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0 0.5 1 1.5 2+ ICU admission 77% Improvement Relative Risk HCQ for COVID-19  Güner et al.  LATE TREATMENT Is late treatment with HCQ beneficial for COVID-19? Retrospective 704 patients in Turkey Lower ICU admission with HCQ (not stat. sig., p=0.16) Güner et al., J. Infection and Public .., Dec 2020 Favors HCQ Favors control

Comparing ICU Admission Rates of Mild/Moderate COVID-19 Patients Treated with Hydroxychloroquine, Favipiravir, and Hydroxychloroquine plus Favipiravir

Güner et al., Journal of Infection and Public Health, doi:10.1016/j.jiph.2020.12.017
Dec 2020  
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HCQ for COVID-19
1st treatment shown to reduce risk in March 2020
*, now known with p < 0.00000000001 from 421 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.
3,800+ studies for 60+ treatments.
Retrospective 824 hospitalized patients in Turkey showing lower ICU admission for HCQ vs. favipiravir.
risk of ICU admission, 77.3% lower, RR 0.23, p = 0.16, treatment 604, control 100, inverted to make RR<1 favor treatment, IPTW multivariate analysis, HCQ vs. favipiravir.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Güner et al., 29 Dec 2020, retrospective, Turkey, peer-reviewed, 23 authors.
This PaperHCQAll
Comparing ICU admission rates of mild/moderate COVID-19 patients treated with hydroxychloroquine, favipiravir, and hydroxychloroquine plus favipiravir
Rahmet Guner, Imran Hasanoglu, Bircan Kayaaslan, Adalet Aypak, Esragul Akinci, Hurrem Bodur, Fatma Eser, Ayse Kaya Kalem, Orhan Kucuksahin, Ihsan Ates, Aliye Bastug, Yasemin Tezer Tekce, Zeynep Bilgic, Fahriye Melis Gursoy, Hatice Nisa Akca, Seval Izdes, Deniz Erdem, Emra Asfuroglu, Habibe Hezer, Hatice Kilic, Musa Cıvak, Sibel Aydogan, Turan Buzgan
Journal of Infection and Public Health, doi:10.1016/j.jiph.2020.12.017
Background: In this study, we aimed to compare the intensive care unit (ICU) admission rate of hospitalized mild/moderate COVID-19 patients treated with hydroxychloroquine (HCQ), favipiravir, and HCQ plus favipiravir. Methods: Single center retrospective designed observational study conducted in Ankara City Hospital. Patients who were hospitalized between March 15, 2020 and June 1, 2020 in COVID-19 inpatient clinics with laboratory confirmed diagnosis of COVID-19 were included in the study. An inverse probability of treatment weighting (IPTW) for multiple treatment groups approach was used to balance the differences in several variables on admission. Results: Among 2441 patients hospitalized with diagnosis of COVID-19 during the study period, 824 were eligible for the analysis. Median age of patients was 42 (18−93 years). Among all, 347 (43.2%) of the patients had mild disease, 470 (56.8%) had pneumonia. Propensity scores ranged from 0.1841 to 0.9381 in the HCQ group, from 0.03643 to 0.29885 in the favipiravir group, and from 0.03542 to 0.56184 in the HCQ plus favipiravir group. After IPTW for multiple treatment groups was applied, all the covariates in the planned propensity score had weighted standardized effect sizes below 10% which were ranged from 0.005 to 0.092. Multivariate analysis of treatment effect (adjusted effect of treatment) was indicated that there is no statistically significant difference between HCQ, favipiravir, and HCQ plus favipiravir treatment. After using combination of SMOTE and Bootstrap resampling approach, we found no statistically significant difference between HCQ and HCQ plus favipiravir groups in terms of ICU admission. However, compared with the HCQ group, ICU admission rate was statistically significantly higher in the favipiravir group. We obtained the similar results after the sensitivity analysis.
Author contributions Concept and design of the study: RG, IH, BK, EA, AKK, FE. Data collection: IH, BK, AA, AKK, FE, OK, YTT, ZB, FMG, HNA. Data analysis: RG, IH, IA, AB, BC, S İ, DE, SA, MC, HB. Interpretation of the data: RG, IH, BK, EA, HH, HK, OK, FE. Drafting the manuscript: RG, IH, TB, BK. Critical revision of the manuscript: IH, BK, AA, EA, SI, DE. All authors approved the final version of the manuscript. Ethical approval The study was approved by the Turkish Ministry of Health and ethics board of Ankara City Hospital (No: E1-20-764). Conflict of interest None to declare.
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Yee, VGAM: Vector Generalized Linear and Additive Models
Late treatment
is less effective
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