Study: No evidence of efficacy of hydroxychloroquine in hospitalized patients

Because TCM is - charitably - pseudoscience. Many of its remedies involve grinding up endangered animals into concoctions that have no plausible mechanism of treating the thing they're meant to treat.

> I've had anecdotal experience that it's helpful for milder coronavirus symptoms.

I have anecdotal experience that my microsorium musifolium plant has been effective in preventing coronavirus infection in my household. Unfortunately, just like your statement, this doesn't qualify as evidence and shouldn't be used to make public health decisions.

Regardless, let's wade in…

1. That's not's a study. That's not a metareview. That's a puff piece by people who have a strong, strong self-interest in promoting TCM, because they want to keep their department chairs.

2. Oh heck, I'll just quote the entire last paragraph:

"The safety of TCM in the treatment of emerging coronavirus diseases was not included in the observation on SARS patients. It was reported that some herbs used in TCM contain nephrotoxins and mutagens, while the toxicological features of the most of Chinese herbal medicines remain to be fully understood. Furthermore, herbs used in TCM can mimic, or magnify, or oppose the effect of conventional medicines. Thus, the safety of TCM used in treatment of emerging coronavirus infections should be carefully evaluated. It is particularly important to avoid toxicity or interfere with the efficacy of conventional treatment caused by herb-drug interaction."

So, in conclusion, we don't know if this works, and this stuff may be toxic, and it may have drug interactions, and oh by the way there's no quality control on this so you have no idea what's in the medications.

Might as well recommend acupuncture and getting your chakras aligned, couldn't hurt! (Probably less of a chance it hurting than taking a wild dose of unregulated herbal supplements.)

1: It’s probably the bullwhip effect and hysteresis in the supply chain but that’s speculation on my part.

Some thoughts:

My understanding is this is a powerful alkaloid. My experience has been that similar compounds can help combat inflammation. They also can work to help kill infection at times.

By the time people with Covid19 need oxygen, inflammation doesn't seem to be the primary problem. So I wouldn't think it would be particularly helpful at that point.

Ventilators get prescribed in part on the assumption that inflammation in the lungs is a major impediment to getting sufficient oxygen. Ventilators are failing at a shockingly high rate, with a death rate up around 80% or so. Some doctors are moving away from ventilators because the death rate is so high.

I spoke recently with a researcher who suggested impaired vasodilation was a possible explanation for the reports of low oxygen combined with a surprising lack of pneumonia and inflammation in some cases and that makes a lot of sense to me. The mechanism causing low oxygen does not appear to be the obvious answer of "lung inflammation and pneumonia."

That doesn't mean this drug can't play a meaningful role at some stage. It mostly means it's not the magic bullet solution for advanced cases that they were hoping for.

This in no way surprises me because the things it actually treats do not appear to be the cause of low oxygen in advanced covid19 cases.