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The study's author(s) claim no funding was received. They are getting smarter - they usually list the pharmas.
They get around to admitting how much they guessed, assumed, estimated etc. For example they're somewhat puzzled as to how accurte their data is because they didn't have good data on comorbidities. Recall people were being coded as having died from Covid when they actually died from cancer - so add in those people who had died of cancer and had taken HCQ. This study means nothing. But, it will be regarded as authoritative....
https://www.sciencedirect.com/science/article/pii/S075333222301853X#sec0075
"Our study has some limitations. First, some of the results should be taken with caution, particularly the results obtained in France, Turkey and Belgium. For these countries, data concerning HCQ exposure were scarce. As a result, estimates in these countries are more imprecise. Unfortunately, due to the lack of political determination to assess the effect of off-label prescriptions during the COVID-19 crisis, it is unlikely that additional large-scale data will be generated from these countries. Second, the data used were extracted directly from cohort studies. However, a practice study carried out in France showed that HCQ prescription was highly heterogeneous and largely influenced by several factors, the most important being the presence of an established departmental procedure supporting its prescription [95]. Taken together, these results suggest a strong centre effect based, which may have biased the true HCQ exposure. Unfortunately, hospital databases were not available to precisely determine the true HCQ exposure in deceased patients with COVID-19. Third, we estimated the mortality of hospitalised patients using data from published cohorts. Similarly, mortality rates significantly varied across hospitals and regions, which may have been influenced by variable age, sex, comorbidities, ICU capacity, improvement in COVID-19 management, and trust of the population in the national health system and pandemic-related policies [96], [97], [98]. This is supported by our sensitivity analysis using national surveillance data from Spain and USA. However, the relative effect of HCQ exposure on outcomes was not modified. Fourth, we did not use all sources of uncertainties related to variables included in the models. We only included variables related to the HCQ treatment effect. Thus, HCQ-related deaths may be considerably over- or under-estimated. Indeed, the 95% confidence interval of the OR of all-cause mortality related to HCQ ranged from 2% to 20%. In other words, our results might be overestimated by a factor 5 (i.e. the actual number of deaths related to HCQ would be ≈3000 deaths) or underestimated by a factor 2 (i.e. the actual number of deaths related to HCQ would be ≈30000 deaths). Thus, the effect of HCQ on mortality was the main source of uncertainty for the proposed estimates. Finally, some estimates could not be calculated due to missing or incomplete information, such as the number of hospitalisations in China, South Korea, Russia and Qatar. The number of deaths related to HCQ worldwide was obviously underestimated because of the lack of studies in regions, such as East Europe, United Kingdom, Germany, Scandinavia, Africa, and South America. Since the number of inhabitants living in the countries included in the present study was ≈ 600 million, we might speculate that the real number of HCQ-induced deaths might be significantly higher given the wide use of HCQ during the first and subsequent waves in numerous countries [85], [99], [100]. In addition, the number of deceased outpatients exposed to HCQ is unknown. Accordingly, the present results should be viewed as rough estimates only.
In conclusion, the number of HCQ-related deaths is estimated at 16990, even though this number is probably underestimated because of the lack of data from most countries. More importantly, this study illustrates the limitations of treatment-effect extrapolation from chronic to severe conditions without accurate data and the need to produce quickly high-level evidence from RCTs in case of emergent diseases."