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Concerns About the Special Article on Hydroxychloroquine and Azithromycin in High Risk Outpatients with COVID-19 by Dr. Harvey Risch

  • Fox, Matthew P1
  • D'Agostino McGowan, Lucy2
  • James, Bryan D3
  • Lessler, Justin4
  • Mehta, Shruti H4
  • Murray, Eleanor J1
  • 1 Boston University
  • 2 Wake Forest University
  • 3 Rush University Medical Center
  • 4 Johns Hopkins
Published Article
American Journal of Epidemiology
Oxford University Press
Publication Date
Aug 29, 2020
DOI: 10.1093/aje/kwaa189
PMID: 32860038
PMCID: PMC7499476
PubMed Central


In May, this journal published an opinion piece by one of the members of the Editorial Board, Dr. Harvey Risch, that reviewed several papers and argued that using hydroxychloroquine (HCQ) + azithromycin (AZ) early to treat symptomatic COVID-19 cases in high-risk patients should be broadly applied. As members of the journal's editorial board, we are strongly supportive of open debate in science, which is essential even on highly contentious issues. However, we must also be thorough in our examination of the facts and open to changing our minds when new information arises. In this commentary, we document several important errors in the manuscript by Dr. Risch, review the literature he presented and demonstrate why it is not of sufficient quality to support scale up of HCQ+AZ, and then discuss the literature that has been generated since his publication, which also does not support use of this therapy. Unfortunately, the current scientific evidence does not support HCQ+AZ as an effective treatment for COVID-19, if it ever did; and even suggests many risks. Continuing to push the view that it is an essential treatment in the face of this evidence is irresponsible and harmful to the many people already suffering from infection.

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