key: cord-0731525-aqo6ih6b
authors: Nguyen, Tuan V.
title: Uncertain effects of hydroxychloroquine and azithromycin on SARS-Cov-2 viral load
date: 2021-01-04
journal: Int J Antimicrob Agents
DOI: 10.1016/j.ijantimicag.2020.106169
sha: f5fa55ff0d9de159b36c6987f87c522bb156a515
doc_id: 731525
cord_uid: aqo6ih6b

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estimate of treatment effect and incorrect P values [2] . Using the authors' data, I estimated that the intraclass correlation in the rate of negative tests was 0.37 (95% confidence interval: 0.22 to 0.52), suggesting a substantial within-patient correlation that needs to be accounted for.

The mixed-effects logistic regression model [3] can be used to model the change within each patient, and hence give an unbiased estimate of treatment effect. Using the authors' data in the appendix [1] , I conducted a mixed-effects logistic regression analysis accounting for the interaction effects of HCQ and azithromycin and time ( Table 1 ) . While the rate of negative tests increased with time, the increase was not significantly different between those on HCQ and those not on HCQ (P = 0.355). Interestingly, patients on azithromycin had a significantly greater rate of negative tests compared to those not on azithromycin (P = 0.019; Figure 1 ). On the basis of the results presented, I propose an alternative interpretahttps://doi.org/10.1016/j.ijantimicag.2020.106169 0924-8579/© 2020 Elsevier Ltd and International Society of Antimicrobial Chemotherapy. All rights reserved. tion that the effect of hydroxychloroquine and azithromycin on the elimination of viral load remains uncertain.

No conflict of interest

Ethical Approval obtained NA

Hydroxychloroquine and azithromycin as a treatment of COVID-19: results of an open-label non-randomized clinical trial

Intraclass correlation -A discussion and demonstration of basic features

Intermediate and advanced topics in multilevel logistic regression analysis