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All Studies   Meta Analysis   Recent:  
0 0.5 1 1.5 2+ Mortality 26% Improvement Relative Risk Mortality, early 2020 28% Mortality, late 2020 -10% HCQ for COVID-19  Delgado et al.  LATE TREATMENT Is late treatment with HCQ beneficial for COVID-19? Retrospective 9,638 patients in the USA (March - December 2020) Lower mortality with HCQ (p=0.0025) Delgado et al., Research Square, February 2023 Favors HCQ Favors control

Investigational medications in 9,638 hospitalized patients with severe COVID-19: lessons from the “fail-and-learn” strategy during the first two waves of the pandemic in 2020

Delgado et al., Research Square, doi:10.21203/
Feb 2023  
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PSM retrospective 9,638 patients in the USA, showing significantly lower mortality with HCQ in early 2020 (1,157 HCQ patients), and no significant difference in late 2020 (82 HCQ patients). The few patients treated in the later period may be in more serious condition due to the effort required to overcome the politicization and censorship in the study country. Authors refer to their result as "no relevant benefit in mortality between the two surges".
risk of death, 26.0% lower, OR 0.74, p = 0.002, treatment 1,239, control 8,399, both periods combined, RR approximated with OR.
risk of death, 28.0% lower, OR 0.72, p = 0.001, treatment 1,157, control 2,064, early 2020, propensity score matching, RR approximated with OR.
risk of death, 10.0% higher, OR 1.10, p = 0.82, treatment 82, control 6,335, late 2020, propensity score matching, RR approximated with OR.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Delgado et al., 20 Feb 2023, retrospective, USA, preprint, 7 authors, study period 1 March, 2020 - 31 December, 2020.
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Investigational medications in 9,638 hospitalized patients with severe COVID-19: lessons from the “fail-and-learn” strategy during the first two waves of the pandemic in 2020
Adam C Delgado, Brendon Cornett, Ye Ji Choi, Christina Colosimo, Vincent P Stahel, Oliwier Dziadkowiec, Philip F Stahel
Background: The early surge of the novel coronavirus disease 2019 (COVID-19) pandemic introduced a signi cant clinical challenge due to the high case-fatality rate in absence of evidence-based treatment recommendations. The empirical modalities were relegated to historical expertise from the traditional management of acute respiratory distress syndrome (ARDS) in conjunction with off-label pharmaceutical agents endorsed under the "emergency use authorization" paradigm by regulatory agencies. This study was designed to evaluate the insights from the "fail-and-learn" strategy in 2020 before the availability of COVID-19 vaccines and access to reliable insights from high-quality randomized controlled trials. Methods: A retrospective, multicenter, propensity-matched, case-control study was performed on a data registry comprising 186 hospitals from a national health care system in the United States, designed to investigate the e cacy of empirical treatment modalities during the early surge of the COVID-19 pandemic in 2020. Re ective of the time-windows of the initial two surges of the pandemic in 2020, patients were strati ed into "early" (March 1-June 30) versus "late" (July 1-December 31) study cohorts. Logistic regression was applied to determine the e cacy of prevalent medications (remdesivir, azithromycin, hydroxychloroquine, corticosteroids, tocilizumab) and supplemental oxygen delivery modalities (invasive vs. non-invasive ventilation) on patient outcomes. The primary outcome measure was in-hospital mortality. Group comparisons were adjusted for covariates related to age, gender, ethnicity, body weight, comorbidities, and treatment modalities pertinent to organ failure replacement. Results: From a total of 87,788 patients in the multicenter data registry screened in this study, 9,638 patients were included who received 19,763 COVID-19 medications during the rst two waves of the 2020 pandemic.The results showed inconclusive variable results pertinent to the impact of empirical medications on patient outcomes. In contrast, the necessity for oxygen supply showed signi cantly increased odds of mortality beyond the effect of the investigational medications. Of all the covariates associated with increased mortality, invasive mechanical ventilation had the highest odds ratios of 8.34 in the rst surge and 9.46 in in the second surge of the pandemic (P<0.01). Conclusion: This retrospective multicenter observational cohort study on 9,638 hospitalized patients with severe COVID-19 during revealed that the necessity for invasive ventilation had the highest odds of mortality, beyond the variable effects observed by administration of the prevalent EUA-approved investigational drugs during the rst two surges of the early 2020 pandemic in the United States.
Authors' contributions: PFS, OD, and BC designed the study. CC wrote the IRB application and the data request from the multicenter registry. BC provided the statistical analysis. All authors assisted with analysis and interpretation of the data. ACD wrote the rst draft of the manuscript. PFS and VPS wrote the nal version of the manuscript. VPS formatted the tables and gures and assisted with a literature search and writing of the discussion. All authors read and approved the nal version of the manuscript prior to submission. Competing interests: The senior author (PFS) is employed by HCA Healthcare. The views expressed in this editorial exclusively represent the authors' personal perspective and do not necessarily represent o cial views of HCA Healthcare or any of its a liated entities. PFS is the Editor-in-Chief of the journal ( and attests that he was not involved in the peer-review process or editorial management and decision-making related to this submission. The authors declare no other con icts of interest related to this study.
Afzali, Noris, Lambrecht, Kemper, The state of complement in COVID-19, Nat Rev Immunol
Ayerbe, Risco-Risco, Forgnone, Perez-Pinar, Ayis, Azithromycin in patients with COVID-19: a systematic review and meta-analysis, J Antimicrob Chemother
Aziz, Haghbin, Sitta, E cacy of tocilizumab in COVID-19: A systematic review and meta-analysis, J Med Virol
Barbash, Davis, Minturn, Kahn, Adoption and deadoption of medications to treat hospitalized patients with COVID-19, Crit Care Explor
Bose, Adapa, Aeddula, Medical management of COVID-19: Evidence and experience, J Clin Med Res
Climente-Marti, Ruiz-Millo, Lopez-Cruz, Impact of intermediate to high doses of methylprednisolone on mortality rate in patients with COVID-19 pneumonia-induced severe systemic in ammation, Int J Clin Pract
Coomes, Haghbayan, Interleukin-6 in Covid-19: A systematic review and meta-analysis, Rev Med Virol
Dequin, Heming, Meziani, Effect of hydrocortisone on 21-day mortality or respiratory support among critically ill patients with COVID-19: A randomized clinical trial, JAMA
Docea, Tsatsakis, Albulescu, A new threat from an old enemy: Re-emergence of coronavirus, Int J Mol Med
Elshaboury, Monk, Bebell, Remdesivir use and outcomes during the FDA COVID-19 emergency use authorization period, Ther Adv Infect Dis
Eze, Mezue, Nduka, Obianyo, Egbuche, E cacy and safety of chloroquine and hydroxychloroquine for treatment of COVID-19 patientsa systematic review and meta-analysis of randomized controlled trials, Am J Cardiovasc Dis
Farzan, Vahabi, Ghomi, Evaluation of invasive ventilation (intubation) prognosis in patients with Covid-19 symptoms, Int J Surg Open
Firstenberg, Stahel, Hanna, Kotaru, Crossno et al., Successful COVID-19 rescue therapy by extra-corporeal membrane oxygenation (ECMO) for respiratory failure: a case report, Patient Saf Surg
Garcia-Albeniz, Amo, Polo, Morales-Asencio, Hernan, Systematic review and meta-analysis of randomized trials of hydroxychloroquine for the prevention of COVID-19, Eur J Epidemiol
Gordon, Mouncey, Al-Beidh, Interleukin-6 Receptor Antagonists in Critically Ill Patients with Covid-19, N Engl J Med
Group, Horby, Lim, Dexamethasone in hospitalized patients with Covid-19, N Engl J Med
Henry, Vikse, Benoit, Favaloro, Lippi, Hyperin ammation and derangement of renin-angiotensin-aldosterone system in COVID-19: A novel hypothesis for clinically suspected hypercoagulopathy and microvascular immunothrombosis, Clin Chim Acta
Hermine, Porcher, Effect of interleukin-6 receptor antagonists in critically ill adult patients with COVID-19 pneumonia: two randomised controlled trials of the CORIMUNO-19 Collaborative Group, Eur Respir J
Holshue, Debolt, Lindquist, Lofy, Wiesman et al., First case of 2019 novel coronavirus in the United States, N Engl J Med
Horby, Lim, Emberson, Dexamethasone in hospitalized patients with Covid-19, N Engl J Med
Humeniuk, Mathias, Cao, Safety, tolerability, and pharmacokinetics of remdesivir, an antiviral for treatment of COVID-19, in healthy subjects, Clin Transl Sci
Infante, Ricordi, Caprio, Fabbri, Hydroxychloroquine in the COVID-19 pandemic era: in pursuit of a rational use for prophylaxis of SARS-CoV-2 infection, Expert Rev Anti Infect Ther
Jacobs, Stammers, Louis, Multi-institutional analysis of 200 COVID-19 patients treated with extracorporeal membrane oxygenation: Outcomes and trends, Ann Thorac Surg
Kato, Kurzrock, Repurposing interleukin-6 inhibitors to combat COVID-19, J Immunother Precis Oncol
Khan, Siddique, Shereen, Emergence of a novel coronavirus, severe acute respiratory syndrome coronavirus 2: Biology and therapeutic options, J. Clin. Microbiol
Ma, Gu, Zhao, Liu, Dong et al., A promising antiviral candidate drug for the COVID-19 pandemic: A mini-review of remdesivir, Crit Rev Immunol
Mahmudpour, Roozbeh, Keshavarz, Farrokhi, Nabipour, COVID-19 cytokine storm: The anger of in ammation, Cytokine
Malik, Gupta, Zhong, Rasmussen, Manautou et al., Emerging therapeutic modalities against COVID-19, Pharmaceuticals
Mastaglio, Ruggeri, Risitano, The rst case of COVID-19 treated with the complement C3 inhibitor AMY-101, Clin Immunol
Mcfee, COVID-19: Therapeutics and interventions currently under consideration, Dis Mon
Mehta, Purpura, Mcconville, What about tocilizumab? A retrospective study from a NYC Hospital during the COVID-19 outbreak, PLoS ONE
Michot, Albiges, Chaput, Tocilizumab, an anti-IL-6 receptor antibody, to treat COVID-19-related respiratory failure: a case report, Ann Oncol
Mina, Newton, Hadda, Noninvasive ventilation in treatment of respiratory failure-related COVID-19 infection: Review of the literature, Can Respir J
Moraes, Marra, Matos, Hydroxychloroquine for treatment of COVID-19 patients: a systematic review and meta-analysis of randomized controlled trials, Einstein
Ponthieux, Dauby, Maillart, Tocilizumab-induced unexpected increase of several in ammatory cytokines in critically ill COVID-19 patients: The anti-in ammatory side of IL-6, Viral Immunol
Putman, Chock, Tam, Antirheumatic disease therapies for the treatment of COVID-19: A systematic review and meta-analysis, Arthritis Rheumatol
Raju, Biatris, Therapeutic role of corticosteroids in COVID-19: a systematic review of registered clinical trials, Fut J Pharm Sci
Rosas, Brau, Waters, Tocilizumab in Hospitalized Patients with Severe Covid-19 Pneumonia, N Engl J Med
Sellitto, Corbi, Bertini, Effect of remdesivir on mortality rate and clinical status of COVID-19 patients: a systematic review with metaanalysis, J. Chemother
Stahel, Barnum, Complement inhibition in coronavirus disease (COVID)-19: A neglected therapeutic option, Front Immunol
Stahel, How to risk-stratify elective surgery during the COVID-19 pandemic?, Patient Saf Surg
Tobin, Laghi, Jubran, Caution about early intubation and mechanical ventilation in COVID-19, Ann Intensive Care
Tomazini, Maia, Cavalcanti, Effect of dexamethasone on days alive and ventilator-free in patients with moderate or severe acute respiratory distress syndrome and COVID-19: The CoDEX randomized clinical trial, JAMA
Valenzuela, Ibanez, Poli, First Report of Tocilizumab Use in a Cohort of Latin American Patients Hospitalized for Severe COVID-19 Pneumonia, Front Med
Van Rensburg, Lorente, Decloedt, Current evidence for directed and supportive investigational therapies against COVID-19, Afr J Thorac Crit Care Med
Wilder-Smith, Freedman, Isolation, quarantine, social distancing and community containment: pivotal role for old-style public health measures in the novel coronavirus (2019-nCoV) outbreak, J Travel Med
Wohl, Espinueva, Dau, COVID-19 therapies for inpatients: a review and quality assessment of clinical guidelines, ERJ Open Res
Wu, Mcgoogan, Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in China: Summary of a report of 72 314 cases from the Chinese Center for Disease Control and Prevention, JAMA
Late treatment
is less effective
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