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.,
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
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.
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Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
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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.
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
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© 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.
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