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Trump Pushes Lupus-Coronavirus Study, But The Evidence Is Mixed

President Donald Trump again touted the drug hydroxychloroquine on Saturday, citing an unspecified study showing that lupus patients are fighting off coronavirus infections because they take the drug hydroxychloroquine.

Trump has come under fire from some health experts and journalists for hyping the hydroxychloroquine as a potential “game-changer.” That did not change Saturday when many Trump critics accused him of peddling pseudo-science.

But as is often the case with the president’s claims, anecdotal accounts both support and undermine the study he is touting.

The Lupus Foundation of America said Saturday that there is no evidence that lupus patients are shielded from the virus because they take hydroxychloroquine. An alliance of doctors studying coronavirus in people with autoimmune disorders also said 25% of patients the group is observing has the virus despite begin on hydroxychloroquine.

There is some anecdotal evidence that lupus patients have lower rates of coronavirus than the general public.

“None of my lupus patients have developed covid, which is quite remarkable,” Dr. Daniel Wallace, a rheumatologist at Cedars-Sinai Hospital in Los Angeles, said in a teleconference for the Lupus Research Alliance.

Wallace said that of around 1,000 patients with coronavirus that have showed up at his hospital network, “one has had lupus.”

“It may be that the drugs that these patients are taking provides them with type of protection. I find this rather interesting and I can’t quite explain it,” Wallace said.

Dr. Peggy Crow, the chief of rheumatology at the Hospital for Special Surgery in New York, echoed Wallace’s observations.

“The anecdotal experience,” she said on the teleconference, “is that many more presumably healthy people are developing infections with COVID-19 than we’ve seen in our lupus patients, or rheumatoid arthritis patients.”

“I think lupus patients are being very careful,” she said, noting that people with the disease have compromised immune systems.

“I think overall [they’re] doing pretty well under the circumstances.”

Trump did not identify his source for the lupus-coronavirus claim. But he appears to have been referencing a limited observational study that Dr. Mehmet Oz, the celebrity doctor, and other high-profile physicians have hyped in interview on Fox News and in other venues.

Oz and Dr. Jeff Colyer, the former governor of Kansas, have cited research that noted that 80 lupus patients did not contract coronavirus in Wuhan, the epicenter of the coronavirus outbreak. The observation led the team of researchers in Wuhan to theorize that the lupus patients had protection because they use hydroxychloroquine to fight their autoimmune disorder.

The researchers have since released a clinical study that found that patients given hydroxychloroquine fought off coronavirus more effectively than a control group.

Trump has come under fire from critics for pushing hydroxychloroquine and azithromycin as a potential “game-changer” in the fight against coronavirus. Not only are studies inconclusive on whether the drug will work against the virus, but his endorsement has led to disruptions in prescriptions for lupus and rheumatoid arthritis patients.

Trump first mentioned the drug combo in a press conference March 19 following the release of a French study of 24 patients with coronavirus.

Health experts urged caution over the limited number of patients analyzed in the study. Another knock on the research was that the study was not randomized, making it impossible to discern whether the patients would have improved without hydroxychloroquine.

Dr. Anthony Fauci, the government’s top expert on infectious disease, has cautioned against hanging too much hope on hydroxychloroquine, which also treats malaria. His thinly veiled rebuke of the drug has not deterred Trump from touting it.

“There’s a rumor out there that because it takes care of lupus very effectively, as I understand it — it’s you know, a drug that’s used for lupus, so there’s a study out there that says people that have lupus haven’t been catching this virus,” Trump said Saturday.

“Now maybe it’s true, maybe it’s not. Why don’t you investigate that?” he said to reporters.

Trump did not identify the study, but his claims are similar to those in hyped recently by Oz, Colyer, and another doctor who has appeared on Fox News in recent days.

Oz, a cardiologist, vaguely referenced a study from China in an interview March 31 on “Fox & Friends” and in a segment on his own show. He agreed with host Brian Kilmeade that U.S. health officials should investigate whether lupus patients have lower coronavirus infection rates than the rest of the public.

Dr. Ramin Oskoui, the CEO of Foxhall Cardiology, said in an interview Thursday on Fox News that he is not aware of anyone with lupus contracting coronavirus.

“We’re not seeing patients with lupus who take Plaquenal, we’re not seeing these individuals develop COVID. I’m not aware of any reported case; the Chinese have actually looked at this,” Oskoui said.

Oz touted the study again on April 2 on his show, saying that he had seen an “early draft” of the study.

“I have struggled with the decision to discuss this brand new research today, but the situation’s moving so quickly and it’s impossible of the destruction caused by this virus, so we’re going to talk about it while acknowledging errors could be discovered in this research down the road,” said Oz, who has expressed optimism for hydroxychloroquine for several weeks.

Oz did not provide additional information about the research, but the details he provided of it match with information that Colyer referenced in a March 29 op-ed in The Wall Street Journal.

Colyer, who is a surgeon by training, is chairman of the Department of Health and Human Services’ rural health committee.

The research team, led by Zhang Zhan of Renmin Hospital at Wuhan University, said the observation raised the possibility that lupus patients were avoiding coronavirus infection because of they already take hydroxychloroquine.

“In view of the urgency of the epidemic situation and the lack of effective anti-coronavirus drugs…the team proposed to carry out a clinical trial of hydroxychloroquine in patients with novel coronavirus pneumonia,” the research report stated.

Zhan’s team released a study in the online journal medRvix that found positive results for coronavirus patients administered hydroxychloroquine.

The study, which looked at 62 patients, found that patients given hydroxychloroquine showed improvements in fevers, coughs and pneumonia compared to a control group.

The New York Times published a story about the research, noting that it was more robust than the French study. But other research has found that hydroxychloroquine is not as effective as Trump and others hope.

A randomized study from Shanghai University found that patients fared no better with coronavirus when given hydroxychloroquine.

It is unclear how many Americans with lupus have coronavirus.

About 1.5 million Americans — or 1-in-200 — have been diagnosed with some form of lupus. As of Sunday, approximately 1-in-1,000 Americans — or 320,000 — have tested positive for coronavirus.

Trump’s statement Saturday drew rebuttals from numerous health experts and lupus advocacy groups.

The Lupus Foundation of America said there is no evidence yet that people who already take hydroxychloroquine are protected against coronavirus. Another group that is tracking coronavirus in rheumatoid arthritis patients found that patients taking the drug have come down with coronavirus.

“One frequently asked question: over 25% of patients who developed a COVID-19 were on HCQ at the time of diagnosis,” The COVID-10 Global Rheumotology Alliance tweeted Thursday.

The group said that of 110 coronavirus patients who submitted information for its survey, 22 are taking hydroxychlroquine. Of those, seven have recovered from coronavirus, 12 remain sick, and one person had died.

“Based on early data currently available in our registry, we are not able to report any evidence of a protective effect from hydroxychloroquine against COVID-19,” the alliance said on Twitter.

Written by Chuck Ross

Chuck Ross is a contributor to The Schpiel.

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