Researchers in the United Kingdom managed to enroll one of every six hospitalized COVID-19 patients into a large study that found a cheap steroid called dexamethasone helps and that a widely used malaria drug does not.

In the United States, one smaller but rigorous study found a different drug can shorten recovery time for seriously ill patients, but many questions remain about its best use.

Few definitive studies have been done in the U.S., with some undermined by people getting drugs on their own or lax methods from drug companies sponsoring the work.

“Everything about this feels very strange,” said Angus, who is leading an innovative study using artificial intelligence to help pick treatments.

A MALARIA DRUG GOES VIRAL.

To scientists, it was a recipe for disaster: In a medical crisis with no known treatment and a panicked population, an influential public figure pushes a drug with potentially serious side effects, citing testimonials and a quickly discredited report of its use in 20 patients.

The Food and Drug Administration allowed its emergency use even though studies had not shown it safe or effective for coronavirus patients, and the government acquired tens of millions of doses.

I want to throw that out there.” In May, he said he was taking the drugs himself to prevent infection after an aide tested positive.

Rais Vohra, medical director of a California poison control center, told of a 52-year-old COVID-19 patient who developed an irregular heartbeat after three days on hydroxychloroquine – from the drug, not the virus.

Craving better information, a University of Minnesota doctor who had been turned down for federal funding spent $5,000 of his own money to buy hydroxychloroquine for a rigorous test using placebo pills as a comparison.

David Boulware’s results showed hydroxychloroquine did not prevent COVID-19 in people closely exposed to someone with it.

A UK study found the drug ineffective for treatment, as did other studies by the U.S.

Rahda Rajasingham, aimed to enroll 3,000 health workers in a study to see if hydroxychloroquine could prevent infection, but recently decided to stop at 1,500.

When the study started, “there was this belief that hydroxychloroquine was this wonder drug,” Rajasingham said.

A small number of patients given usual care serve as a comparison group for all of the treatments being tested, so more participants wind up getting a shot at trying something.

The drug’s maker, Gilead Sciences, also started its own studies, but they were weak -- one had no comparison group and, in the other, patients and doctors knew who was getting the drug, which compromises any judgments about whether it works.

While these studies were underway, Gilead also gave away the drug on a case-by-case basis to thousands of patients.

Some criticized releasing those results rather than continuing the study to see if the drug could improve survival and to learn more about when and how to use it, but independent monitors had advised that it was no longer ethical to continue with a placebo group as soon as a benefit was apparent.

Until that study, the only other big, rigorous test of a coronavirus treatment was from China.

As that country rushed to build field hospitals to deal with the medical crisis, doctors randomly assigned COVID-19 patients to get either two HIV antiviral drugs or the usual care and quickly published results in the New England Journal of Medicine.

For decades, lidocaine was routinely used to prevent heart rhythm problems in people suspected of having heart attacks until a study in the mid-1980s showed the drug actually caused the problem it was meant to prevent, he said

The drug later gave disappointing results in a rigorous study and ultimately was approved merely for less serious cases of flu and not severely ill hospitalized patients