Expect more useless science like this recently published paper https://www.medrxiv.org/content/10.1101/2020.04.16.20065920v2#disqus_thread to begin appearing in the medical literature. Pharma's SOP, when low cost, safe, and effective interventions like vitamin C, niacin, vitamin E, chloroquine (CQ), or hydroxychloroquine (HCQ), threaten to erode their markets and revenues, is to execute campaigns of clinical trial sabotage.
This paper will never survive peer-review. It is weak, biased, and multiply confounded.
First, we have the issue of serious conflicts of interest. At least two authors possess conflicts of interest likely to bias their work.
"The study’s co-authors come from the University of Virginia or the University of South Carolina. One of the authors, Jayakrishna Ambati, is listed as the inventor on a University of Virginia patent application 'relating to COVID-19.'"
Another "...of the study’s co-authors, S. Scott Sutton, has taken research grant money from Gilead Sciences, which is currently developing a Coronavirus drug that is likely to be much more expensive than Hydroxychloroquine, which costs less than one dollar per tablet. Sutton’s curriculum vitae shows that on three occasions dating back to 2012 he has studied the impact of therapies on veterans with HIV/AIDS and then submitted that research to Gilead, including two times as principal investigator for Gilead and another company on projects funded for a total of $100,000."
Second, it is a small study using a weak research design methodology: retrospective cohort analysis. Basically, the researchers selected cases from data found in the VA medical record system.
Third, the authors did not disclose the dose and frequency of HCQ and azithromycin (AZ) used in the study groups. This is important information that should not be omitted.
Also, the treatment groups did not receive zinc, which is essential to HCQ's mechanism of action for suppressing viral replication in CoVID-19.
Fourth, the subjects were not randomly assigned. In fact, the groups were significantly imbalanced. The subjects assigned to the HCQ and HCQ+AZ treatment groups had the most severe disease and were predictably more likely to die. The authors even admit that subjects treated with "....hydroxychloroquine, with or without azithromycin, was more likely to be prescribed to patients with more severe disease." This represents subject selection bias and introduces a serious confounding effect that essentially renders the study meaningless.
Fifth, any of the reasons above would be enough to kick this "science" to the curb. But another real kicker is how the authors conveniently ignored the fact that despite all the selection bias and over weighted disease burden in the treatment groups, the NO TREATMENT group was TWO TIMES more likely to require mechanical VENTILATION (compared to those that received HCQ + AZ). The risk of ventilation was 6.9% in HQ+AZ group and 14.1% in the no-treatment group. That's a significant difference that was not noted in their contrived conclusion.
Finally, this study is little more than bad, biased research, the likes of which are commonly bought-and-paid for by pharmaceutical companies (like Gilead). They buy and bias doctors and scientists with research grants, patent license royalties, and "bags of silver' like those paid to Judas before he betrayed Christ. This paper represents the beginning of the HCQ/AZ/zinc clinical trial sabotage campaign intended to sow disinformation to protect their market for far more expensive "solutions."
It is critical that poor science like this be properly reviewed and exposed for the bad science it is. Unfortunately, this trash science and its contrived conclusions are already being misrepresented in the news and all over social media.
Let the battle for truth begin.