New Scientific Analysis of Hydroxychloroquine and Azithromycin for COVID-19 Patients

Hydroxychloroquine Tablets COVID-19

Analysis shows that hydroxychloroquine alone is not effective for the treatment of COVID-19 patients and that the combination of hydroxychloroquine and azithromycin increases the risk of mortality.

New analysis shows hydroxychloroquine does not lower mortality in COVID-19 patients, and is associated with increased mortality when combined with the antibiotic azithromycin.

A new meta-analysis of published studies into the drug hydroxychloroquine shows that it does not lower mortality in COVID-19 patients, and using it combined with the antibiotic azithromycin is associated with a 27% increased mortality. The study is published in Clinical Microbiology and Infection, the official journal of the European Society of Clinical Microbiology and Infectious Diseases (ESCMID).

“This meta-analysis shows that hydroxychloroquine alone is not effective for the treatment of COVID-19 patients and that the combination of hydroxychloroquine and azithromycin increases the risk of mortality,” say the authors who include Thibault Fiolet, Center for Research in Epidemiology and Population Health, INSERM, Institut Gustave Roussy and Paris-Sud 11 University/Paris-Saclay University, Paris, France. “These data support current clinical recommendations such as those of the US National Institutes of Health (NIH) which do not recommend the use of hydroxychloroquine alone or in combination with azithromycin for COVID-19 patients.”

Chloroquine is used to prevent and treat malaria, while hydroxychloroquine is a less toxic metabolite of chloroquine and is used to treat rheumatic diseases such as systemic lupus erythematosus (SLE), rheumatoid arthritis (RA), juvenile idiopathic arthritis (JIA) and Sjogren’s syndrome. Hydroxychloroquine in particular has received extensive media coverage since the outbreak of the SARS-CoV-2 pandemic as a potential treatment for COVID-19. Azithromycin is used to treat a wide range of bacterial infections, but has also been promoted as a potential treatment for COVID-19 due to its alleged antiviral or anti-inflammatory properties.

In this new analysis, the authors searched for studies that assessed chloroquine or hydroxychloroquine with or without the antibiotic azithromycin. The authors found 29 articles that met their criteria, all except one of which were conducted on hospitalized patients and evaluated the effects of hydroxychloroquine with or without azithromycin.

Among the 29 articles, 3 were randomized controlled trials, one was a non-randomized trial and 25 were observational studies, including 11 with a ‘critical’ risk of bias and 14 with a ‘serious or moderate’ risk of bias*. After excluding studies with a critical risk of bias, the meta-analysis included 11,932 patients in the hydroxychloroquine group, 8,081 in the hydroxychloroquine with azithromycin group and 12,930 in the control group (who received neither drug).

The results showed that hydroxychloroquine was not associated with mortality, either in all trials combined, or in separate analyses of randomized controlled trials or observational studies. The relative risk of death for use of hydroxychloroquine was 17% lower than controls for all studies combined, but 9% higher in randomized controlled trials. In both cases, these results were not statistically significant.

However, the combination of hydroxychloroquine and azithromycin in patients with COVID-19 was associated with a statistically significant 27% increase in mortality compared with controls. The authors say: “These results confirm the preliminary findings of several observational studies which have shown that the combination of hydroxychloroquine and azithromycin might increase the risk of acute, life-threatening cardiovascular events.”

The authors discuss limitations of their work which include the differing levels of COVID-19 disease severity across patients and also the actual definition of severity. Furthermore, most of the studies included were observational studies (not designed to find a causal relationship). Finally, this meta-analysis did not include results from the European DisCoVeRy trial and the WHO Solidarity trial that are not yet published or communicated (but both have already discontinued their hydroxychloroquine arms).

The authors conclude: “There is already a great number of studies that have evaluated hydroxychloroquine alone or in combination and it seems unlikely at this stage that any efficacy will ever emerge. Our results suggest that there is no need for further studies evaluating these molecules, and the European DisCoveRy and WHO international Solidarity clinical trials have already discontinued treatment arms using hydroxychloroquine.”

Reference: “Effect of hydroxychloroquine with or without azithromycin on the mortality of COVID-19 patients: a systematic review and meta-analysis” by Thibault Fiolet, Anthony Guihur, Mathieu Rebeaud, Matthieu Mulot, Nathan Peiffer-Smadja and Yahya Mahamat-Saleh, 26 August 2020, Clinical Microbiology and Infection.
DOI: 10.1016/j.cmi.2020.08.022

64 Comments on "New Scientific Analysis of Hydroxychloroquine and Azithromycin for COVID-19 Patients"

  1. This article is suspect of lying to the public.

  2. Just like the Roman Church accused Galileo of heresy for believing that our world is round.
    Wake up Robert and start believing in well researched science.

  3. Hydroxychloroquine can work with zinc in early treatment. Doing a meta analysis of severe cases which it was never claimed to help doesn’t answer the question of if it’s worth trying. Funny how no one wants to test if it works the way it was theorised.

    • Why aren’t the people who “theorized” the treatment doing double-blinded studies?

      By the way, I “theorize” that dried eye of newt, combined with powdered pumice and menstrual blood of a virgin, applied as a suppository, reduces mortality from Covid-19. Why aren’t you out there doing studies on my “theory”?

    • Bullshevik. You people and dictator leader have been claiming that “hydroxy” is the miracle cure since the early days. You have been moving goal posts ever since. First, it was hydroxy. Then you said it was hydroxy and arythromycin combo. Then It was these 2 drugs plus zinc. Then vitamin c. Now, your latest story is that it is this cocktail administered early.

      You and the fake news network (particularly Ingraham) have been talking about the Lazarus effect (bringing people back from near death) with hydroxy since the early days.

      Own up to your anti vax, flat earth, science illiterate belief system and be proud of it.

      • Jay Turberville | October 16, 2020 at 4:49 pm | Reply

        Sorry. The combination of three was what was advocated from the very early on. The hypothesis was that HCQ was a zinc ionophore and thus helped zinc make its way into the cells were it could be helpful. They weren’t talking about “eye of newt” or anything remotely similar. It just boggles my mind why the clinical trials don’t seem to have tested what was originally proffered as a likely treatment. Looking for such trials that include zinc is how I happened across this article and discussion

  4. Stevland Ambrose | August 30, 2020 at 1:58 pm | Reply

    Hydroxychloroquine is thought to work as a prophylaxis when combined with zinc. The only study that I’ve seen that uses HCQ sensibly — as a prophylaxis soon after a positive COVID-19 diagnosis — was the Henry Ford Health Systems study. Something tells me this meta-analysis did not include that study. And let’s not forget The Lancet’s HCQ retraction. Something smells rotten.

    • That rotten smell originates in your cranium and reaches the olfactory nerves via the effluence leaking through the cribriform plate.

    • Although you are clearly not science literate nor are you familiar with the scientific method, you should just know that science is a real thing. That device you are using to propagate your ignorance, that device was developed using science.

    • I’m sorry… so a news article stating that NIH is starting a study is supposed to be evidence that it works?

      Why don’t you start a study to see if people could fly if they jump off tall buildings, with you as the subject? That would immediately enable people to fly, right?

  5. This will be investigated for fraud just like the articles posted and retractred by Lancet and new england journal of medicine.
    Notice that since 1993 the NIH identified low pH fusion as the dominant method of coronavirus fusion into host cells…and thisbis why CQ and HCQ work..they raise the pH of the host cells…and the NIH found its important to give these meds early before pH fusion occurs. A window of about 10-14 days. Many people were given these drugs after being admitted in the hospital and only after that early time frame this is all known.

    • Covid-19 was not known in 1993, and the furine cleavage in the spike protein of Sars-CoV-2 binding to ACE receptors is how THIS coronavirus infects cells.

      Not sure where that “low pH” babble originated from. Probably from some other misinformation site you sheep go to. If you lower the pH level of a cell below 7.35, of course the patient won’t get Covid – he’d be dead.

    • Yeah, yeah. It’s fraud. It’s a hoax.

      You gotta admit – its a pretty good hoax. They got every country in the world to participate in the hoax. All of it was done just to embarrass Donald “saddam wanna be” Trump. They even got people to pretend that they lost friends and family to this hoax.

      Those liberals and their lamestream media are always trying to pull the wool over your eyes. Yet they let Hillary and her cabal of child traffickers operate at the basement of a pizza place without reporting on it. They don’t care about child trafficking.

  6. whole lotta Trump propaganda ministry trolls here!

  7. John D. Horton | August 30, 2020 at 3:33 pm | Reply

    Note their own words: Furthermore, most of the studies included were observational studies (not designed to find a causal relationship) Now we know that Italy and Belgium have just come out with two studies that both showed 30% reduction in deaths- 3500 and 8000 patients, the Italian study claimed: “Our data were subjected to extremely rigorous statistical analysis, taking into account all the variables and possible confounding factors that could come into play. The drug efficacy was evaluated in various subgroups of patients. The positive results of hydroxychloroquine treatment remained unchanged, especially in those patients showing a more evident inflammatory state at the moment of admission to hospital.” This doesnt include Raoults 3700 and 1000 patient studies that show less than 1% death in patients testing positive for covid(older patients included in study-early treatment) etc. If you havent read Norman Doidge’s recent “Hydroxychloroquine:A Morality Tale”, IMHO, You are missing one of the most delightful and brilliantly clear articles ever written.

    • Think to yourself – are these studies double-blinded? Was the n number high enough to account for the variability in the patient population – age, gender, co-morbidities?

      Once you have done the analysis, come back here to comment. Or, if you are too lazy to do the analysis, read a meta study like this that does the analysis.

      • Somehow I would trust the Italian researchers whose report was published in the European Journal of Internal Medicine, over a foul-mouthed internet troll with BS in his name.

  8. Douglas Fensand | August 30, 2020 at 3:38 pm | Reply

    Every time a new study suggests hydroxychloroquine is effective in treating the wuhan virus the nih trots out more fake information to scare people off.
    Thank you Dr Fauci!

    • Exactly! They blocked the most effective treatment/prophylaxis ever – eye of newt with powdered pumice and menstrual blood of a virgin administered rectally. Try it. Try it. What harm can it do?

      You morons belong in the dark ages.

  9. I have a pulmonologist with 90 Covid
    patients on the hydroxy 3 hit system, he
    told me last week all are doing fine and
    has not lost a Covid patient yet, this
    article is all political related bulls#!t

  10. Jason Morgan, MD | August 30, 2020 at 5:02 pm | Reply

    as a planet, can we PLEASE stop wasting good money after bad on this snake oil nonsense?!? We are discovering good, useful (not miraculous) therapeutic options. This is a distraction that belongs treating RA and those disorders for which it is approved.

    • Jacob Friedman | August 31, 2020 at 1:14 pm | Reply

      If you can find any cases that followed the protocol and failed, then you earn the right to call this “snake oil nonsense”.

      I searched for many hours.
      Countless of cases, worldwide, have followed the simple protocol, all resulting in remarkable success.

      Here’s a clue:
      This study omitted the Zinc. (Which is usually the case in failed results. Not-to-mention the protocol is mostly effective when administered at early stage.)

      For your convenience, here’s a quick review of the “Zelenko protocol”, aka “Hydroxy protocol”:
      200mg HCQ twice daily for 5 days. 220mg Zinc once daily for 5 days. To be taken within first few days of symptoms.

      I can’t help but wonder how many of your patients lost their lives due to your oversight…

      • Actually, there is more to the Zelenko Protocol. First, the temporal limitation is 5-days; that is, it must be administered within 5-days of symptom onset. Second, patients are risk stratified: > 60 years old, comorbidities, or any one experiencing shortness of breath (SOB). Finally, the dosing is as follows:

        220mg of Zinc sulfate PO QD for 5-days
        200mg of Hydroxychloroquine sulfate PO BID for 5-days
        500mg of Azithromycin PO QD for 5-days

        That stated, counter to the scientific method, no study has attempted to independently verify the hypothesis, the Zelenko Protocol, a protocol which touts a 99.3% success rate in high-risk patients and a 84% reduction in hospitalizations for the same.

        • Actually, my eye of newt/pumice/menstrual blood treatment works 110% of the time. It’s true because I say so.

          Because that’s how science works, right?

          Read up on what evidence based medicine is, and what level of evidence is required, and how it needs to be obtained, before criticizing bona-fide scientists, you uneducated morons. Anecdotal evidence doesn’t cut it. Just because someone names a “protocol” after themselves doesn’t cut it either.

      • “Here’s a clue”?

        They should rename Dunning-Kruger syndrome, and call it Jacob-Friedman syndrome in your honor.

  11. Kenneth arnold | August 30, 2020 at 5:33 pm | Reply

    I would not trust these French researchers for anything. They really have no clue if anything works. How many times have Europeans got anything right about the COVID-19 virus. They didn’t find out you can get the virus again after you have had it once before

    • You are absolutely correct. Those Europeans have no clue. America leads the world… in Covid deaths. MAGA! Those stupid Europeans are so far below that chart, it’s as if they aren’t even there. We beat their combined monthly case count in just a day. We got this!!

  12. Another load of BS. I feel like this particular News App is as Bias as this article. Every headline notification leans the same way. No need to read the articles. Time to delete this App! 👋

  13. Scott Slotterbeck | August 30, 2020 at 6:17 pm | Reply

    Only hydroxychloroquine is subject to idiotic Left-wing politics. It’s disgusting and anyone who brings politics into science is…anti-science. If you mention Trump, you are anti-science, and most assuredly have as much knowledge as to how science works as does my German Shepherd. In fact, she knows more than you do. BTW, zero mention of zinc.

    • We are honored to have the distinguished scientist Dr Scott Slotterbeck among us, ladies and gentlemen. He’s going to tell us why evidence based medicine is wrong, and how the medieval alchemists at market corners had it right… as soon as he finishes babbling about his dog, that is.

  14. The Zolenko treatment with Hyroxy, zinc and Zpack is only claimed to be effective in the first 5 days. These bogus studies usually leave out the zinc.

    • If you must spew misinformation, at least get the name of your witch doctor right.

      • You are a crude and repugnant human. The studies did not use zinc and they did not treat early. Actually the dose of HcQ given in some of the studies would kill a horse. Your abusive language is contrite and makes you come across as an angry uninformed person. Dr. Zelenko’s protocol has been used successfully all over the world. Keep your politics out of science.

  15. Maybe we should just listen to Trump supporters. Since every comment is just hammering the otherside. We’ll see who’s first in line for the vaccine. And whose kids are first to want to stay home too scared to go to school. You can disagree and still support the others for their decisions.

    • Jacob Friedman | August 31, 2020 at 1:31 pm | Reply

      And if you or your loved ones get the virus (especially with underlying health problems) I imagine you’ll run as fast as can and take the Hydroxy with Zinc.

      If not, well, i hope your Life-insurance premiums are paid up.

  16. And yet, the Executive Branch of the U.S. Government has been using HCQ+Azithromicyn+zinc effectively. That includes the President of the United States of America.

    • Luke, the president was taking HCQ+Zn, not azithromycin. According to the Zelenko Protocol, azithromycin is only necessary if one has actually contracted the COVID-19 disease, not for prophylaxis. Its purpose is to prevent a secondary bacterial infection of the lungs, an infection that might be caused by damaged done by the virus.

  17. Better a million die needlessly than Trump be correct. That is a lot of hate!

    • Stevland Ambrose | August 31, 2020 at 12:01 pm | Reply


      In my estimation this is the environment which has enabled Big Pharma to suppress a drug that is not profitable. It is obvious to half of the world if they care to look. But the other half steadfastly refuse to see it.

  18. Stop the lies. Do research on hydroxychloroquine and Zinc now!

  19. A lot of research HAS been done that shows hydroxychloroquine is very hard on the heart, and can do much damage, and this negates the limiting it provides of the cytokine storm that creates the lethal lung inflammation that is the biggest killer in COVID-19. I do not believe that Trump ever took the stuff! After so many of his lies, I wouldn’t believe it till I saw it, in person, after analyzing that it wasn’t just a sugar pill that he was taking!

    • If you analyze the research closer, you’ll notice that the danger to the heart is only with high doses of more than 800mg per day.

      Whereas the protocol for this virus calls for 400mg per day, for only 5 days.
      At that level the reports show less side effects than Tylenol.

  20. What utter BS. These people set up the non-test to fit what they wanted the outcome to be. They probably have never come close to an actual COVID-19 patient in their lives. They are academics not doctors.
    If I get COVID-19 I want a front line doctor. Some of the best in the world have been brave enough to try Hydroxy on patients like me who are over sixty with other issues.
    Besides that, Dr. Fauci and the FDA are known to have done this very same thing in the nineties. They refused to approve a drug that was being used to combat HIV and that was showing good results. They did not test it but kept it off the approved list until others did an FDA approved test on it.
    By the time the doctors had raised the money and ran the test, the big pharmaceuticals had come up with a very expensive drug the FDA and Fauci approved. The cheap drug was ignored even though the test showed positive results. This is all about money. I would not be surprised if these doctors are on George Soros payroll.

    • Jacob Friedman | August 31, 2020 at 1:42 pm | Reply

      Some choose Soros as the villain.
      Some choose Bill Gates.
      Some choose the Illuminati.
      And some prefer the Freemasons.
      Perhaps Jeff Bezos?

      Or… perhaps just many many private individuals making bad choices?

  21. This is not a real study. It should not be published. It has no controls and us observational. A book report that can be written anyway you want

  22. John D. Horton | August 31, 2020 at 5:51 am | Reply

    Is hydroxy dangerous?
    We are talking about peoples lives being lost or saved by the use of hydroxychloroquine. I just want to save lives. I could give you several articles showing hydroxy has almost no harmful side effects for most people in short term use. Dr Risch showed that even hydroxy + azith increases chance of death by less than 1/10000. Doidge actually speaks of it helping the heart with covid because it is an anticoagulant. I challenge you to look at the hydroxy safety profile before 2020 and it “was” one of the safest drugs on the market-even being sold over the counter in some countries. This may be a big game to you, but if thousands of people are needlessly dying because of disinformation I can assure you that is not a joke to them or the people who love them. I have been following this ever since in late March/early April I saw the treatment by Raoult that showed essentially 100% viral clearance in 5 days.
    Fauci attacked the Henry Ford study because the results were possibly influenced by steroids. When Henry Ford separated out those variables to address his concern and the results still showed hydroxy effective-he was silent. Still no comment on 50% death reduction(and this wasnt even using in its optimum manner-outpatient!) . It seemed as if 50% death reduction simply didnt catch his eye. I am grateful for doctors but my whole view of the medical establishment has changed.

    • In a study published by Dr. Didier Raoult on 6/25, he noted that out of 3,737 patients that 25 (or 0.67%) experinced a QTc interval increase > 60 ms., putting these patients in danger of torsades de pointes (TdP). I believe this study was panned to obscure this important safety information. My solution is acquire a KardiaMobile 6L and magnesium supplement to counteract the effects of HCQ+AZ if one gets into trouble. Unfortunately, magnesium will also counteract the effects of inter-cellular zinc, zinc inhibiting virus replication.

  23. The battle over Hydroxychloroquine reminds me of the battle of the currents: direct current versus alternating current, the former advocated by Thomas Edison, the latter advocated by George Westinghouse and Nikola Tesla. Thomas Edison, realizing he was on the losing side, conducted all manner of bizarre experiments to prove to the uninformed public that alternating current was too dangerous. He and his conspirators executed animals, pets, a human being, and even an elephant to make their point. It was quite a misinformation campaign. So what is the problem?

    Because the generic drug, hydroxychloroquine, acting as a zinc ionophore can increase the inter-cellular concentration of zinc, inhibiting RNA-dependent RNA polymerase (RdRp), it has the ability to not only halt the replication of SARS-CoV-2 but all other RNA viruses: group IV and V. It also sensitizes cells to chemotherapy, making it anti-cancer as well. The wide use of such a therapy would be manifested in enormous losses for the pharmaceutical industry, an industry the supplies two-thirds of the FDA budget, an industry were bureaucrats from the FDA, CDC, NIH are later employed by, an industry that provides big ad dollars to Facebook, Twitter, Google, and the media. Basically, the decision makers have been brought-off to sabotage hydroxychloroquine at all cost, even the lives of 184,000 Americans.

    Bottom line: Do not expect these corrupt researches–paid off by Gilead Sciences and others–to verify the successful hypothesis, the Zelenko Protocol, as the scientific method demands.

  24. Christopher White | August 31, 2020 at 6:09 am | Reply

    This paper compares studies carried out under different conditions. Depending on the conditions, some of these studies show that HCQ worked and some show that it didn’t. What we need to konw is under what conditions does HQC work. What do not need is some kind of average of all the studies done as these cannot be meaningfully compared which is why this paper is unscientific and useless from any thetapeutic perspective.

  25. Just watch the initial tape when Trump claims to be taking hydro. It is so obvious that he is lying. Also when he says that he he’s finished the two week course of the drug and quickly looks at everyone to see if he has gotten away with the pernicious lie. It is just so obvious, like a little kid.

    • Jacob Friedman | August 31, 2020 at 1:25 pm | Reply

      Regardless of what the President says or does (or what you think of him) the “Hydroxy protocol” is extremely effective when done properly.

      Check it out. The info is all over online.

      Personally i consider the HCQ + Zinc like i consider “Tamiflu”. Namely, if i get sick (Heaven forbid) THEN i’d take it asap, stay home 2 – 3 days, and then back to normal.

  26. Yes..if given late in the illness.

  27. Please be patient with me. I can see this is a hot potato. But can one of you scientists check this video out please. This is a very ordinary nurse guy with no political axe to grind who does seem to confirm what these unpopular people here are saying – namely that the recent Belgium study does seem to suggest that low doses of HCQ do significantly reduce mortality. He also notes that previous studies were based on doses which were much too high, and not surprisingly showed some alarming side effects. Can someone help me out here and tell me what the think of this? No nastiness please. I’m trying to understand.

  28. Its truly disheartening to hear the tone of “StopTheBS.” There are over 100 studies on HCQ and COV19… the science is not settled at all. Thousands of MD physicians prescribe HCQ for COV19 the world over. According to “StopTheBS” they are witch doctors prescribing virgin blood enemas. How is this arrogant condescending tone helpful? Are you so sure of yourself that you’d bet someone’s life on your opinions? I’ll tell you that good clinicians do not talk like this about their colleagues. Good doctors know how complicated it is treating human illness and are open to different approaches and new data. Whoever you are, your witty insults of those who may disagree with you do nothing to advance science, and are quite dangerous when they limit discourse and lead to the current state of censorship of medical professionals daring to question government agencies and pharmaceutical companies.

  29. StopTheBS, stop the BS.

  30. You doctors are responsible for over 220,000 DEAD.
    You KNOW HCQ given as a preventive, 200mg once every 14 days, works.
    You KNOW HCQ/Az/Zinc given *EARLY* (early is defined as upon a positive test regardless of symptoms)and following the 5 day protocol, works. It cures.
    You KNOW waiting until a patient is so sick they need to be hospitalized creates 35K-75K+ of income for you and your hospital. Whereas the out patient cure of the triple drug given early is a staggering $80 cost. No money there, right?
    Its also CRUCIAL to keep the world in a complete locked down mask and glove wearing panic politically. You’re doctors, you’re not politicians. Please stop killing people for political reasons. When the truth comes out, and it ALWAYS does, those of you who failed to treat your now dead patients properly will be sued for negligence/ manslaughter. And rightfully so. Ask yourself, will the CDC/WHO pay your premiums after you’ve settled dozens, hundreds or suits? Wake up…

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