之前我好几次讲出了所谓Paxlovid特效药的实验数据其中的猫腻,因为无论怎么吹嘘一个药的疗效,它不可能违反一个铁律: 一群病人的住院率和死亡率不可能低过一个社会普通人的总住院率和总死亡率。
美国普通人年住院率约为10.7%, 死亡率约为0.8%。
如果这群病人的年纪偏大(比如高于65岁), 还有基础病什么的,他们的住院率和死亡率无可避免的要远高于普通人(0岁~100岁)。
比如,美国65岁的年住院率约为17%, 死亡率约为2%。
今天又有文章吹嘘Paxlovid (帕克斯洛韦贵吗 https://bbs.wenxuecity.com/myhouse/12116997.html ),列举了一系列数据,又一次忽悠了几乎所有读者。
它的误导性结论是:1。复阳率与对照组没有明显不同。 2。Paxlovid大幅度降低住院率和死亡率。
关于Rebound (复阳)
它引用的https://www.journalofinfection.com/article/S0163-4453(22)00557-6/fulltext 有三个数据来源。其中有两个数据,最多只有二百多个samples,复阳2~3个,数据太少,也不说明问题。
看了数据最多的一篇,它是比较服用Paxlovid和Molnupiravir,并不是比较服用Paxlovid与不服用的。结论是:服用Paxlovid和Molnupiravir的, 复阳率差不多,到了转发的中文就成了Paxlovid与对照组差不多,误导读者以为服用Paxlovid与不服用的,复阳率差不多。误导读者认为服用Paxlovid副作用小。
https://www.medrxiv.org/content/10.1101/2022.06.21.22276724v1.full-text
In summary, COVID-19 rebound occurred in patients treated with Paxlovid or with Molnupiravir, especially in those with underlying medical conditions. COVID-19 rebound is not unique to Paxlovid and the risks were similar for Paxlovid and Molnupiravir
关于住院率和死亡率
看了数据最多的一篇,有约3万病人,其中约6000服用Paxlovid,其余约24000没有服用。
服用Paxlovid的多数是: 年老的、 肥胖的(BMI>30)、多种基础病、没有打过疫苗的。
住院率: 服用Paxlovid的为0.66%, 没服用0.96%
死亡率: 服用Paxlovid的为0.0%(一个都没死), 没服用0.161%
已经看到有报道Paxlovid对没有打过疫苗的更有疗效,对65岁以下的没有疗效。实验的两类人不相同,加上住院率的微弱数据 (0.66%和0.96%)的比较,它们不能说明什么问题。重要的是: 服药的新冠病人28天的住院率(0.66%)远低于上面所说的65岁普通人(约1.3%),明显不合理。
如果按照正常年死亡率为0.8%, 28天的死亡率为0.061%。得新冠的死亡率为0.161%, 高过0.061%,这个合理。
再看服药的那组, 都是老人,28天死亡率应该是0.15%, 也就是9人。 如今那6000个老年,有多种基础病, 肥胖的新冠病人竟然一个都没死。任何人做实验遇到低于9人死亡的数据,违反上面所说的铁律,就应该认定这样的数据invalid. 这跟宣称能造出永动机是一个道理。
https://www.medrxiv.org/content/10.1101/2022.06.14.22276393v2.full-text
During the study period, 6036 (19.9%) patients were prescribed nirmatrelvir plus ritonavir and 24,286 (80.1%) patients were not. Patients prescribed nirmatrelvir were more likely to be older, have more comorbidities, and be unvaccinated. Hospitalization occurred in 40 (0.66%) and 232 (0.96%) patients prescribed and not prescribed nirmatrelvir plus ritonavir, respectively. The adjusted risk ratio was 0.55 (95% confidence interval 0.38 to 0.80, p = 0.002). Observed risk reduction was greater among unvaccinated patients and obese patients.
A total of 39 deaths within 28 days of COVID-19 diagnosis were observed among the 30,322 study patients diagnosed as outpatients. All deaths occurred among patients who were not prescribed nirmatrelvir plus ritonavir. Thirteen of the patients died while hospitalized after COVID-19 diagnosis and 28 (74%) of the deaths occurred in vaccinated patients.