Hydroxychloroquine provides beneficial effect in preventing Covid-19, according to a large randomized study.

© GEORGE FREY/AFP/Archives Hydroxychloroquine provides a beneficial effect in preventing Covid-19, according to a large randomized study.

Collective intelligence and social networks play an important role in the assessment and evaluation of scientific studies. This made it possible to debunk the study on hydroxychloroquine published on May 22, 2020 in the renowned journal The Lancet. Or that of the fraudulent study Pradelle et al. published on January 2, 2024 and retracted eight months later by the editor-in-chief of the journal. The mainstream media are quick to select and promote scientific articles aimed at discrediting early treatments, such as that of Pradelle-Lega which falsely concluded that “17,000 people could have died from taking hydroxychloroquine. » From a hypothetical calculation based on a model and fabricated data, in the study, it had almost become a statement in the media, thus contributing to the general misinformation of the public. For the most part, the media did not mention the retraction.  Not only does the lie take the elevator, but when data contradicts the lies of the media, the latter fail in their mission to correct the information.

However, the truth about early treatments and their effectiveness is becoming more and more present. A very important fact has just been published in a scientific journal. Because it is too disturbing, the media will not write the truth described in this article. As soon as it was published, the association BonSens.org published an article about it ”  Efficacy and safety of hydroxychloroquine in prophylaxis against symptomatic covid19: new randomized double-blind study ». BonSens.org added: “In the current context where some still dispute the effectiveness of hydroxychloroquine, it seems important to us to inform you of the publication of this new double-blind randomized clinical trial which confirms, via a meta-analysis including this trial and similar randomized clinical trials, the efficacy and safety of this molecule in chemoprophylaxis [prevention] in the context of covid19.”

In a series of tweets, Nicolas Védrines described the main points of this study which form the basis of this article.

Seven points should be cited concerning the publication of COPCOV, A large, double-blind, randomized controlled trial (RCT) of hydroxychloroquine and chloroquine as a preventative measureincluding 4,652 participants at risk of infection (caregivers, etc.) between April 2020 and March 2022. The final interpretation is that there is now “evidence of a moderate protective benefit“.  

The first point is the significant decrease in symptomatic covid-19 cases measured by PCR, with a very significant benefit, RR (Ratio de cote in French, Risk Ratio in English) of 0.43 [0.27 to 0.69; p = < 0.001]. This benefit of treatment is confirmed by a meta-analysis of the authors on this subject, with a RR of 0.58 [0.43 to 0.79; p = < 0.001]. Let us recall that the measurement of symptomatic PCRs allowed the validation of covid-19 vaccines. This positive result should therefore lead to changes in recommendations.

The second point is that the hydroxychloroquine-chloroquine treatment is devoid of effectiveness on infections. Serology does not show any difference between the groups. The treatment reduces the symptoms. The authors explain: “The absence of a significant protective effect against asymptomatic infection may indicate that the protective benefit is proportional to the viral load, and therefore to the severity of the disease“. This reasoning supports a therapeutic interest post infection, with early use.

The third point to remember concerns the primary assessment, i.e. a covid-like symptom associated with a laboratory positivity (via PCR or serology, etc.). This measure is quasi significant with a p-value of 0.05. A p-value is significant if it is less than 0.05… This is a scientific rule that is open to criticism. This publication is unfairly criticized on this point… because a meta-analysis by the authors on randomized trials confirms the efficacy on this primary criterion, with a RR of 0.80 [95% CI, 0.71 to 0.91; p = < 0.001]).

This overall protective efficacy against symptomatic covid-19 is further confirmed in meta-analysis, including only the best randomized trials, those with low risks of bias (see Figure A5).

Rapid and adverse reactions on social networks

False information appears on social networks through accounts held by individuals whose interests are unclear (dishonest, paid ?) who intervene very quickly. This seems all the more normal, because many influential people fear the anger linked to the health scandal. When this publication is shared on the social network X, critical notes from the community appear to discredit the study with these words ” limited cohort “, or ” reduced workforce “. The study included 4,652 participants, making it the largest study on this subject. The authors point out that it is a ” vast ” study. They also write that ” The trial ended below its recruitment target, but, due to the higher than expected incidence, it was able to provide evidence for protective efficacy “.

In addition, the authors describe the difficulties in recruiting for the trial and link them to controversies and misinformation, including that about the toxicity of hydroxychloroquine. Here is what they write: “However, there were prolonged delays and enrollment difficulties as the study began in 2020. These were related to adverse publicity and withdrawal of approvals resulting from false claims of frequent serious cardiotoxicity.”  Furthermore, there have been misinterpretations and shortcuts: late-phase inefficacy with overdose is not generalizable (e.g., the British ReCoveRy trial gave toxic doses of hydroxychloroquine to hospitalized patients who were therefore in poor health). The authors point out that ” The negative results of large RCTs have been extrapolated to indicate a lack of efficacy for HCQ at all stages of infection “. The critics of this study would thus be, at the same time, responsible for the recruitment difficulties. It is therefore insulting that they dare to complain about it!

Furthermore, such a study would have stopped the inclusion of patients at this stage, because the results show efficacy. It is, in fact, not ethical to give a placebo when there is evidence of efficacy.

Criticism also concerns the main measurement of the trial, which was modified during the trial without considering its interest. To the main measurement of a covid symptom with PCR confirmation if possible… or serology, taken on Day 0, Day 30, Day 60 and Day 90, the measurement of serology was added, which was not initially planned. The authors write: “The main result was then modified to include seroconversion“. This brings additional interest to the measurement of PCRs described in point 1 and whose results are very favorable to the treatment. This addition to the protocol makes it possible to have more events. The measurement of covid symptoms confirmed by PCRs was the initial choice, which is of course the most interesting. The authors note, however, that this main measurement with serology is certainly less reliable than the measurement of PCRs: “an imprecision of the serodiagnosis which dilutes the power of the study ». For example, within 90 days of the study, a non-covid symptom coupled with an asymptomatic covid infection will result in a symptomatic covid case, whereas it was asymptomatic covid.

A significant reduction in work stoppages

After the efficacy observed against covid symptoms confirmed by PCR, the ineffectiveness against infection and the efficacy on covid symptoms confirmed by PCR or serology, the fourth point concerns a reduction in work stoppages. This is a simple, factual element. According to the study, ” the number of days lost over 90 days was 337 per 1,000 participants in the treatment group, and 441 per 1,000 in the placebo group… a difference of 104 days ». Finally, if such a protocol had been applied to our caregivers, how many work stoppages would have been avoided ?  What would have been the associated financial savings ? When we consider the fact that hospitals suffered from a lack of staff and that work stoppages could have been avoided, then more patients could have been treated. We can only wonder about the loss of opportunity for patients, and this study shows that the ban on prescribing hydroxychloroquine has cost human lives.

The toxicity of HCQ is non-existent

For the fifth point, in the face of false information on the toxicity of hydroxychloroquine, did three months of daily use of hydroxychloroquine or Chloroquine kill people? No. Were there serious side effects? No… According to the authors, “Hydoxychloroquine and chloroquine were safe and well tolerated in the chemoprevention of COVID-19.” The figures… “Overall, 9.4% of HCQ/CQ recipients had at least 1 adverse event compared to 10.4% of placebo recipients. Fewer HCQ/CQ recipients had severe adverse events (1.3%) than placebo recipients (2.5%; p = 0.005) ».

An abnormally long publication delay

The sixth point is related to the abnormal study and publication delay. The controversy on the subject had a negative impact on recruitment and publication… This randomized trial is so positive for hydroxychloroquine that the delays are intriguing and raise the question of problems of censorship. We are therefore talking about a health scandal.

The seventh point concerns the conclusion of the authors who are not unknown. One of the main researchers of this study is Nicholas White, British Professor of Tropical Diseases. If sometimes the conditional is used to facilitate a publication, it is written without the conditional: ” evidence of protection against symptomatic covid and a reduction in lost working days“, “our meta-analysis confirms… a beneficial effect“, “HCQ could have been deployed with benefit earlier “… The health scandal is becoming clearer.

In conclusion, we should not oppose vaccine and treatment and hydroxychloroquine can help. It should benefit from a recommendation from the authorities. An application file is to be done. The ANSM (National Agency for the Safety of Medicines and Health Products) does not seem inclined to do it. Only associations like BonSens.org will do this work (of anti-conspiracy and common sense). However, science is in a bad way. Royalty-free molecules are incredibly and falsely denigrated (via false studies), because they present a real danger for the business model of pharmaceutical laboratories. One question remains: do the regulatory authorities still prioritize positive health measures that are devoid of economic or political interest??

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