Swinging the pendulum: lessons learned from public discourse concerning hydroxychloroquine and COVID-19

Abstract

Introduction Several months into the COVID-19 pandemic, safe and effective treatments against this global health disaster have yet to be identified. Clinical research trials around the world are underway testing a wide array of possible medications. In particular, the off-label use of hydroxychloroquine for COVID-19 prophylaxis and treatment has created many unprecedented challenges for the scientific community and the public. Areas covered We critically assessed major events from February – May 2020 that contributed to widespread use of hydroxychloroquine for the treatment and prophylaxis of COVID-19. We aimed to explore how opinions toward hydroxychloroquine may shift from early enthusiasm (based on in vitro and preliminary clinical data) to the hope for a miracle cure (through communication and promotion of questionable results) and, finally, to a rise of skepticism as more in-depth analyses are emerging. Expert opinion Mindful and rigorous acquisition of data, as well as its interpretation, are essential to an effective pandemic response. The rapid and premature promotion of results has had major implications for global crisis management, even creating distrust among the public. It is crucial for the medical and scientific community to incorporate the lessons learned from this situation.

#Covid4Rheum: an analytical twitter study in the time of the COVID-19 pandemic

“…The main issues were the presumed vulnerability of RMD patients for COVID-19 infection due to immunosuppressive therapy, the management of the hydroxychloroquine shortage and the potential use of immunosuppressive treatment for COVID-19 infections. The results illustrate the importance of these topics for the rheumatological community during the COVID-19 pandemic [15]. Furthermore, they underline the potential of Twitter to foster the exchange of medical knowledge ("from Twitter to bedside").…”

Protocol for the DisCoVeRy trial: multicentre, adaptive, randomised trial of the safety and efficacy of treatments for COVID-19 in hospitalised adults

“… 40 41 However, many of the articles supporting hydroxychloroquine suffered from methodological shortcomings and were in fact non-informative. 42 Hydroxychloroquine has been widely promoted as soon as February 2020 as an effective drug by some scientists and politics, 43 leading to difficulties in recruiting patients in randomised clinical trials such as DisCoVeRy. 44 This is why the ever-changing scientific background supporting the use of each candidate treatment should be clear, detailed and regularly updated and pragmatic, adaptive clinical trials should be encouraged.…”

Open Science Saves Lives: Lessons from the COVID-19 Pandemic

“…An outstanding example is the current debate on the effectiveness of hydroxychloroquine as a treatment for COVID-19, which started after the publication of a methodologically flawed preprint by Gautret and colleagues [24]. Widely shared (1,458 shares in the media including 54 in the news (as of 13 th July 2020)), this study quickly caught the attention of the public, creating a high-demand for a treatment that has not been proven beneficial and has many potential harmful side-effects [77]. Moreover, the misuse of preprints may discourage researchers from sharing their own in the future, particularly in research areas in which the use of preprints is a quite recent phenomenon, as in medical research (MedRxiv was launched in June 2019).…”