Hydroxychloroquine in treating Covid-19

A malaria drug widely touted as a potential cure for COVID-19 showed no benefit against the disease over standard care -- and was in fact associated with more deaths, the biggest study of its kind showed Tuesday.

The US government funded analysis of how American military veterans fared on hydroxychloroquine was posted on a medical preprint site and has not yet been peer reviewed.

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The experiment had several important limitations, but adds to a growing body of doubt over the efficacy of the medicine that counts President Donald Trump and right wing news channel Fox News among its biggest backers.

Researchers looked at the medical records of 368 veterans hospitalized nationwide who either died or were discharged by April 11. Death rates for patients on hydroxychloroquine were 28 percent, compared to 22 percent when it was taken with the anti-biotic azithromycin -- a combination favored by French scientist Didier Raoult, whose study on the subject in March triggered a surge of global interest in the drug.

The death rate for those receiving only standard care was 11 percent.

Hydroxychloroquine, with or without azithromycin, was more likely to be prescribed to patients with more severe illness, but the authors found that increased mortality persisted even after they statistically adjusted for higher rates of use.

They have received significant attention during the novel coronavirus pandemic and have been shown in lab settings to block the virus from entering cells and prevent it replicating -- but in the pharmaceutical world, "in vitro" promise often fails to translate into "in vivo" success.

The true answer can only be determined through very large, randomized clinical trials that assign patients to receive either the drug under investigation or a placebo. Several of these are underway, including notably in the United States, Europe, Canada and the United Kingdom.