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Concerns About the Special Article on Hydroxychloroquine and Azithromycin in High-Risk Outpatients With COVID-19

Matthew P Fox, Lucy D'Agostino McGowan, Bryan D James

    American Journal of Epidemiology
    |August 30, 2020
    PubMed

    Insights

    Hydroxychloroquine (HCQ) plus azithromycin (AZ) is not an effective treatment for coronavirus disease 2019 (COVID-19). Current evidence shows no benefits and highlights significant risks associated with this therapy.

    Area of Science:

    • Infectious Diseases
    • Pharmacology
    • Public Health

    Background:

    • An opinion piece advocated for widespread use of hydroxychloroquine (HCQ) plus azithromycin (AZ) for early COVID-19 treatment in high-risk patients.
    • The proposed treatment strategy was based on a review of selected scientific papers.

    Purpose of the Study:

    • To critically evaluate the evidence supporting the use of HCQ + AZ for COVID-19.
    • To review the literature cited in the original opinion piece and subsequent research.
    • To address the scientific and ethical concerns regarding the promotion of unproven COVID-19 therapies.

    Main Methods:

    • Documenting errors in the original manuscript advocating for HCQ + AZ.
    • Reviewing the scientific literature presented in the opinion piece.
    • Analyzing studies published after the initial recommendation.
    • Assessing the quality of evidence for HCQ + AZ efficacy and safety.

    Main Results:

    • The literature presented in the opinion piece was of insufficient quality to support broad application of HCQ + AZ.
    • Subsequent scientific literature generated since the publication does not support the use of HCQ + AZ for COVID-19.
    • The combination therapy shows no proven efficacy and presents potential risks.

    Conclusions:

    • Current scientific evidence does not support hydroxychloroquine plus azithromycin as an effective treatment for COVID-19.
    • Continuing to promote HCQ + AZ for COVID-19 is irresponsible and potentially harmful.
    • Open scientific debate must be grounded in rigorous examination of evidence and evolving data.

    Keywords:
    azithromycinbiasconfoundinghydroxychloroquineobservational studiesrandomized trials

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