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The paper that appears to have triggered the Trump administration's obsession with hydroxychloroquine as a treatment for infection with the novel coronavirus has received a statement of concern from the society that publishes the journal in which the work appeared.
The April 3, 2020, notice, from the International Journal of Antimicrobial Agents, states that the March 20 article, "Hydroxychloroquine and azithromycin as a treatment of Covid-19: results of an open-label non-randomized clinical trial"
does not meet the [International Society of Antimicrobial Chemotherapy's] expected standard, especially relating to the lack of better explanations of the inclusion criteria and the triage of patients to ensure patient safety.
The notice, which is from the ISAC and not the journal itself, is a bit ambiguous. The society says it "shares the concerns" about the paper, but it doesn't appear to be taking additional action.
Dr Didier Raoult
The study was led by Didier Raoult, of the University of Marseille, whose publication history has come under scrutiny.
Last month, Elisabeth Bik took a close look at the IJAA article and detailed a long list of serious problems with the study, including questions about its ethical underpinnings, messy confounding variables, missing patients, rushed and conflicted peer review, and confusing data.
Infectious disease specialist Benjamin Davido, MD, from Raymond-Poincaré Hospital in Garches, Paris, also pointed out in an interview with Medscape that it doesn't provide answers to all the questions that clinicians on the front line are looking for.
Others have used PubPeer to report additional issues with the Raoult article.
Raoult has not responded to a request for comment from Retraction Watch.
Of course, the horse has left the proverbial barn on this one. An untold number of patients have been receiving hydroxychloroquine, as well as chloroquine, for COVID-19 infection, thanks in large part to cheerleading for the drugs from President Trump.
Although a certain amount of haste is to be expected in a medical crisis, and sometimes spitballing may be a viable option, the use of poorly investigated therapies is hardly risk free. In this case, not only do the drugs carry significant side effects, but they are critical treatments for people with lupus and rheumatoid arthritis — patients who now have to hope that they can still get access to medications that are keeping them alive. (Now come reports that states are hoarding hydroxychloroquine and chloroquine for precisely these people.)
In other words, although the president might be narrowly correct when he says that COVID-19 patients have "nothing to lose" by taking the drugs, the game is zero-sum.
And we are likely to see lots of "promising" but ultimately unhelpful treatments in the days and weeks ahead. As we wrote the other day in Wired:
When it comes to findings, the Covid-19 train is an express, while the rigorous science coach is a local. Until that local arrives at its final destination, it may be wise to label all this research—preprints, peer-reviewed papers, and for goodness' sake, pronouncements from Donald Trump—with a black-box warning: "There is some evidence for this now. It will likely turn out to be at least partially wrong."
This article originally appeared on Retraction Watch.
Medscape Infectious Diseases © 2020
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