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0 0.5 1 1.5 2+ Mortality 12% Improvement Relative Risk Mortality (b) 86% Mortality (c) -557% Hospitalization 12% Case -14% c19hcq.org Gentry et al. HCQ for COVID-19 PrEP Is pre-exposure prophylaxis with HCQ beneficial for COVID-19? Retrospective 10,948 patients in the USA (March - September 2020) Study underpowered for serious outcomes Gentry et al., The American J. the Medical Scien.., doi:10.1016/j.amjms.2022.08.006 Favors HCQ Favors control
Development of SARS-CoV-2 infection in patients with rheumatic conditions on hydroxychloroquine monotherapy vs. patients without rheumatic conditions: a retrospective, propensity-matched cohort study
Gentry et al., The American Journal of the Medical Sciences, doi:10.1016/j.amjms.2022.08.006
Gentry et al., Development of SARS-CoV-2 infection in patients with rheumatic conditions on hydroxychloroquine monotherapy.., The American Journal of the Medical Sciences, doi:10.1016/j.amjms.2022.08.006
Sep 2022   Source   PDF  
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Updated version of [Gentry] showing no significant difference in outcomes with HCQ use. The previous version is more informative because authors previously analyzed rheumatic disease patients, while they now compare rheumatic disease patients with non-rheumatic disease patients. Systemic autoimmune disease patients have very different baseline risk for COVID-19, for example Ferri et al. show OR 4.42, p<0.001 [Ferri]. In Table 3, the counts and the odds ratio do not match for ICU admission. 13 variables were statistically significantly different after PSM. There was no inpatient mortality with HCQ, compared to 3 deaths without HCQ. Outpatient deaths may be more likely to be due to other causes, as most COVID-19 patients in the US are hospitalized before death. This study is excluded in meta analysis: patients in this study are a subset of those in a larger study; not adjusting for the different baseline risk of systemic autoimmune patients.
risk of death, 12.0% lower, RR 0.88, p = 0.99, treatment 3 of 41 (7.3%), control 3 of 36 (8.3%), NNT 98, odds ratio converted to relative risk, COVID-19 mortality.
risk of death, 85.7% lower, RR 0.14, p = 0.99, treatment 0 of 6 (0.0%), control 3 of 6 (50.0%), NNT 2.0, relative risk is not 0 because of continuity correction due to zero events (with reciprocal of the contrasting arm), COVID-19 mortality - inpatients.
risk of death, 557.1% higher, RR 6.57, p = 0.99, treatment 3 of 35 (8.6%), control 0 of 30 (0.0%), continuity correction due to zero event (with reciprocal of the contrasting arm), COVID-19 mortality - outpatients.
risk of hospitalization, 12.2% lower, RR 0.88, p = 0.81, treatment 6 of 41 (14.6%), control 6 of 36 (16.7%), NNT 49, COVID-19 hospitalization.
risk of case, 13.9% higher, RR 1.14, p = 0.57, treatment 41 of 5,474 (0.7%), control 36 of 5,474 (0.7%), odds ratio converted to relative risk.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Gentry et al., 11 Sep 2022, retrospective, USA, peer-reviewed, 6 authors, study period 1 March, 2020 - 30 September, 2020.
Contact: chris.gentry@va.gov.
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Abstract: Journal Pre-proof Development of SARS-CoV-2 infection in patients with rheumatic conditions on hydroxychloroquine monotherapy vs. patients without rheumatic conditions: a retrospective, propensity-matched cohort study Chris A. Gentry PharmD, BCPS , Sharanjeet K. Thind MD , Riley J. Williams II PharmD, BCPS , Sage C. Hendrickson PharmD, BCPS , George Kurdgelashvili MD , Mary Beth Humphrey MD, FACP PII: DOI: Reference: S0002-9629(22)00348-2 https://doi.org/10.1016/j.amjms.2022.08.006 AMJMS 1725 To appear in: The American Journal of the Medical Sciences Received date: Accepted date: 2 November 2021 15 August 2022 Please cite this article as: Chris A. Gentry PharmD, BCPS , Sharanjeet K. Thind MD , Riley J. Williams II PharmD, BCPS , Sage C. Hendrickson PharmD, BCPS , George Kurdgelashvili MD , Mary Beth Humphrey MD, FACP , Development of SARS-CoV-2 infection in patients with rheumatic conditions on hydroxychloroquine monotherapy vs. patients without rheumatic conditions: a retrospective, propensity-matched cohort study, The American Journal of the Medical Sciences (2022), doi: https://doi.org/10.1016/j.amjms.2022.08.006 This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. © 2022 Published by Elsevier Inc. on behalf of Southern Society for Clinical Investigation. Original article Title: Development of SARS-CoV-2 infection in patients with rheumatic conditions on hydroxychloroquine monotherapy vs. patients without rheumatic conditions: a retrospective, propensity-matched cohort study Short title: Prevention of SARS-CoV-2 infection with hydroxychloroquine Authors: Chris A. Gentry, PharmD, BCPS, 1 Sharanjeet K. Thind, MD,2 Riley J. Williams II, PharmD, BCPS,1 Sage C. Hendrickson, PharmD, BCPS,1 George Kurdgelashvili, MD,2 Mary Beth Humphrey, MD, FACP.3 1 Pharmacy Service, Oklahoma City Veterans Affairs Healthcare System, 921 Northeast 13th Street (119), Oklahoma City, OK 73104 2 Section of Infectious Diseases, Department of Medicine, University of Oklahoma Health Sciences Center and Section of Infectious Diseases, Medical Service, Oklahoma City Veterans Affairs Healthcare System, 921 Northeast 13th Street (111c), Oklahoma City, OK 73104 3 Section of Rheumatology/Immunology, Department of Medicine, University of Oklahoma Health Sciences Center and Section of Rheumatology/Immunology, Medical Service, Oklahoma City Veterans Affairs Healthcare System, 921 Northeast 13th Street (111c), Oklahoma City, OK 73104 1 Corresponding author: Chris A. Gentry, Pharm.D., BCPS Chief, Pharmacy Service Oklahoma City Veterans Affairs Healthcare System 921 Northeast 13th Street (119) Oklahoma City, Oklahoma 73104 Email: chris.gentry@va.gov Telephone: 405-456-5470 Facsimile: 405-456-5900 Declaration of Interest CAG: None MBH: None SKT: None RJW: None SCH: None GK: None Role of the Funding Source This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. Key words:..
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