Treatment with hydroxychloroquine, azithromycin, and combination in patients hospitalized with COVID-19

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Conflicts of Interest

Identified Weaknesses

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Paper Summary

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Hydroxychloroquine and Azithromycin Linked to Lower COVID-19 Mortality in Hospitalized Patients (Retrospective Study)

This retrospective study found that treatment with hydroxychloroquine alone or in combination with azithromycin was associated with reduced mortality in hospitalized COVID-19 patients. Independent predictors of mortality included age, chronic kidney disease, and disease severity upon admission.

Possible Conflicts of Interest

One author disclosed receiving speaker's bureau honoraria from Bayer. Another author disclosed receiving similar honoraria from Gilead, ViiV, and Janssen. One author received consultation honoraria from ContraFect. All other authors declared no conflicts of interest.

Identified Weaknesses

Retrospective Design

Retrospective studies are susceptible to biases and cannot establish causality. The observed association between hydroxychloroquine treatment and reduced mortality could be due to other factors not fully accounted for in the analysis.

Lack of Randomization

The non-randomized design may have led to selection bias, where sicker patients may not have received hydroxychloroquine. This could confound the relationship between treatment and mortality.

Observational Study

Observational study can show some associations but causality is not certain. More research is needed to confirm potential causality.

Rating Explanation

Despite the large sample size, the retrospective and non-randomized design significantly limits the strength of the findings. The study's findings should be interpreted cautiously and validated by prospective randomized controlled trials before drawing firm conclusions.

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