Concerns about the Special Article on Hydroxychloroquine and Azithromycin in High-Risk Outpatients with COVID-19

Matthew P. Fox, Lucy D'Agostino McGowan, Bryan D. James, Justin Lessler, Shruti H. Mehta, Eleanor J. Murray

Research output: Contribution to journalReview articlepeer-review

4 Scopus citations


In May 2020, the Journal published an opinion piece by a member of the Editorial Board, in which the author reviewed several papers and argued that using hydroxychloroquine (HCQ) + azithromycin (AZ) early to treat symptomatic coronavirus disease 2019 (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, review the literature 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 the 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.

Original languageEnglish (US)
Pages (from-to)491-495
Number of pages5
JournalAmerican journal of epidemiology
Issue number4
StatePublished - Apr 1 2021


  • azithromycin
  • bias
  • confounding
  • hydroxychloroquine
  • observational studies
  • randomized trials

ASJC Scopus subject areas

  • Epidemiology


Dive into the research topics of 'Concerns about the Special Article on Hydroxychloroquine and Azithromycin in High-Risk Outpatients with COVID-19'. Together they form a unique fingerprint.

Cite this