has cost two people their lives - liver failure. Not to say they didn't have problems already, but the house arrest gave virtue to their addiction.

And say what you will about Islam/the covering of the face, at the end of the day when the veil comes off, it is a joyous move..too many see the removal of this Covid Facemask as a negative increase threat.

I guess witnessing two funerals which deserved so much more than cats hiding in a box was heart breaking, the 8 year old girl who jumped from me like I was a coiled rattlesnake got me thinking about the emotional toll.

Also, witnessing two confirmed with The Covid survive when their own lifestyles should have had them in the ground on their own accords five years ago.

Suppose that is four, then.

Cannot speak for our esteemed host and his and family's ordeal. It was about the same time as my associate and his Z-Pack and the fashionable hits against supplemental or passive actions.
Posted by: swksvolFF   2021-09-03 20:40  

#12  g(r)omgoru is not the only one to post kook articles on the subject, swksvolFF. There are plenty of fixed opinions on both extremes here.

g(r)omgoru, disagreeing with you is not proof that the other is either stupid or ignorant.

HCQ is one of a number of zinc ionophores that can be useful as part of a prophylactic protocol and in the early stage of the disease to prevent progression of the thing. Its advantage is that it is inexpensive, has a long history of use so dosages and dangers are well known and, until the Dr. Fauci drummed up anti-HCQ hysteria, was readily available in the U.S. But others, such as quercetin, are nutraceuticals that do not need a doctor’s prescription, available in a variety of foods or in the vitamin aisle of American grocery stores and drug stores.
Posted by: trailing wife   2021-09-03 19:37  

#11  It occurs to me that the only kook articles posted, like the magnetized shots, have been posted by you, g(r)om, as a means to set up and bash those you don't agree with.
Posted by: swksvolFF   2021-09-03 18:56  

#10  So long as its your articles, and follow your opinions, to your conclusions on our own. Got it.
Posted by: swksvolFF   2021-09-03 18:52  

#9  p.s. I don't actually object to your faith (or whatever) it's the "scientific proofs" of your position that you feel compelled to share with the rest of us that gets me irritated. What's so hard to understand about "Please Don't Litter - Help Keep Rantburg Clean"?
Posted by: g(r)omgoru   2021-09-03 18:39  

#8  Yada, yada, yada. The fact is, your covid anti-vaxxerism is finished as a popular movement in USA. Because,
Insurance companies are now asking COVID-19 patients to share in the cost of their treatment

Your fellow scientific geniuses may ignore the risks of death or permanent impairment - because "It can't happen to me: I'm special" - but they can't ignore the rise in their insurance premiums.

So, I suggest you fellas find a new venue. I bet most of you will shine as "Intelligent Design" advocates.
Posted by: g(r)omgoru   2021-09-03 18:28  

#7  Nah, these are the type of people who will poison your dog, spread a rumor it really died of Covid 20, and have the neighborhood Karens do the door knock with them behind.
Posted by: swksvolFF   2021-09-03 18:15  

#6  Oh, you had to Look Away from the actual details because I'm a zealot. Right.
Posted by: Thing From Snowy Mountain   2021-09-03 17:58  

#5  #2. The fact you’ve taken Your vax (or two or three) doesn’t give you the moral high ground. You’re just another schmuck who took a shot. The effect of the vax is still largely unknown. I hope it be vax works but just shut up.
Posted by: Lonzo Hapsburg5562   2021-09-03 17:53  

#4  ^Nobody's going to shoot your dog - the use of Predator UAVs to deal with unvaccinated has been approved.
Posted by: g(r)omgoru   2021-09-03 17:23  

#3  #2 Please don’t shoot my dog when you come to forcefully vaccinate us.
Posted by: Saltie Fork   2021-09-03 17:08  

#2  I already showed you how they rigged the trials.

No. That you showed to me that you are a zealot incapable of rational thought.
Posted by: g(r)omgoru   2021-09-03 16:54  

#1  I already showed you how they rigged the trials. You just looked away, asshole. Since you're not willing to look at the actual data, go bother someone else. Maybe go to reddit, they like the vax.
Posted by: Thing From Snowy Mountain   2021-09-03 16:18  

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