Changes

One of the early studies published on HCQ as a possible treatment for COVID-19 was [https://jornalggn.com.br/sites/default/files/2020/04/paper-preventsenior.pdf Empirical treatment with hydroxychloroquine and azithromycin for suspected cases of COVID-19 followed-up by telemedicine] which was published as a preprint on April 15<ref name=c19study/> by the Prevent Senior Institute in São Paulo, Brazil.  The study had several limitations that made it less than ideal... it wasn't randomized and it had to assume that patients who were exhibiting flu-like symptoms during São Paulo's SARS-CoV-2 pandemic had contracted SARS-CoV-2 (testing wasn't widely available at the time), but the study also had several strengths.  Unlike retrospective studies like the VA study, it had a natural control group - it offered to give HCQ and azithromycin to 636 symptomatic outpatients, 412 of whom accepted the treatment (the treatment group) and 224 of whom refused the medications (the control group).  It also used HCQ ''early'' which is when antivirals are most effective and the patients were monitored by telemedicine<ref name =Brazilstud/> (unlike Boulware's study). So what where the results?

One of the early studies published on HCQ as a possible treatment for COVID-19 was [https://jornalggn.com.br/sites/default/files/2020/04/paper-preventsenior.pdf Empirical treatment with hydroxychloroquine and azithromycin for suspected cases of COVID-19 followed-up by telemedicine] which was published as a preprint on April 15<ref name=c19study/> by the Prevent Senior Institute in São Paulo, Brazil.  The study had several limitations that made it less than ideal... it wasn't randomized and it had to assume that patients who were exhibiting flu-like symptoms during São Paulo's SARS-CoV-2 pandemic had contracted SARS-CoV-2 (testing wasn't widely available at the time), but the study also had several strengths.  Unlike retrospective studies like the VA study, it had a natural control group - it offered to give HCQ and azithromycin to 636 symptomatic outpatients, 412 of whom accepted the treatment (the treatment group) and 224 of whom refused the medications (the control group).  It also used HCQ ''early'' which is when antivirals are most effective and the patients were monitored by telemedicine<ref name =Brazilstud/> (unlike Boulware's study). So what where the results?

{{Need for hospitalization was 1.9% in the treatment group and 5.4% in the control group (2.8 times greater) and number needed to treat was 28. In those who started treatment before versus after the seventh day of symptoms, the need for hospitalization was 1.17% and 3.2%, respectively. Conclusion: Empirical treatment with hydroxychloroquine associated with azithromycin for suspected cases of COVID-19 infection reduces the need for hospitalization (p< 0.001).<ref name =Brazilstud/>}}  ''That'' is a ''highly'' significant result, not "anecdote".  Actually, highly significant ''results'' as the study showed two things.   

{{quotebox|Need for hospitalization was 1.9% in the treatment group and 5.4% in the control group (2.8 times greater) and number needed to treat was 28. In those who started treatment before versus after the seventh day of symptoms, the need for hospitalization was 1.17% and 3.2%, respectively. Conclusion: Empirical treatment with hydroxychloroquine associated with azithromycin for suspected cases of COVID-19 infection reduces the need for hospitalization (p< 0.001).<ref name =Brazilstud/>}}  ''That'' is a ''highly'' significant result, not "anecdote".  Actually, highly significant ''results'' as the study showed two things.   

#  Need for hospitalization is substantially reduced (2.8 times less) when patients are treated with HCQ.

#  Need for hospitalization is substantially reduced (2.8 times less) when patients are treated with HCQ.

#  Patients who are treated with HCQ before the seventh day of symptoms do significantly better than patients who receive the treatment late.

#  Patients who are treated with HCQ before the seventh day of symptoms do significantly better than patients who receive the treatment late.