Covid-19: Nearly 17 people died in six countries due to the use of chloroquine, says French study.
The study was conducted in France, the United States, Belgium, Italy, Spain, and Turkey, and did not include Brazil and India, which prescribed the drug on a large scale during the pandemic.
RFI - Almost 4 years ago, the French microbiologist and professor of infectious diseases at the University of Aix Marseille, Didier Raoult, claimed to have defeated Covid-19 thanks to a molecule used in the treatment of malaria, chloroquine.
But according to a study published in France, the use of Plaquenil, the non-commercial version of chloroquine, not only failed to save lives, but also killed nearly 17.000 people in six countries: France, the United States, Belgium, Italy, Spain, and Turkey.
Researchers analyzed the increase in mortality among patients treated with chloroquine during the first wave of the Covid-19 pandemic, between March and July 2020, using three data points: the number of hospitalized Covid patients, their mortality rate, and the drug prescription rate.
The study reveals that, during the first wave of Covid-19, between March and July 2020, 16.990 deaths were recorded in the six countries, unevenly distributed. Turkey had 95 deaths, France 199, Belgium 240, Italy 1822, Spain 1895, and the United States 12.739.
To arrive at the result, the research used a multiplicative model, as explained to RFI by its main author, Professor of Clinical Medicine, specializing in internal medicine at the University Hospital Center of Lyon, Jean-Christophe Lega.
"What we must keep in mind is that this is a rough estimate, in the sense that it only concerns a few countries over a short period of time, and the total number of deaths is probably much higher," he explains.
Furthermore, the research does not include Brazil and India, which prescribed chloroquine on a large scale during the pandemic.
"The study focused on six countries because they had developed modeling work based on published data," he explains. "We used four parameters: the effect of chloroquine on mortality, the number of patients hospitalized for Covid-19, and then the prescription rate. This dataset was only available for six countries," he points out.
Death due to hydroxychloroquine toxicity - According to Lega, the toxicity of chloroquine in patients already weakened by Covid could have led to the deaths of thousands of people.
"We have pharmacovigilance data on one hand, and randomized controlled trials on the other, which show us that chloroquine can have cardiac toxicity. This data is already well known, especially in the use of the drug in cases of autoimmune diseases and for malaria," where the drug is normally indicated, explains the doctor.
But in the context of Covid, he explains that there was an evolution in the condition of patients who had mild illnesses, to a disease with significant mortality rates and, above all, inflammation of the heart. "In approximately 10 to 30% of patients, it is very likely that this toxicity was increased in the context of Covid," he says.
The main lesson from the study, according to the researcher, is that part of the medical community drew hasty conclusions.
"Because the prescriptions (of chloroquine) were properly executed by ourselves, the doctors," he laments. In some hospital centers, prescriptions for the drug were given in 16% of Covid-19 cases. In others, prescriptions reached up to 90% of cases, the study shows.
"I think it's actually an important message not to extrapolate results from preliminary studies or large-scale cell models during a health crisis," he says.
"It's necessary to maintain reason. Asking for caution and urgency is not prescribing. In fact, urgency lies in conducting studies with a very high level of evidence that allow for the implementation of effective and safe strategies in the context of a health crisis," he insists.
Political leaders defended its use - The doctor points to the medical community as being responsible, but during the pandemic, political leaders supported the drug.
In France, President Emmanuel Macron personally spoke with Didier Raoult in Marseille.
But the case of Brazil is probably the most emblematic, with former president Jair Bolsonaro as a defender and even a user of the drug.
Former President Jair Bolsonaro displays a box of hydroxychloroquine at the Alvorada Palace in Brasília.
Former President Jair Bolsonaro displays a box of hydroxychloroquine at the Alvorada Palace in Brasília. AFP
"I think what we should keep in mind is caution, so that everyone can remain in their role," says Lega.
"In my opinion, when one is in charge of an authority, of a mandate (...) we must be careful and remain as close as possible to the results, once again, without extrapolation, without intuition," he says.
The research should reinforce existing data on chloroquine. "Ultimately, we are not generating new results regarding the efficacy and safety of the drug, we are only producing estimates, albeit imperfect, about the consequences that this type of prescription could have," he acknowledges.
"Randomized clinical trials showing the lack of efficacy of chloroquine and a flaw regarding its toxicity were conducted in 2020. Therefore, this information is now well known to the medical community," he says.