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Study of president's nostrum at Beth Israel confirms potentially fatal heart risk
By adamg on Mon, 05/04/2020 - 10:55am
Doctors at Beth Israel Deaconess Medical Center reported Friday that a review of the cases of 90 Covid-90 patients given hydroxychloroquine showed they were more likely to develop a heart condition that could become fatal - and that the effect was more pronounced when they were also given the president's other preferred drug, an antibiotic called azithromycin.
In their report in JAMA Cardiology, the doctors reported that one out of five of the patients given hydroxychloroquine developed a heart-rhythm issue called QT prolongation, which can lead to a fast, irregular heartbeat and potentially death.
One patient, who was receiving both that drug and the antibiotic, did develop a more serious version of the problem, known as torsades de pointes. The doctors noted that, in addition to the patients they studied, Beth Israel stopped enrolling patients with severe Covid-19 pneumonia in a clinical trial involving high doses of chloroquine and azithromycin "because of preliminary safety concerns about excessive cardiotoxicity."
The JAMA Cardiology study of patient records was of Beth Israel Covid-19 patients who received at least one day's dosage of the drug between March 1 and April 7. A little more than half of the patients were also givenzithromycin. At the time they were given the drug or drugs, 30 of the patients were considered critically ill; 23 were on ventilators. About half the patients had high blood pressure, roughly 29% had diabetes. The median age of the patients was 60.
Ten patients had hydroxychloroquine discontinued early because of potential adverse drug events, including intractable nausea, hypoglycemia, and 1 case of torsades de pointes.
The doctors conclude that doctors need to be really, really careful before considering using hydroxychloroquine, given how many people with serious Covid-19 problems have underlying "comorbidities," the fact that other required drugs, such as certain diuretics, can also affect heart rhythms and with growing evidence that the virus itself can damage heart tissue.
They pointed to the one patient, on both drugs, who had to be given lidocaine to restore his or her hearth rhythms after developing torsades de pointes - the patient also had acute respiratory distress syndrome, bradycardia, hypothermia and cardiomyopathy, and was under heavy sedation.
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Comments
This is why we have clinical trials
That wheel has been invented and perfected and augmented with on-the-fly Bayesian analysis.
Dumbasses who think they just "know" or that their "beliefs" and ill-informed opinions are more valid than actual research need to STFU before more people die.
“What do you have to lose?”
.
Interesting!
I love these historical items.
dumb
asses won't stfu because they run the quarterly profit system, so they are busy a) lying, b) trying to profit off consumer behavior, c) having conniptions about consumer behavior, d) trying to profit off of their own conniptions, or
and this one is my favorite, e) slavishly regurgitating insane 4chan-anon arguments that support the above status quo even if and especially when it does not work in their favor financially, since they are just a screwball from the burbs who picked team elephant before puberty.
fuck every thing.
A note on reading that JAMA article
Some Web designers have way too much time on their hands. You can't use the scroll bar to go up and down that article like on a normal Web page. Instead, you need to first click on the article text and then use your down arrow key (or up if you want to, well, go up).
Oh there's a scrollbar on the
Oh there's a scrollbar on the LEFT side of the window for the article itself. Very confusing and non-standard!
Hate for Trump every time hydroxychloroquine mentioned?
It was nice to see the NY papers covering the life-saving effects of hydroxychloroquine on one of Boston's finest. I know Captain Greland's amazing recovery was covered locally but the lifesaving role of hydroxychloroquine seemed to be downplayed in the local stories for fear that it might reflect positively on President Trump. This is dangerous pettiness by the media, putting hatred above lifesaving information.
Once again, UHub belittles the president's encouraging words for hydroxychloroquine, this time based on a Beth Israel study that included very critically ill patients, beyond hope. President Trump has always been clear that this drug is not for everyone and is best when prescrbed early, by a physician. It was well within the President's guidance for B.I. to stop hydroxycholoriquine on patients not suitable for it. Still, it would be nice to hear both sides of the issue including the lives saved like Captain Greland. Aside from bashing President Trump on this lifesaving therapy, do the critics wish to bash the doctors who saved Captain Greland and thousands of others using hydroxychloroquine?
If it helps 1 person but hurts
If it helps 1 person but hurts 100, should we still use it?
It's an easy formula
Anyone who takes it and lived = true believer who had faith in the President and did what's right
Anyone who takes it and dies = heretic who was probably secretly part of the Deep State and would have died anyway so no harm done.
Ultimately - if its good news for Trump, then its true and good and holy - if its bad, then its clearly lies and slander by the liberal media. Just like any other cult.
Sounds like the test for witchcraft
Throw the person into the water (while alive):
If they float they are a witch and must be put to death.
If they sink they are not a witch (which means they drowned, but at least they're not a witch!)
How do the doctors know
How do the doctors know that HCQ was responsible for his recovery and that he wouldn't have recovered without it?
Drugs need to be tested to determine safety AND efficacy. Do you know of any randomized controlled trials that have shown HCQ to be effective against covid-19?
What a responsible President would say
Since you're confused, this is what a responsible president would say:
"I'm neither a doctor nor expert in the field of Medicine or infectious diseases. It would be wrong for me to recommend any specific treatment beyond what is recommended by the CDC and FDA. That said, as President I care deeply about the health and welfare of all Americans. I will use my power to ensure Doctors and Scientists have absolutely everything they need to develop treatments to save as many lives as possible. I will also do everything I can to ensure front line workers stay safe themselves. As a nation, we can get through this if everyone works together and respects the knowledge and advice of our superior medical community."
See? That's all he had to say and most people would be happy and respectful. But sadly, he's neither stable nor a genius.
Tide Pods
Shouldn't you be eating one? What have you got to lose?
Always been clear?
Can you point me to any quote from him that clearly states that? Because what I've seen has been a lot of quotes like "what do you have to lose?", "we don't have time to test this" and "It’s nothing lost by doing nothing.", which does not sound like he's looking for people to take the advice of their doctor and only take this when prescribed early by their doctor.
huh?
Is the media in this context referring to the JAMA article or UHub? Do you even know? Or was that just reflexive troll bot prose?
Time for your plug to be pulled
That's like saying that he has "always been clear" about the winning Megabucks number on June 1, 2020. He was talking out his ass and had no fucking idea. He's clear just like you're clear: speaking with great conviction and knowing absolutely nothing. Doesn't it bother you even a little bit to be a liar?
How many of you have taken ......
This is just more of the same.....
Now that President Trump has touted the successes with The Gilead Drug Remdesivir -- Just wait till the bad stories start to bubble to the surface about it
If anyone can name any drug whether prescription potent and life-saving, or just an Over the Counter Knock-off used to aleviate some annoying symptoms, which is without some nasty side effects, in at least some cohort of the population -- Well I think that such a drug must be manufactured from Unobtainium Sulfate by the Keebler Elves
If it weren't for side-effect the Trial Lawyers would have to invent a new profession.
Once again -- HydroxyChloraQuine*1 is being used on a regular, quite large scale basis to treat rheumatoid arthritis, and Lupus, a chronic condition which is far less lethal than COVID-19. HCQ is also regularly prescribed by the hundreds of millions of tablets as a prophylactic to prevent Malaria in Sub Saharan Africa and other Tropical areas.
By the way -- Yesterday evening in about 2 hours of TV-time, I saw at least a half dozen ads which were recruiting people who had been taking Zantax and because of some bad reactions just might make some money for some Trial Lawyers
*1
WebMd on Hydroxychloraquine
https://www.webmd.com/drugs/2/drug-5482/hydroxychloroquine-oral/details
.
Lotta sound and fury there
You're leaving out the part about how drugs that are helpful for people with one set of symptoms can be harmful for others.
I mean, aspirin's great! But for somebody with an ulcer or other GI problems? Maybe not so good. Same with Tylenol and somebody with liver disease.
Trump's magic bullet, yes, is good for people with certain conditions. Lupus is probably a better example in the US, we don't tend to get much malaria these days.
But it's long been noted to have a risk of causing a particular change in how the heart's electrical system works. Maybe not a big deal with otherwise healthy people. But many Covid-19 patients are often not otherwise healthy. Many have heart problems. And some of the drugs they get for other issues, such as certain diuretics (used to try to reduce pneumonia) can cause the same heart effects. So combining all that may be a deadly combination.
Which you would know had you actually read the JAMA article.
So Herr Orange heard something, blew it completely out of proportion and put people's lives at risk. Sorry, he helped kill veterans. Remember veterans? The people who defended your rights and stuff?
Just once, I'd like to see
Just once, I'd like to see somebody like you say "I was really excited about this, but it looks like I was wrong and it isn't going to turn out how I'd hoped."
Honesty and responsibility are acquired tastes, but minimizing, deflecting, denying, obfuscating, etc. are shameful activities for someone who fancies themselves a fully-grown adult. If you want to stand for something in opposition to the predominant political currents of this region, that's fine. You may find it even more rewarding to stay standing even after you turn out to be wrong. Own it, accept it, and move on. Don't hide.
What an odd construction
This is the oddest capitalization. Makes one wonder who or what composed this screed. Worth a text analysis?
"Nowy Liberté" my ass.
There's also a notable lack
There's also a notable lack of actual science behind the enthusiasm for Remdesivir. What there is, is a press release that someone got in front of Trump and Fauci.
There is one reasonably good double-blind trial, which suggests that Remdesivir doesn't work. But Gilead got attention, and will be getting lots of money for something that might work but isn't the slam-dunk people are treating it as.
My source on this is a medical blog, by an academic researcher and breast surgeon. He goes on at some length, but the summary is that maybe it works, and maybe there's dubious stock market manipulation, and it's going to be hard to do proper studies on either Remdesivir or hydroxycholorquine for Covid-19.
It’s truly fascinating
How political cures have become. My mom, a very liberal Democrat, forwarded me an article on HCQ being unjustly attacked. It also included the problems with Remdesivir.
Stay out of the politics and stay safe.
Unjustly attacked?
How so?
And complaining about that drug doesn't automatically make you a supporter of remdesivir ...
I don’t have the link
Because it’s in email form. But basically negative studies were poorly done. Also mild heart changes are known side effects of HCQ so that’s what contraindications are for. Also, we’re talking about a two week period of increased risk vs dying of Covid19
Here's a hypothesis: you're
Here's a hypothesis: you're the one making this political. JAMA, as non-partisan a source as there is, simply reported poor results for a potential treatment. Since you've already decided, for mostly political reasons since you'd likely never heard of this drug until the president started talking about, that you support this treatment, any news that isn't positive must be partisan and can therefore be ignored... or better yet, added to the ever-growing pile of evidence that every corner of reality is conspiring against your politics.
We can test this pretty easily. Simply stop assuming that everything is political, and then observe whether or not your perceptions of how political everything is goes down.
You're incorrect about the takeaway
The study published in JAMA doesn't report poor results for hydroxychloroquine and azithromycin; it instead highlights an important risk of associated cardiac effects. To determine whether this is a poor result for this drug therapy there would need to be a comparison of mortality with a comparable course of treatment without those drugs. In this particular study, just under half recovered enough to be discharged while 4 of 90 died. The remainder remained hospitalized at the end of the study. How this compares to typical outcomes at Beth Israel I do not know -- but this was a patient cohort which apparently had no shortage of comorbidities and the average BMI was in the obese range.
So the lesson from this study is to be alert for lengthened QT intervals and apply appropriate remediation and/or discontinue this therapy if this is observed -- not that HCQ+Z-pack fails as a therapy. Chemo drugs often carry severe side effects but they're still used when the overall outcomes with those drugs are better than without them.
You're right about all of
You're right about all of this. I should've said "results you're not happy to hear about" instead of "poor results".
Well your hypothesis is flawed
I heard about HCQ through an article on Twitter and did a literature search. This was done before the President started touting it.
I’m not voting for the President, but based on what I read I believe HCQ works. It is believed to do 3 things, block the ACE2 enzyme, responsible for transporting the Coronavirus particle across the bilipid membrane, inhibit Replicase to slow the virus from copying itself and raise the cell pH to inhibit the production of endosomes to prevent the copies from leaving.
I could be wrong about interpreting th works of the scientists, but it’s not political. And lastly, HCQ is a zinc ionophore, that’s how replicase is believed to to inhibited and the change in pH. A natural alternative to HCQ is Quercetin, which is also a zinc ionophore, and has no known side effects. So if someone is zinc deficient HCQ will not help them.
Sorry, no
You want to peddle that, you need to come with citations.
So I learned
a new word today. Thanks Adam!
After the "Action" it will be time to analyze the battle
When this is over there will be plenty of time to actually analyze what worked and how well, etc. In the meantime until things settle down -- let's let the medical profession do what they can for people in more or less perilous circumstances. Despite what the bureaucratic-types are spewing -- this really is not the time for Double-blind Gold-standard drug testing.
As for the cardiologists who are weighing-in about a handful of heart arrhythmia -- to a significant extent they can do so because the "elected-non-emergency" procedures which have been banned or severely restricted involve a lot of them.
Meanwhile, the people actually treating the COVID-19 patients both in and out of hospitals -- are facing real-time potentially life and death decisions. Some fraction of their patients are desperately ill and are in-need of the best possible clinical judgement -- read-that as educated guesses. Some of those interventions will work, some wont. Some people seemingly ready to cross the Styx -- won't have the coin for Charon and will turn back to the land of the living -- in inexplicably.
Remdecivir, HydroChloroquine and possibly other things sitting in the Medicine Cabinet such as Actrema [another drug used for arthritis] may help some to recover. Many of the people in really bad shape will not recover no matter what therapy to which they are subjected -- including being installed on a ventilator. Most of these will be both old and suffering from several "co-morbidity factors."
Later someone can "Deep-Machine-Learn" all of the information from these battlefield interventions and find out what really worked and what at best did no harm, etc. That's for the next Coronavirus Pandemic.
In the meantime let's let the COVID-19 version of the WWII "medic on the battlefield" put on a tourniquet and dump some sulfa into the open wounds and move on to the casualty.
Finally -- the President has been credited by at least one Democrat Politician [from Detroit] for making it possible for her to receive what she considers to have been life-saving treatment -- HCQ -- so give the Trump-hatred a rest.
Adult size adolescent rebellion
Trump has the mentality of an adolescent. Whether from a brain injury caused by long term syphilis or a untreatable psychological condition, he is an man with the emotional responses of an adolescent.
What is stereotypical of adolescents? Rebellion. Doesn't matter what the rebellion is about; all that matters is finding a reason to disagree. Trump supporters remind me of adolescents in a perpetual state of rebellion.
Science is the accepted method of evaluating a disease? Rebel against the science.
Virtually visit (comments sections) in a place the tends to be liberal, act reactionary pseudo-conservative.
The particular question or issue is not important. What is important is to continue acting out as an adolescent that just has to be contrarian. Even when all the evidence possible proves them wrong.