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 widely during the pandemic.
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RFI Almost four years ago, French microbiologist and professor of infectious diseases at Aix Marseille University Didier Raoult claimed that he had defeated Covid19 thanks to a molecule used to treat malaria, chloroquine.
However, according to a study published in France, the use of Plaquenil, the noncommercial version of chloroquine, not only did not save lives, but also killed almost 17,000 people in six countries: France, the United States, Belgium, Italy and Spain and Turkey.
Researchers analyzed the increase in mortality among patients treated with chloroquine during the first wave of the Covid19 pandemic between March and July 2020 using three data points: the number of Covid patients hospitalized, their mortality rate and the prescription fee medication.
The study shows that an uneven 16,990 deaths were recorded across the six countries during the first wave of Covid19 between March and July 2020. Turkey had 95 deaths, France 199, Belgium 240, Italy 1822, Spain 1895 and the United States 12,739.
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To reach the conclusion, the research used a multiplicative model, as explained to RFI by its lead author, Professor of Clinical Medicine specializing in Internal Medicine at the University Hospital of Lyon, JeanChristophe Lega.
“We should remember that this is a rough estimate in the sense that it only affects a few countries over a short period of time and the total number of deaths is probably much higher,” he explains.
Additionally, the investigation does not include Brazil and India, which have widely prescribed chloroquine during the pandemic.
“The study focused on six countries because they developed modeling work based on published data,” he explains. “Because we used four parameters: the impact of chloroquine on mortality, the number of patients hospitalized for Covid19 and then the prescription rate. This data set was only available in 6 countries,” he points out.
Death from hydroxychloroquine toxicity According to Lega, the toxicity of chloroquine in patients already weakened by Covid could have led to the death of thousands of people.
“On the one hand, we have data from pharmacovigilance and, on the other hand, tests and randomized controls that show us that chloroquine may be cardiac toxic. These data are already well known, especially in the use of the drug in autoimmune diseases and in malaria, in which the drug is usually indicated, explains the doctor.
But in connection with Covid, there has been a development from patients with mild illnesses to a disease with significant mortality rates and, above all, heart inflammation, he explains. “In about 10 to 30% of patients, it is very likely that this toxicity was increased in the context of Covid,” he says.
The most important lesson from the study, according to the researcher, is that part of the medical community jumped to conclusions.
“Because the prescriptions (for chloroquine) were implemented well by us doctors,” he complains. In some hospital centers, prescriptions for the drug were issued in 16% of Covid19 cases. In other cases, prescriptions reached up to 90% of cases, the study shows.
“I think it is indeed an important message not to extrapolate results from preliminary studies or largescale cell models during a health crisis,” he says.
“It is necessary to maintain reason. Calling for caution and urgency is not a commandment. In fact, the urgency is to carry out studies with a very high level of evidence that allow the implementation of effective and safe strategies in the context of a health crisis,” he insists.
Political leaders supported the deployment The doctor points out that the medical community is responsible, but during the pandemic political leaders supported the drug.
In France, President Emmanuel Macron personally traveled to Marseille for talks with Didier Raoult.
But the Brazilian case is probably the most emblematic, with former President Jair Bolsonaro seen as a proponent and even user of the drug.
Former President Jair Bolsonaro shows a box of hydroxychloroquine at the Palácio da Alvorada in Brasília.
Former President Jair Bolsonaro shows a box of hydroxychloroquine at the Palácio da Alvorada in Brasília. AFP
“I think what we should keep in mind is caution so that everyone can stay in their role,” Lega says.
“In my opinion, as managers of an authority, of a mandate (…) we have to be careful and stay as close as possible to the results, again without extrapolation, without intuition,” he says.
Research should strengthen existing data on chloroquine. “Ultimately, we do not generate new results on the effectiveness and safety of the drug, but only estimates, albeit imperfect, of the consequences that this type of prescription could have,” he admits.
“The randomized clinical trials that showed the lack of effectiveness of chloroquine and a lack of toxicity were conducted in 2020. So this information is now well known to the medical community,” he says.