COVID-19 Outpatients – Early Risk-Stratified Treatment with Zinc Plus Low Dose Hydroxychloroquine and Azithromycin: A Retrospective Case Series Study
Derwand et al.,
COVID-19 Outpatients – Early Risk-Stratified Treatment with Zinc Plus Low Dose Hydroxychloroquine and..,
International Journal of Antimicrobial Agents, doi:10.1016/j.ijantimicag.2020.106214 (date from earlier preprint)
79% lower mortality and 82% lower hospitalization with early HCQ+AZ+Z. No cardiac side effects. Retrospective 518 patients (141 treated, 377 control).
risk of death, 79.4% lower, RR 0.21, p = 0.12, treatment 1 of 141 (0.7%), control 13 of 377 (3.4%), NNT 37, odds ratio converted to relative risk.
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risk of hospitalization, 81.6% lower, RR 0.18, p < 0.001, treatment 4 of 141 (2.8%), control 58 of 377 (15.4%), NNT 8.0, odds ratio converted to relative risk.
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Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
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Derwand et al., 3 Jul 2020, retrospective, USA, peer-reviewed, 3 authors, average treatment delay 4.0 days, dosage 200mg bid days 1-5, this trial uses multiple treatments in the treatment arm (combined with AZ and zinc) - results of individual treatments may vary.
Abstract: International Journal of Antimicrobial Agents 56 (2020) 106214
Contents lists available at ScienceDirect
International Journal of Antimicrobial Agents
journal homepage: www.elsevier.com/locate/ijantimicag
COVID-19 outpatients: early risk-stratified treatment with zinc plus
low-dose hydroxychloroquine and azithromycin: a retrospective case
series study
Roland Derwand a,1, Martin Scholz b,1,∗, Vladimir Zelenko c
a
b
c
Alexion Pharma Germany GmbH, 80687, Munich, Germany
Heinrich-Heine-University, Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany
Medical Group Practice, Monroe, NY, 10950, USA
a r t i c l e
Keywords:
SARS-CoV-2
COVID-19
Outpatients
Zinc
Hydroxychloroquine
Azithromycin
i n f o
a b s t r a c t
The aim of this study was to describe the outcomes of patients with coronavirus disease 2019 (COVID-19)
in the outpatient setting after early treatment with zinc, low-dose hydroxychloroquine and azithromycin
(triple therapy) dependent on risk stratification. This was a retrospective case series study in the general practice setting. A total of 141 COVID-19 patients with laboratory-confirmed severe acute respiratory
syndrome coronavirus 2 (SARS-CoV-2) infection in the year 2020 were included. The main outcome measures were risk-stratified treatment decision and rates of hospitalisation and all-cause death. A median of
4 days [interquartile range (IQR) 3–6 days; available for n = 66/141 patients] after the onset of symptoms,
141 patients (median age 58 years, IQR 40–67 years; 73.0% male) received a prescription for triple therapy
for 5 days. Independent public reference data from 377 confirmed COVID-19 patients in the same community were used as untreated controls. Of 141 treated patients, 4 (2.8%) were hospitalised, which was significantly fewer (P < 0.001) compared with 58 (15.4%) of 377 untreated patients [odds ratio (OR) = 0.16,
95% confidence interval (CI) 0.06–0.5]. One patient (0.7%) in the treatment group died versus 13 patients
(3.4%) in the untreated group (OR = 0.2, 95% CI 0.03–1.5; P = 0.12). No cardiac side effects were observed.
Risk stratification-based treatment of COVID-19 outpatients as early as possible after symptom onset using triple therapy, including the combination of zinc with low-dose hydroxychloroquine, was associated
with significantly fewer hospitalisations.
© 2020 The Author(s). Published by Elsevier Ltd.
This is an open access article under the CC BY-NC-ND license
(http://creativecommons.org/licenses/by-nc-nd/4.0/)
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