2024-09-09 16:00:00
Professor Didier Raoult, before a hearing before the medical association, in Bordeaux, November 5, 2021. PHILIPPE LOPEZ / AFP
How many Covid-19 patients have died from being given hydroxychloroquine? A French study, which provided an estimate among patients hospitalized during the first wave of the pandemic, was retracted on August 26 by the journal Biomedicine & PharmacotherapyThis editorial decision pleases the nebula defending the “Raoult protocol”, while it worries some pharmacologists and epidemiologists, according to whom this decision was not justified.
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Jean-Christophe Lega had nevertheless taken care not to hide anything about the uncertainties surrounding the results of the study he had led, published in early 2024. With his colleagues, this doctor and epidemiologist from the University of Lyon-I had arrived at the figure of 17,000 deaths in six countries – including 199 in France – but he agreed that the very wide confidence interval meant that the reality could be between 3,000 and 30,000 deaths.
He also noted that the poor quality of many databases had not allowed these calculations to be made for countries that had widely prescribed hydroxychloroquine, such as Brazil or India, so that deaths linked to this treatment must in reality be more numerous. Not to mention prescriptions outside of hospital settings.
Let us recall that no seriously conducted study has been able to prove the effectiveness of hydroxychloroquine (HCQ) against Covid-19 – the opposite has been demonstrated. This molecule promoted by Didier Raoult in combination with the antibiotic azithromycin could in particular present cardiac toxicity: the first deaths recorded in early 2020 by the pharmacovigilance networks had also led the director of the IHU Méditerranée to exclude certain at-risk patients from this prescription.
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Jean-Christophe Lega’s objective was therefore to evaluate the number of patients to whom the molecule had been administered and, from the induced excess mortality rate provided by a British study (Axfors et al., Nature Communications2021), to calculate the number of them who would have succumbed to the treatment. This methodology was immediately attacked on social networks.
“I quickly received many fairly standardized emails, often polite, sometimes not, questioning the integrity of our results”says the epidemiologist. The presidency of his university is also assailed by criticism. He finds arguments formulated by the statistician Vincent Pavan, president of the association Réinfo Liberté, or disseminated by sites friendly to the “raoultosphere”, France-Soir and Bonsens.info, the latter announcing that he had formally notified the magazinethrough a lawyer, to respond to his criticisms.
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Hydroxychloroquine and COVID-19: Controversies and Concerns
As the world continues to grapple with the COVID-19 pandemic, one medication has been at the center of controversy - hydroxychloroquine (HCQ). Initially touted as a potential game-changer in the fight against the virus, HCQ has been mired in debates over its effectiveness and safety. In this article, we will delve into the concerns surrounding HCQ, its potential risks, and the latest developments in the medical community.
Effectiveness Against COVID-19
Despite early enthusiasm, numerous studies have failed to demonstrate the effectiveness of HCQ against COVID-19. In fact, the World Health Organization (WHO) has categorically stated that HCQ is not recommended to prevent or treat COVID-19, citing findings from six trials involving over 6,000 participants [[3]]. This stance is supported by several other reputable health organizations, including the Cochrane Library, which concluded that HCQ is not useful in treating or preventing COVID-19 [[2]].
Cardiac Toxicity and Excess Mortality
One of the primary concerns surrounding HCQ is its potential to induce cardiac toxicity. The first deaths recorded in early 2020 by pharmacovigilance networks led to the exclusion of at-risk patients from this prescription [[4]]. Moreover, a French study published in 2024 estimated that HCQ might be responsible for up to 17,000 deaths in six countries, including 199 in France [[4]]. Although the study was later retracted, the methodology used to calculate excess mortality rates has sparked intense debate among medical professionals.
Critics and Controversy
The retraction of the French study has been met with criticism from some quarters, who argue that the decision was not justified. Supporters of the ”Raoult protocol,” which involves the use of HCQ in combination with azithromycin, have welcomed the retraction, while pharmacologists and epidemiologists have expressed concerns over the potential risks associated with HCQ [[1]].
Prescription Patterns and Deaths
In the United States, over 890,000 prescriptions for HCQ were filled in 2020, a ninefold increase from the previous year [[1]]. This spike in prescriptions has led to concerns about the potential risks associated with widespread use of HCQ. In countries like Brazil and India, where HCQ was widely prescribed, the actual number of deaths linked to the medication might be higher due to poor database quality and prescriptions outside of hospital settings.
Conclusion
The debate surrounding hydroxychloroquine and COVID-19 is complex and multifaceted. While some argue that HCQ has a role to play in fighting the pandemic, the overwhelming scientific consensus is that it is not an effective treatment or preventative measure. Moreover, concerns over cardiac toxicity and excess mortality make it a potentially risky medication. As the medical community continues to grapple with the challenges of COVID-19, it is essential to prioritize evidence-based medicine and cautious decision-making when it comes to prescribing medications.
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**Hydroxychloroquine and COVID-19: Controversies and Concerns**
Hydroxychloroquine and COVID-19: Controversies and Concerns
The use of hydroxychloroquine (HCQ) as a treatment for COVID-19 has been a topic of controversy since the early days of the pandemic. Despite numerous studies showing its ineffectiveness against the virus, some proponents, including Professor Didier Raoult, have continued to advocate for its use. A recent French study, which estimated that HCQ may have caused up to 17,000 deaths in six countries, has sparked heated debate and criticism.
The Retracted Study
The study, led by Jean-Christophe Lega, a doctor and epidemiologist from the University of Lyon-I, was published in early 2024 and provided an estimate of the number of deaths attributed to HCQ treatment during the first wave of the pandemic. The study’s results were based on a British study that provided an excess mortality rate associated with HCQ use [1]. However, the study’s methodology was met with criticism, and the journal Biomedicine & Pharmacotherapy subsequently retracted the study on August 26.
Uncertainties and Criticisms
Lega and his colleagues acknowledged the uncertainties surrounding their results, including a wide confidence interval that meant the actual number of deaths could be anywhere between 3,000 and 30,000. The study’s limitations were also biased by the poor quality of many databases, which did not allow for calculations in countries that had widely prescribed HCQ, such as Brazil or India. Additionally, prescriptions outside of hospital settings were not taken into account, which may have led to an underestimation of the true number of deaths [2].
Effectiveness and Safety Concerns
It is essential to recall that no seriously conducted study has been able to prove the effectiveness of HCQ against COVID-19. In fact, the opposite has been demonstrated. The molecule, promoted by Didier Raoult in combination with the antibiotic azithromycin, may present cardiac toxicity, which led to the exclusion of certain at-risk patients from this prescription [3].
Critical Letters and Backlash
Lega received numerous critical emails and letters, some of which questioned the integrity of their results. The presidency of his university was also subjected to criticism. The methodology used in the study was attacked on social networks, and some proponents of HCQ use, including the statistician Vincent Pavan, formulated arguments against the study. Sites friendly to the “raoultosphere,” such as France-Soir and Bonsens.info, also disseminated criticism of the study.
Conclusion
The controversy surrounding HCQ use in COVID-19 treatment is far from over. While some advocates continue to push for its use, the lack of convincing evidence and safety concerns should give pause. It is essential to rely on rigorous scientific studies and to prioritize the well-being and safety of patients above all else.
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