Just published @TheLancet@twitter.com
The largest study of hydroxychloroquine shows a significant increase in death (~35%) and >2-fold increase of serious heart arrhythmias. ~96,000 patients, ~15,000 on HCQ or CQ from 671 hospitals, 6 continents.
@evgenykuznetsov.org They go into why some people were prescribed those drugs and others weren't. Basically hospitals in the US are allowed to experiment in these cases and some did, as far as I understand it. From their data they seemed to have controlled both groups quite well for a number of factors both known to affect COVID-19 and arrhythmias -- which, surprise, are often the same factors.
@evgenykuznetsov.org As for your guess that the people on the drugs were more severely ill, I doubt that. First off, that's not how antiviral treatment works. You have to start with the drugs as soon as possible (goes for antivirals like remdesivir too) so you have no time to see how someone develops. They excluded all patients who were put on chloroquine more than 48 hrs after diagnosis.
@evgenykuznetsov.org Also: It would be extremely unethical to "take more chances" just because someone looks sicker to you. That's generally something most doctors I know would be very cautious of. If only from the experience that these kind of judgements are often wrong. It's very hard to judge how sick someone really is, especially with a systemic illness like this.
Per procrastinatum ad astra