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Comment by acqq | Hacker News Reader

The picture is from https://science.sciencemag.org/content/368/6493/829 published "22 May 2020" at the time when less was known about Chloroquine and hydroxychloroquine than today about treating Covid-19 (1). That's the needed perspective when watching the picture, where the rest is still relevant.

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E.g. June 23, 2020 "NIH: Trial Investigating Hydroxychloroquine for COVID-19 Stopped"

https://www.empr.com/home/news/hydroxychloroquine-trial-halt...

17 June 2020 "“Solidarity” clinical trial"

https://www.who.int/emergencies/diseases/novel-coronavirus-2...

"hydroxychloroquine does not result in the reduction of mortality of hospitalised COVID-19 patients, when compared with standard of care."

And before, Jun. 9, 2020: "Three big studies dim hopes that hydroxychloroquine can treat or prevent COVID-19":

https://www.sciencemag.org/news/2020/06/three-big-studies-di...

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Is any of these studies using Zinc? We know that a lot of people have both Vitamin D and Zinc deficiency. How HCQ works is to transport the Zinc into the cell so that Zinc can stop the RNA replication. (I’m a layman here, but it’s what I’ve managed to understand after deliberate research)

Thus, HCQ without Zinc is like using a bucket but forgetting the water to stop the fire. Just throwing buckets at the fire isn’t gonna work much when there’s no water in the bucket.

Have a look at this [1] studies that shows around a 9% less mortality when treated with Zinc and a even more when treated EARLY with HCQ PLUS Zinc. (Please take a look at the numbers in the last table, it’s very clear that HCQ + Zinc reduces mortality)

[1]: https://www.medrxiv.org/content/10.1101/2020.05.02.20080036v...

I think there are 2 hypothesis for HCQ. One is that it blocks autophagosome-lysosome fusion. The second is that it is a Zinc ionophore, which enables Zinc to enter cells to stop viral replication. It seems that almost all the studies are not using Zinc. Here is a retrospective observational study showing effectiveness of HCQ+Zinc. It is a mystery to me why this second path doesn’t get more attention. Quercetin is also a Zinc ionophore. So Quercetin+Zinc should also be studied.

https://www.medrxiv.org/content/10.1101/2020.05.02.20080036v...

This recent research from China suggest another possibility..that it acts as an ACE2 blocker.

https://www.biorxiv.org/content/10.1101/2020.06.22.164665v1....

The problem is that this crank doctor from France used exactly this treatment (Zinc+HCQ) in a crappy study and proclaimed it as hugely successful.

This was then picked up by a crowd of "right wing deplorables" up to and including the orange man in the white house.

The scientific establishment can not allow this bunch of clowns to turn out right, thus further inquiry is being suppressed.

Call it a conspiracy theory, but that's exactly how human egos have played a role in the history of science.

From the very paper linked by the parent and the parent-parent:

"This was an observational retrospective analysis that could be impacted by confounding variables"; "We also do not have data on the time at which the patients included in the study initiated therapy with hydroxychloroquine, azithromycin, and zinc." "The cohorts were identified based on medications ordered rather than confirmed administration, which may bias findings towards favoring equipoise between the two groups." "In light of these limitations, this study should not be used to guide clinical practice."

So, good reason to have a more clinical trial for testing HCQ + ZINC + Azitromycin vs HCQ alone (vs NO Medicine). But that's something I'm not seeing at the moment, which is a shame.

230 studies looking at Hydroxychloroquine [1]

Only 10 studies looking into HCQ and Zinc [2]

[1]:https://clinicaltrials.gov/ct2/results?cond=Covid-19&term=hy...

[2]:https://clinicaltrials.gov/ct2/results?cond=Covid-19&term=hy...

And Hesperidin+Zinc

https://aapsonline.org/preliminary-injunction-sought-to-rele...

more: https://news.ycombinator.com/item?id=23405435

and: https://defyccc.com/another-junk-anti-hydroxychloroquine-stu...

From that link:

"AAPS files with the court a chart showing how countries that encourage HCQ use, such as South Korea, India, Turkey, Russia, and Israel, have been far more successful in combatting COVID-19 than countries that have banned or discouraged early HCQ use, as the FDA has."

However: that chart is totally misleading, it's a typical "non sequitur". "Case fatality rate" is just a ratio "death" through "cases". Where those with weaker symptoms are recognized as "cases" the rate is lower. How they are recognized is not the same across different countries.

Agreed. Excess mortality is the real measure.

Note, you seem to be posting studies that did not pair HCQ with zinc, _and_ are not using it prophylactically. Is my understanding correct?

For example: https://www.sciencemag.org/news/2020/06/three-big-studies-di... links to https://www.recoverytrial.net/files/hcq-recovery-statement-0... which does not mention zinc, and it's patients admitted to the hospital (not prophylactic). Digging further, to the source given in that pdf, not a mention of zinc: https://www.recoverytrial.net/@@search?SearchableText=zinc which is the whole point of using HCQ in the first place.

> you seem to be posting studies that did not pair HCQ with zinc

I'm just posting studies that were the basis for what FDA decided June 15, 2020 (1):

"FDA has revoked the emergency use authorization (EUA) to use hydroxychloroquine and chloroquine to treat COVID-19 in certain hospitalized patients when a clinical trial is unavailable or participation is not feasible. We made this determination based on recent results from a large, randomized clinical trial in hospitalized patients that found these medicines showed no benefit for decreasing the likelihood of death or speeding recovery."

And I don't have more information than that.

1) https://www.fda.gov/drugs/drug-safety-and-availability/fda-c...

Note that while AAPS presents as a proper organisation, its previous greatest hits include HIV denialism, vaccine/autism conspiracy theory pushing and “smoking is fine actually” stuff. It’s not a proper medical organisation. If it said water was wet, I would be checking.

Thanks. It also has just 5000 members!

From Wikipedia:

"The Association of American Physicians and Surgeons (AAPS) is a conservative non-profit association founded in 1943. The group was reported to have about 5,000 members in 2014. The association has promoted a range of scientifically discredited hypotheses, including the belief that HIV does not cause AIDS, that being gay reduces life expectancy, that there is a link between abortion and breast cancer, and that there is a causal relationship between vaccines and autism. It is opposed to the Affordable Care Act and other forms of universal health insurance."

https://en.wikipedia.org/wiki/Association_of_American_Physic...

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