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Clinical characteristics and predictors of the duration of hospital stay in COVID-19 patients in Jordan

Alqassieh et al., F1000Research, doi:10.12688/f1000research.27419.1
Dec 2020  
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Hospitalization time 18% Improvement Relative Risk HCQ for COVID-19  Alqassieh et al.  LATE TREATMENT Is late treatment with HCQ beneficial for COVID-19? Prospective study of 131 patients in Jordan Shorter hospitalization with HCQ (not stat. sig., p=0.11) c19hcq.org Alqassieh et al., F1000Research, December 2020 FavorsHCQ Favorscontrol 0 0.5 1 1.5 2+
HCQ for COVID-19
1st treatment shown to reduce risk in March 2020
 
*, now with p < 0.00000000001 from 411 studies, recognized in 46 countries.
No treatment is 100% effective. Protocols combine treatments. * >10% efficacy, ≥3 studies.
4,300+ studies for 75 treatments. c19hcq.org
Prospective observational study of 131 COVID-19 patients in Jordan, showing 18% shorter hospital stay with HCQ, p = 0.11.
hospitalization time, 18.2% lower, relative time 0.82, p = 0.11, treatment 63, control 68.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Alqassieh et al., 10 Dec 2020, prospective, Jordan, preprint, 10 authors.
This PaperHCQAll
Clinical characteristics and predictors of the duration of hospital stay in COVID-19 patients in Jordan
Rami S Alqassieh, Isam K Bsisu, Mohammed Qussay Al-Sabbagh, Naser M El-Hammuri, Moh’d A Yousef, Mohammad A El Jarbeh, Ahmed A Sharqawi, Heba Z Smadi, Sami A Abu-Halaweh, Mohammad M Abufaraj
F1000Research, doi:10.12688/f1000research.27419.1
Background: On March 11th, 2020, the World Health Organization (WHO) declared coronavirus disease 2019 (COVID-19) as a global pandemic. Healthcare systems in low-and middle-income countries may face serious limitations during a pandemic, for which understanding the predictors of prolonged hospital stay are crucial in decreasing the mortality rate. The aim of this study was to investigate the predictors of increased length of hospitalization among COVID-19 patients. Methods: In this prospective study, we investigated the effect of presenting symptoms and laboratory investigations on the duration of hospitalization of 131 COVID-19 patients at a tertiary hospital in Jordan from March 17th to April 9th, 2020. Results: Patients median age was 24 years [interquartile range (IQR): 8-39], of which 67 (51.15%) were males and 64 (48.85%) were females. Smokers had shorter in-hospital stay (OR: -3.52; 95% CI: -6.73 to -0.32; P=0.03). Taste loss (OR: 5.1; 95% CI: 1.95 to 8.25; P<0.01) and chills or rigors (OR: 4.08; 95% CI: 0.73 to 7.43; P=0.02) were the symptoms significantly associated with increased in-hospital stay, while those who had malaise (OR: -4.98; 95% CI: -8.42 to -1.59; P<0.01) and high white blood cell (WBC) count (OR: -0.74; 95% CI: -1.31 to -0.17; P=0.01) had faster recovery. Conclusions: Our study found that the most common presenting Open Peer Review Reviewer Status
References
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'article-title': 'The SARS, MERS and novel coronavirus (COVID-19) epidemics, the newest ' 'and biggest global health threats: what lessons have we learned?', 'volume': '49', 'author': 'N Peeri', 'year': '2020', 'journal-title': 'Int J Epidemiol.'}, { 'key': 'ref-31', 'doi-asserted-by': 'publisher', 'first-page': '1054-62', 'DOI': '10.1016/S0140-6736(20)30566-3', 'article-title': 'Clinical course and risk factors for mortality of adult inpatients with ' 'COVID-19 in Wuhan, China: a retrospective cohort study.', 'volume': '395', 'author': 'F Zhou', 'year': '2020', 'journal-title': 'Lancet.'}, { 'key': 'ref-32', 'doi-asserted-by': 'publisher', 'first-page': '1324-1329', 'DOI': '10.1111/jth.14859', 'article-title': 'D-dimer levels on admission to predict in-hospital mortality in ' 'patients with Covid-19.', 'volume': '18', 'author': 'L Zhang', 'year': '2020', 'journal-title': 'J Thromb Haemost.'}, { 'key': 'ref-33', 'doi-asserted-by': 'publisher', 'first-page': 'e480', 'DOI': '10.1016/S2214-109X(20)30068-1', 'article-title': 'Potential association between COVID-19 mortality and health-care ' 'resource availability.', 'volume': '8', 'author': 'Y Ji', 'year': '2020', 'journal-title': 'Lancet Glob Health.'}], 'container-title': 'F1000Research', 'original-title': [], 'language': 'en', 'link': [ { 'URL': 'https://f1000research.com/articles/9-1439/v1/xml', 'content-type': 'application/xml', 'content-version': 'vor', 'intended-application': 'text-mining'}, { 'URL': 'https://f1000research.com/articles/9-1439/v1/pdf', 'content-type': 'application/pdf', 'content-version': 'vor', 'intended-application': 'text-mining'}, { 'URL': 'https://f1000research.com/articles/9-1439/v1/iparadigms', 'content-type': 'unspecified', 'content-version': 'vor', 'intended-application': 'similarity-checking'}], 'deposited': { 'date-parts': [[2021, 6, 11]], 'date-time': '2021-06-11T10:40:29Z', 'timestamp': 1623408029000}, 'score': 1, 'resource': {'primary': {'URL': 'https://f1000research.com/articles/9-1439/v1'}}, 'subtitle': [], 'short-title': [], 'issued': {'date-parts': [[2020, 12, 10]]}, 'references-count': 33, 'URL': 'http://dx.doi.org/10.12688/f1000research.27419.1', 'relation': { 'has-review': [ { 'id-type': 'doi', 'id': '10.5256/f1000research.30300.r85534', 'asserted-by': 'subject'}, { 'id-type': 'doi', 'id': '10.5256/f1000research.30300.r86710', 'asserted-by': 'subject'}]}, 'ISSN': ['2046-1402'], 'subject': [], 'container-title-short': 'F1000Res', 'published': {'date-parts': [[2020, 12, 10]]}, 'assertion': [ { 'value': 'Not Approved, Approved with reservations', 'URL': 'https://f1000research.com/articles/9-1439/v1#article-reports', 'order': 0, 'name': 'referee-status', 'label': 'Referee status', 'group': {'name': 'current-referee-status', 'label': 'Current Referee Status'}}, { 'value': '10.5256/f1000research.30300.r85534, Denise Battaglini, Anesthesia and Intensive ' 'Care, San Martino Policlinico Hospital, Genoa, Italy, 02 Jun 2021, version 1, 1 ' 'approved with reservations, 1 not approved', 'URL': 'https://f1000research.com/articles/9-1439/v1#referee-response-85534', 'order': 0, 'name': 'referee-response-85534', 'label': 'Referee Report', 'group': {'name': 'article-reports', 'label': 'Article Reports'}}, { 'value': '<b>Isam Bsisu</b>; \n' '<i>Posted: 02 Jun 2021</i>; We would like to thank Dr.&nbsp;Denise Battaglini ' 'for his valuable review, which will enable us to improve the quality of our ' 'manuscript.&nbsp; \u200b\u200b\u200b\u200b\u200b\u200bThis study included data ' 'collected at the beginning of the pandemic in Jordan, during which&nbsp;all ' 'patients diagnosed with COVID-19 were admitted to hospital during the study’s ' 'timeframe. We agree with the reviewer that the aforementioned laboratory ' 'investigations and interventions are important in determining the clinical ' 'course, and could&nbsp;have been predictors of hospital stay. Due&nbsp;to the ' 'limited number of cases at that time, we were unable to compare between cases ' 'in terms of outcomes and ICU admission. For instance, there were only 7 ' 'mortality cases related to COVID-19 in the whole country on the last day of ' 'patients recruitment, April 9th, 2020. Moreover, this prospective study only ' 'documented the laboratory investigations performed at that time, which were ' "done based on their indication and patient's clinical scenario.&nbsp; The " 'scientific knowledge and clinical practice is dynamically changing during ' 'COVID-19 pandemic, and so does the indicated investigations, the guidelines for ' 'medical management, and post discharge medical care for cured patients. We ' 'understand that this study was conducted and published prior to the two peaks ' 'in Jordan. However, it provided unique data in which we can understand the ' 'predictors of hospital stay based on one of the most important steps in the ' 'clinical practice of any physician, which is history taking and clinical ' 'examination. In addition, simple laboratory values can be of great benefit as a ' 'predictor. Future studies including patients from the whole country during the ' 'two peaks can be conducted (as we will recommend in our discussion section in ' 'the updated version 2), and it will surely be of great benefit in understanding ' 'the clinical course of the disease and its effect on the hospital stay and ' 'clinical outcome.&nbsp; \u200b', 'URL': 'https://f1000research.com/articles/9-1439/v1#referee-comment-6752', 'order': 1, 'name': 'referee-comment-6752', 'label': 'Referee Comment', 'group': {'name': 'article-reports', 'label': 'Article Reports'}}, { 'value': '10.5256/f1000research.30300.r86710, Omar Soliman Mohamed El-Masry, Department ' 'of Clinical Laboratory Sciences, College of Applied Medical Sciences, Imam ' 'Abdulrahman Bin Faisal University, Dammam, Saudi Arabia, 11 Jun 2021, version ' '1, 1 approved with reservations, 1 not approved', 'URL': 'https://f1000research.com/articles/9-1439/v1#referee-response-86710', 'order': 2, 'name': 'referee-response-86710', 'label': 'Referee Report', 'group': {'name': 'article-reports', 'label': 'Article Reports'}}, { 'value': 'The author(s) declared that no grants were involved in supporting this work', 'order': 3, 'name': 'grant-information', 'label': 'Grant Information'}, { 'value': 'This is an open access article distributed under the terms of the Creative ' 'Commons Attribution Licence, which permits unrestricted use, distribution, and ' 'reproduction in any medium, provided the original work is properly cited.', 'order': 0, 'name': 'copyright-info', 'label': 'Copyright'}]}
Late treatment
is less effective
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