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0 0.5 1 1.5 2+ Mortality -19% Improvement Relative Risk Ventilation -461% ICU admission -463% HCQ for COVID-19  Awad et al.  LATE TREATMENT Is late treatment with HCQ beneficial for COVID-19? Retrospective 336 patients in the USA Higher ventilation (p<0.0001) and ICU admission (p<0.0001) Awad et al., American J. Health-System.., Feb 2021 Favors HCQ Favors control

Impact of hydroxychloroquine on disease progression and ICU admissions in patients with SARS-CoV-2 infection

Awad et al., American Journal of Health-System Pharmacy, doi:10.1093/ajhp/zxab056
Feb 2021  
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HCQ for COVID-19
1st treatment shown to reduce risk in March 2020
*, now known with p < 0.00000000001 from 422 studies, recognized in 42 countries.
No treatment is 100% effective. Protocols combine complementary and synergistic treatments. * >10% efficacy in meta analysis with ≥3 clinical studies.
4,000+ studies for 60+ treatments.
This paper has inconsistent values - the number of treatment and control patients differs in the text and Table 1, we have used treatment 188 and control 148. Retrospective 336 hospitalized patients in the USA showing higher mortality, ICU admission, and intubation with treatment. Confounding by indication is likely. Time varying confounding is also likely due to declining usage over the early period when overall treatment protocols were also improving dramatically. Authors and reviewers appear to be unfamiliar with either of these.
This study is excluded in the after exclusion results of meta analysis: substantial confounding by time likely due to declining usage over the early stages of the pandemic when overall treatment protocols improved dramatically; substantial unadjusted confounding by indication likely.
risk of death, 19.1% higher, RR 1.19, p = 0.60, treatment 56 of 188 (29.8%), control 37 of 148 (25.0%).
risk of mechanical ventilation, 460.7% higher, RR 5.61, p < 0.001, treatment 64 of 188 (34.0%), control 9 of 148 (6.1%), adjusted per study, odds ratio converted to relative risk.
risk of ICU admission, 463.4% higher, RR 5.63, p < 0.001, treatment 67 of 188 (35.6%), control 9 of 148 (6.1%), adjusted per study, odds ratio converted to relative risk.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Awad et al., 18 Feb 2021, retrospective, USA, peer-reviewed, 4 authors.
This PaperHCQAll
Impact of hydroxychloroquine on disease progression and ICU admissions in patients with SARS-CoV-2 infection
PharmD, BCPS Nirvana Awad, PharmD, FASHP Daryl S Schiller, PharmD, BCPS Magda Fulman, MD Azfar Chak
American Journal of Health-System Pharmacy, doi:10.1093/ajhp/zxab056
Purpose. To evaluate whether use of hydroxychloroquine was associated with a reduced likelihood of intensive care unit (ICU) admission in patients with coronavirus disease 2019 (COVID-19) in the early weeks of the pandemic. Methods. A retrospective, observational cohort study was conducted to determine selected treatment outcomes in 336 patients hospitalized with COVID-19 at an acute care community hospital in the Hudson Valley region of New York from March 20 to April 20, 2020. Eligibility included admission to the hospital, a laboratory-confirmed diagnosis of SARS-CoV-2 infection, and no need for intubation or intensive care at admission. The median (interquartile range) ages of patients who received hydroxychloroquine (n = 188) and those who did not (n = 148) were 68 (58-82) and 64 (51-73) years, respectively. In a multivariable model that included age, gender, obesity, diabetes, and hydroxychloroquine use, patients who received hydroxychloroquine were significantly more likely than those not treated with the drug to be transferred to an ICU (odds ratio, [OR], 8.1; 95% confidence interval [CI]: 3.8-17) and significantly more likely to be intubated (OR, 7.99; 95% CI, 3.76-16.91); these associations were not influenced by disease severity. In-hospital mortality did not differ significantly with disease severity between those who did and those who did not receive hydroxychloroquine. Conclusion. Hydroxychloroquine use was significantly associated with increased risks of ICU admission and intubation in patients with mild, moderate, and severe symptoms of COVID-19. There were no significant between-group differences in mortality with use vs nonuse of hydroxychloroquine.
Disclosures The authors have declared no potential conflicts of interest. REVIEW & RECERTIFICATION REWARD PROGRAM The Right Course for Your Career Pay $0 for Enrollment and Exam Preparation Resources
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Bhimraj, Morgan, Shumaker, Infectious Diseases Society of America Guidelines on the treatment and management of patients with COVID-19
Chen, Hu, Zhang, Efficacy of hydroxychloroquine in patients with COVID-19: results of a randomized clinical trial. medRxiv, doi:10.1101/2020.03.22.20040758
Downes, Chiotos, Fitzgerald, Rational dosing of hydroxychloroquine for COVID-19, OSF Preprints
Geleris, Sun, Platt, Observational study of hydroxychloroquine in hospitalized patients with COVID-19, N Engl J Med, doi:10.1056/NEJMoa2012410
Giudicessi, Noseworthy, Freidman, Urgent guidance for navigating and circumventing the QTc-prolonging and torsadogenic potential of possible pharmacotherapies for coronavirus disease 19 (COVID-19)
Guan, Ni, Hu, Clinical characteristics of coronavirus disease 2019 in China. Published online, N Engl J Med, doi:10.1056/NEJMMoa2002032
Magagnoli, Narendran, Pereira, Outcomes of hydroxychloroquine usage in United States veterans hospitalized with COVID-19, doi:10.1101/2020.04.16.20065920
Nika, Blachley, Edwards, Are long-term chloroquine or hydroxychloroquine users being checked regularly for toxic maculopathy?, JAMA Ophthalmol
Perinel, Launay, Botelho-Nevers, Towards optimization of hydroxychloroquine dosing in intensive care unit COVID-19 patients, Clin Infect Dis, doi:10.1093/cid/ciaa394
Rosenberg, Dufort, Udo, Association of treatment with hydroxychloroquine or azithromycin with in-hospital mortality in patients with COVID-19 in New York State, JAMA, doi:10.1001/jama.2020.8630
Self, Semler, Leither, Effect of hydroxychloroquine on clinical status at 14 days in hospitalized patients with COVID-19: a randomized clinical trial, Published, doi:10.1101/2020.04.10.20060558
Vincent, Bergeron, Benjannet, Chloroquine is a potent inhibitor of SARS coronavirus infection and spread, Virol J
Whitley, Ball, Statistics review 4: sample size calculations, Critical Care
Yao, Ye, Zhang, In vitro antiviral activity and projection of optimized dosing design of hydroxychloroquine for the treatment of severe acute respiratory syndrome coronavirus 2. Published online March 9, Clin Infect Dis, doi:10.1093/cid/ciaa237
Late treatment
is less effective
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