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All Studies   Meta Analysis       

Factors Associated With Death in Critically Ill Patients With Coronavirus Disease 2019 in the US

Gupta et al., JAMA Intern. Med., doi:10.1001/jamainternmed.2020.3596
Jul 2020  
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Mortality, HCQ -6% Improvement Relative Risk Mortality, HCQ+AZ 4% HCQ for COVID-19  Gupta et al.  LATE TREATMENT Is late treatment with HCQ beneficial for COVID-19? Retrospective 2,215 patients in the USA No significant difference in mortality c19hcq.org Gupta et al., JAMA Intern. Med., July 2020 FavorsHCQ Favorscontrol 0 0.5 1 1.5 2+
HCQ for COVID-19
1st treatment shown to reduce risk in March 2020, now with p < 0.00000000001 from 419 studies, recognized in 46 countries.
No treatment is 100% effective. Protocols combine treatments.
5,100+ studies for 109 treatments. c19hcq.org
Analysis of 2,215 intensive care unit patients showing no significant differences with this very late stage use of HCQ.
This study is excluded in the after exclusion results of meta analysis: very late stage, >50% on oxygen/ventilation at baseline.
risk of death, 6.3% higher, RR 1.06, p = 0.41, treatment 631 of 1,761 (35.8%), control 153 of 454 (33.7%).
risk of death, 3.7% lower, RR 0.96, p = 0.53, treatment 388 of 1,117 (34.7%), control 396 of 1,098 (36.1%), NNT 75, HCQ+AZ.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Gupta et al., 15 Jul 2020, retrospective, USA, peer-reviewed, baseline oxygen required 87.1%, 34 authors.
This PaperHCQAll
Factors Associated With Death in Critically Ill Patients With Coronavirus Disease 2019 in the US
MD, MPH Shruti Gupta, MD Salim S Hayek, PhD Wei Wang, MD Lili Chan, MSCR Kusum S Mathews, MD, MPH, MSCR Michal L Melamed, MD, MHS Samantha K Brenner, MD, MPH Amanda Leonberg-Yoo, MS Edward J Schenck, MD, MS Jared Radbel, MD Jochen Reiser, PhD Anip Bansal, MD Anand Srivastava, MD, MPH Yan Zhou, MD Anne Sutherland, MD Adam Green, MD, MBA; Alexandre M Shehata, MD Nitender Goyal, MD Anitha Vijayan, Juan Carlos Q Velez, MD, MPH Shahzad Shaefi, MD, PhD Chirag R Parikh, MD Justin Arunthamakun, MBBS Ambarish M Athavale, MD Allon N Friedman, MD Samuel A P Short, BA Zoe A Kibbelaar, Samah Abu Omar, MD, MPH, MSc; Andrew J Admon, PhD John P Donnelly, MD Hayley B Gershengorn, MD, DrPH Miguel A Hernán, MD Matthew W Semler, MD, MMSc; David E Leaf, Carl P Walther, Samaya J Anumudu, Kathleen F Kopecky, Gregory P Milligan, Peter A Mccullough, Thuy-Duyen Nguyen, Megan L Krajewski, Sidharth Shankar, Ameeka Pannu, Juan D Valencia, Sushrut S Waikar, Peter Hart, Oyintayo Ajiboye, Matthew Itteera, Jean-Sebastien Rachoin, Christa A Schorr, Lisa Shea, Daniel L Edmonston, Christopher L Mosher, Aaron Karp, Zaza Cohen, Valerie Allusson, Gabriela Bambrick-Santoyo, Noor Ul Aain Bhatti, Bijal Mehta, Aquino Williams, Patricia Walters, Rolando C Go, Keith M Rose, Amy M Zhou, Ethan C Kim, Rebecca Lisk, Steven G Coca, Deena R Altman, Aparna Saha, Howard Soh, Huei Hsun Wen, Sonali Bose, Emily A Leven, Jing G Wang, Gohar Mosoyan, Girish N Nadkarni, John Guirguis, Rajat Kapoor, Christopher Meshberger, Brian T Garibaldi, Celia P Corona-Villalobos, Yumeng Wen, Steven Menez, Rubab F Malik, Carmen Elena Cervantes, Samir C Gautam, H Byrant Nguyen, Afshin Ahoubim, Leslie F Thomas, Dheeraj Reddy Sirganagari, Pramod K Guru, Paul A Bergl, Jesus Rodriguez, Jatan A Shah, Mrigank S Gupta, Princy N Kumar, Deepa G Lazarous, Seble G Kassaye, Tanya S Johns, Ryan Mocerino, Kalyan Prudhvi, Denzel Zhu, Rebecca V Levy, Yorg Azzi, Molly Fisher, Milagros Yunes, Kaltrina Sedaliu, Ladan Golestaneh, Maureen Brogan, Ritesh Raichoudhury, Soo Jung Cho, Maria Plataki, Sergio L Alvarez-Mulett, Luis G Gomez-Escobar, Di Pan, Stefi Lee, Jamuna Kirshnan, William Whalen, David Charytan, Ashley Macina, Daniel W Ross, Alexander S Leidner, Carlos Martinez, Jacqueline M Kruser, Richard G Wunderink, Alexander J Hodakowski, Eboni G Price-Haywood, Luis A Matute-Trochez, Anne E Hasty, Muner Mb Mohamed, Rupali S Avasare, David Zonies, Rebecca M Baron, Meghan E Sise, Erik T Newman, Kapil K Pokharel, Shreyak Sharma, Harkarandeep Singh, Simon Correa, Tanveer Shaukat, Omer Kamal, Heather Yang, Jeffery O Boateng, Meghan Lee, Ian A Strohbehn, Jiahua Li, Saif A Muhsin, Ernest I Mandel, Ariel L Mueller, Nicholas S Cairl, Chris Rowan, Farah Madhai-Lovely, Vasil Peev, John J Byun, Andrew Vissing, Esha M Kapania, Zoe Post, Nilam P Patel, Joy-Marie Hermes, Amee Patrawalla, Diana G Finkel, Barbara A Danek, Sowminya Arikapudi, Jeffery M Paer, Sonika Puri, Jag Sunderram, Matthew T Scharf, Ayesha Ahmed, Ilya Berim, Sabiha Hussain, Shuchi Anand, Joseph E Levitt, Pablo Garcia, Suzanne M Boyle, Rui Song, Jingjing Zhang, Moh'd A Sharshir, Vadym V Rusnak, Amber S Podoll, Michel Chonchol, Sunita Sharma, Ellen L Burnham, Arash Rashidi, Rana Hejal, Erik T Judd, Laura Latta, Ashita Tolwani, Timothy E Albertson, Jason Y Adams, Steven Y Chang, Rebecca M Beutler, Carl E Schulze, Etienne Macedo, Harin Rhee, Kathleen D Liu, Vasantha K Jotwani, Jay L Koyner, Chintan V Shah, Vishal Jaikaransingh, Stephanie M Toth-Manikowski, Min J Joo, James P Lash, Javier A Neyra, Nourhan Chaaban, Alfredo Iardino, Elizabeth H Au, Jill H Sharma, Marie Anne Sosa, Sabrina Taldone, Gabriel Contreras, David De La Zerda, Pennelope Blakely, Hanna Berlin, Tariq U Azam, Husam Shadid, Michael Pan, Patrick O'hayer, Chelsea Meloche, Rafey Feroze, Kishan J Padalia, Abbas Bitar, Jennifer E Flythe, Matthew J Tugman, Brent R Brown, Ryan C Spiardi, Todd A Miano, Meaghan S Roche, Charles R Vasquez, Amar D Bansal, Natalie C Ernecoff, Csaba P Kovesdy, Miklos Z Molnar, Ambreen Azhar, Susan S Hedayati, Mridula V Nadamuni, Sadaf S Khan, Duwayne L Willett, Amanda D Renaghan, Pavan K Bhatraju, Bilal A Malik, Christina Mariyam Joy, Tingting Li, Seth Goldberg, Patricia F Kao, Greg L Schumaker, Anthony J Faugno, Caroline M Hsu, Asma Tariq, Leah Meyer, Daniel E Weiner
JAMA Internal Medicine, doi:10.1001/jamainternmed.2020.3596
IMPORTANCE The US is currently an epicenter of the coronavirus disease 2019 (COVID-19) pandemic, yet few national data are available on patient characteristics, treatment, and outcomes of critical illness from COVID-19. OBJECTIVES To assess factors associated with death and to examine interhospital variation in treatment and outcomes for patients with COVID-19. DESIGN, SETTING, AND PARTICIPANTS This multicenter cohort study assessed 2215 adults with laboratory-confirmed COVID-19 who were admitted to intensive care units (ICUs) at 65 hospitals across the US from March 4 to April 4, 2020. EXPOSURES Patient-level data, including demographics, comorbidities, and organ dysfunction, and hospital characteristics, including number of ICU beds. MAIN OUTCOMES AND MEASURES The primary outcome was 28-day in-hospital mortality. Multilevel logistic regression was used to evaluate factors associated with death and to examine interhospital variation in treatment and outcomes. RESULTS A total of 2215 patients (mean [SD] age, 60.5 [14.5] years; 1436 [64.8%] male; 1738 [78.5%] with at least 1 chronic comorbidity) were included in the study. At 28 days after ICU admission, 784 patients (35.4%) had died, 824 (37.2%) were discharged, and 607 (27.4%) remained hospitalized. At the end of study follow-up (median, 16 days; interquartile range, 8-28 days), 875 patients (39.5%) had died, 1203 (54.3%) were discharged, and 137 (6.2%) remained hospitalized. Factors independently associated with death included older age (Ն80 vs <40 years of age: odds ratio [OR], 11.15; 95% CI, 6.19-20.06), male sex (OR, 1.50; 95% CI, 1.19-1.90), higher body mass index (Ն40 vs <25: OR, 1.51; 95% CI, 1.01-2.25), coronary artery disease (OR, 1.47; 95% CI, 1.07-2.02), active cancer (OR, 2.15; 95% CI, 1.35-3.43), and the presence of hypoxemia (PaO 2 :FIO 2 <100 vs Ն300 mm Hg: OR, 2.94; 95% CI, 2.11-4.08), liver dysfunction (liver Sequential Organ Failure Assessment score of 2 vs 0: OR, 2.61; 95% CI, 1.30-5.25), and kidney dysfunction (renal Sequential Organ Failure Assessment score of 4 vs 0: OR, 2.43; 95% CI, 1.46-4.05) at ICU admission. Patients admitted to hospitals with fewer ICU beds had a higher risk of death (<50 vs Ն100 ICU beds: OR, 3.28; 95% CI, 2.16-4.99). Hospitals varied considerably in the risk-adjusted proportion of patients who died (range, 6.6%-80.8%) and in the percentage of patients who received hydroxychloroquine, tocilizumab, and other treatments and supportive therapies. CONCLUSIONS AND RELEVANCE This study identified demographic, clinical, and hospital-level risk factors that may be associated with death in critically ill patients with COVID-19 and can facilitate the identification of medications and supportive therapies to improve outcomes.
Author Contributions: Drs Gupta and Leaf had full access to all the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.
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'sequence': 'additional', 'affiliation': [{'name': 'for the STOP-COVID Investigators'}]}, { 'given': 'Rafey', 'family': 'Feroze', 'sequence': 'additional', 'affiliation': [{'name': 'for the STOP-COVID Investigators'}]}, { 'given': 'Kishan J', 'family': 'Padalia', 'sequence': 'additional', 'affiliation': [{'name': 'for the STOP-COVID Investigators'}]}, { 'given': 'Abbas', 'family': 'Bitar', 'sequence': 'additional', 'affiliation': [{'name': 'for the STOP-COVID Investigators'}]}, { 'given': 'Jennifer E', 'family': 'Flythe', 'sequence': 'additional', 'affiliation': [{'name': 'for the STOP-COVID Investigators'}]}, { 'given': 'Matthew J', 'family': 'Tugman', 'sequence': 'additional', 'affiliation': [{'name': 'for the STOP-COVID Investigators'}]}, { 'given': 'Brent R', 'family': 'Brown', 'sequence': 'additional', 'affiliation': [{'name': 'for the STOP-COVID Investigators'}]}, { 'given': 'Ryan C', 'family': 'Spiardi', 'sequence': 'additional', 'affiliation': [{'name': 'for the STOP-COVID Investigators'}]}, { 'given': 'Todd A', 'family': 'Miano', 'sequence': 'additional', 'affiliation': [{'name': 'for the STOP-COVID Investigators'}]}, { 'given': 'Meaghan S', 'family': 'Roche', 'sequence': 'additional', 'affiliation': [{'name': 'for the STOP-COVID Investigators'}]}, { 'given': 'Charles R', 'family': 'Vasquez', 'sequence': 'additional', 'affiliation': [{'name': 'for the STOP-COVID Investigators'}]}, { 'given': 'Amar D', 'family': 'Bansal', 'sequence': 'additional', 'affiliation': [{'name': 'for the STOP-COVID Investigators'}]}, { 'given': 'Natalie C', 'family': 'Ernecoff', 'sequence': 'additional', 'affiliation': [{'name': 'for the STOP-COVID Investigators'}]}, { 'given': 'Csaba P', 'family': 'Kovesdy', 'sequence': 'additional', 'affiliation': [{'name': 'for the STOP-COVID Investigators'}]}, { 'given': 'Miklos Z', 'family': 'Molnar', 'sequence': 'additional', 'affiliation': [{'name': 'for the STOP-COVID Investigators'}]}, { 'given': 'Ambreen', 'family': 'Azhar', 'sequence': 'additional', 'affiliation': [{'name': 'for the STOP-COVID Investigators'}]}, { 'given': 'Susan S', 'family': 'Hedayati', 'sequence': 'additional', 'affiliation': [{'name': 'for the STOP-COVID Investigators'}]}, { 'given': 'Mridula V', 'family': 'Nadamuni', 'sequence': 'additional', 'affiliation': [{'name': 'for the STOP-COVID Investigators'}]}, { 'given': 'Sadaf S', 'family': 'Khan', 'sequence': 'additional', 'affiliation': [{'name': 'for the STOP-COVID Investigators'}]}, { 'given': 'Duwayne L', 'family': 'Willett', 'sequence': 'additional', 'affiliation': [{'name': 'for the STOP-COVID Investigators'}]}, { 'given': 'Amanda D', 'family': 'Renaghan', 'sequence': 'additional', 'affiliation': [{'name': 'for the STOP-COVID Investigators'}]}, { 'given': 'Pavan K', 'family': 'Bhatraju', 'sequence': 'additional', 'affiliation': [{'name': 'for the STOP-COVID Investigators'}]}, { 'given': 'Bilal A', 'family': 'Malik', 'sequence': 'additional', 'affiliation': [{'name': 'for the STOP-COVID Investigators'}]}, { 'given': 'Christina Mariyam', 'family': 'Joy', 'sequence': 'additional', 'affiliation': [{'name': 'for the STOP-COVID Investigators'}]}, { 'given': 'Tingting', 'family': 'Li', 'sequence': 'additional', 'affiliation': [{'name': 'for the STOP-COVID Investigators'}]}, { 'given': 'Seth', 'family': 'Goldberg', 'sequence': 'additional', 'affiliation': [{'name': 'for the STOP-COVID Investigators'}]}, { 'given': 'Patricia F', 'family': 'Kao', 'sequence': 'additional', 'affiliation': [{'name': 'for the STOP-COVID Investigators'}]}, { 'given': 'Greg L', 'family': 'Schumaker', 'sequence': 'additional', 'affiliation': [{'name': 'for the STOP-COVID Investigators'}]}, { 'given': 'Anthony J', 'family': 'Faugno', 'sequence': 'additional', 'affiliation': [{'name': 'for the STOP-COVID Investigators'}]}, { 'given': 'Caroline M', 'family': 'Hsu', 'sequence': 'additional', 'affiliation': [{'name': 'for the STOP-COVID Investigators'}]}, { 'given': 'Asma', 'family': 'Tariq', 'sequence': 'additional', 'affiliation': [{'name': 'for the STOP-COVID Investigators'}]}, { 'given': 'Leah', 'family': 'Meyer', 'sequence': 'additional', 'affiliation': [{'name': 'for the STOP-COVID Investigators'}]}, { 'given': 'Daniel E', 'family': 'Weiner', 'sequence': 'additional', 'affiliation': [{'name': 'for the STOP-COVID Investigators'}]}, { 'given': 'Marta', 'family': 'Christov', 'sequence': 'additional', 'affiliation': [{'name': 'for the STOP-COVID Investigators'}]}, { 'given': 'Francis P', 'family': 'Wilson', 'sequence': 'additional', 'affiliation': [{'name': 'for the STOP-COVID Investigators'}]}, { 'given': 'Tanima', 'family': 'Arora', 'sequence': 'additional', 'affiliation': [{'name': 'for the STOP-COVID Investigators'}]}, { 'given': 'Ugochukwu', 'family': 'Ugwuowo', 'sequence': 'additional', 'affiliation': [{'name': 'for the STOP-COVID Investigators'}]}, {'name': 'STOP-COVID Investigators', 'sequence': 'additional', 'affiliation': []}], 'member': '10', 'reference': [ { 'issue': '11', 'key': 'ioi200056r2', 'doi-asserted-by': 'publisher', 'first-page': '1061', 'DOI': '10.1001/jama.2020.1585', 'article-title': 'Clinical characteristics of 138 hospitalized patients with 2019 novel ' 'coronavirus-infected pneumonia in Wuhan, China.', 'volume': '323', 'author': 'Wang', 'year': '2020', 'journal-title': 'JAMA'}, { 'issue': '5', 'key': 'ioi200056r3', 'doi-asserted-by': 'publisher', 'first-page': '475', 'DOI': '10.1016/S2213-2600(20)30079-5', 'article-title': 'Clinical course and outcomes of critically ill patients with SARS-CoV-2 ' 'pneumonia in Wuhan, China: a single-centered, retrospective, ' 'observational study.', 'volume': '8', 'author': 'Yang', 'year': '2020', 'journal-title': 'Lancet Respir Med'}, { 'issue': '16', 'key': 'ioi200056r4', 'doi-asserted-by': 'publisher', 'first-page': '1574', 'DOI': '10.1001/jama.2020.5394', 'article-title': 'Baseline characteristics and outcomes of 1591 patients infected with ' 'SARS-CoV-2 admitted to ICUs of the Lombardy region, Italy.', 'volume': '323', 'author': 'Grasselli', 'year': '2020', 'journal-title': 'JAMA'}, { 'issue': '21', 'key': 'ioi200056r5', 'doi-asserted-by': 'publisher', 'first-page': '2012', 'DOI': '10.1056/NEJMoa2004500', 'article-title': 'Covid-19 in critically ill patients in the Seattle region: case series.', 'volume': '382', 'author': 'Bhatraju', 'year': '2020', 'journal-title': 'N Engl J Med'}, { 'issue': '24', 'key': 'ioi200056r6', 'doi-asserted-by': 'publisher', 'first-page': '2372', 'DOI': '10.1056/NEJMc2010419', 'article-title': 'Clinical characteristics of Covid-19 in New York City.', 'volume': '382', 'author': 'Goyal', 'year': '2020', 'journal-title': 'N Engl J Med'}, { 'issue': '20', 'key': 'ioi200056r7', 'doi-asserted-by': 'publisher', 'first-page': '2052', 'DOI': '10.1001/jama.2020.6775', 'article-title': 'Presenting characteristics, comorbidities, and outcomes among 5700 ' 'patients hospitalized with COVID-19 in the New York City area.', 'volume': '323', 'author': 'Richardson', 'year': '2020', 'journal-title': 'JAMA'}, { 'issue': '7', 'key': 'ioi200056r9', 'doi-asserted-by': 'publisher', 'first-page': '707', 'DOI': '10.1007/BF01709751', 'article-title': 'The SOFA (Sepsis-related Organ Failure Assessment) score to describe ' 'organ dysfunction/failure: on behalf of the Working Group on ' 'Sepsis-Related Problems of the European Society of Intensive Care ' 'Medicine.', 'volume': '22', 'author': 'Vincent', 'year': '1996', 'journal-title': 'Intensive Care Med'}, { 'key': 'ioi200056r10', 'doi-asserted-by': 'publisher', 'first-page': '145', 'DOI': '10.1016/j.thromres.2020.04.013', 'article-title': 'Incidence of thrombotic complications in critically ill ICU patients ' 'with COVID-19.', 'volume': '191', 'author': 'Klok', 'year': '2020', 'journal-title': 'Thromb Res'}, { 'issue': '6', 'key': 'ioi200056r11', 'doi-asserted-by': 'publisher', 'first-page': '1089', 'DOI': '10.1007/s00134-020-06062-x', 'article-title': 'High risk of thrombosis in patients with severe SARS-CoV-2 infection: a ' 'multicenter prospective cohort study.', 'volume': '46', 'author': 'Helms', 'year': '2020', 'journal-title': 'Intensive Care Med'}, { 'key': 'ioi200056r12', 'article-title': 'Incidence of venous thromboembolism in hospitalized patients with ' 'COVID-19.', 'author': 'Middeldorp', 'journal-title': 'J Thromb Haemost'}, { 'key': 'ioi200056r13', 'doi-asserted-by': 'publisher', 'first-page': '9', 'DOI': '10.1016/j.thromres.2020.04.024', 'article-title': 'Venous and arterial thromboembolic complications in COVID-19 patients ' 'admitted to an academic hospital in Milan, Italy.', 'volume': '191', 'author': 'Lodigiani', 'year': '2020', 'journal-title': 'Thromb Res'}, { 'key': 'ioi200056r14', 'doi-asserted-by': 'publisher', 'first-page': '1', 'DOI': '10.1016/j.thromres.2020.05.049', 'article-title': 'Image-proven thromboembolism in patients with severe COVID-19 in a ' 'tertiary critical care unit in the United Kingdom.', 'volume': '193', 'author': 'Desborough', 'year': '2020', 'journal-title': 'Thromb Res'}, { 'issue': '23', 'key': 'ioi200056r15', 'doi-asserted-by': 'crossref', 'DOI': '10.1097/MD.0000000000015833', 'article-title': 'The cumulative venous thromboembolism incidence and risk factors in ' 'intensive care patients receiving the guideline-recommended ' 'thromboprophylaxis.', 'volume': '98', 'author': 'Zhang', 'year': '2019', 'journal-title': 'Medicine (Baltimore)'}, { 'issue': '5', 'key': 'ioi200056r16', 'doi-asserted-by': 'publisher', 'first-page': '846', 'DOI': '10.1111/bjh.v189.5', 'article-title': 'Thromboembolic risk and anticoagulant therapy in COVID-19 patients: ' 'emerging evidence and call for action.', 'volume': '189', 'author': 'Kollias', 'year': '2020', 'journal-title': 'Br J Haematol'}, { 'issue': '7', 'key': 'ioi200056r17', 'doi-asserted-by': 'publisher', 'first-page': '934', 'DOI': '10.1001/jamainternmed.2020.0994', 'article-title': 'Risk factors associated with acute respiratory distress syndrome and ' 'death in patients with coronavirus disease 2019 pneumonia in Wuhan, ' 'China.', 'volume': '180', 'author': 'Wu', 'year': '2020', 'journal-title': 'JAMA Intern Med'}, { 'issue': '6', 'key': 'ioi200056r18', 'doi-asserted-by': 'publisher', 'first-page': '669', 'DOI': '10.1016/S1473-3099(20)30243-7', 'article-title': 'Estimates of the severity of coronavirus disease 2019: a model-based ' 'analysis.', 'volume': '20', 'author': 'Verity', 'year': '2020', 'journal-title': 'Lancet Infect Dis'}, { 'key': 'ioi200056r19', 'doi-asserted-by': 'crossref', 'DOI': '10.1093/cid/ciaa270', 'article-title': 'Clinical characteristics of refractory COVID-19 pneumonia in Wuhan, ' 'China.', 'author': 'Mo', 'year': '2020', 'journal-title': 'Clin Infect Dis'}, { 'key': 'ioi200056r20', 'doi-asserted-by': 'crossref', 'DOI': '10.1093/cid/ciaa415', 'article-title': 'Obesity in patients younger than 60 years is a risk factor for Covid-19 ' 'hospital admission.', 'author': 'Lighter', 'year': '2020', 'journal-title': 'Clin Infect Dis'}, { 'key': 'ioi200056r21', 'doi-asserted-by': 'crossref', 'DOI': '10.1002/oby.22831', 'article-title': 'High prevalence of obesity in severe acute respiratory syndrome ' 'coronavirus-2 (SARS-CoV-2) requiring invasive mechanical ventilation.', 'author': 'Simonnet', 'year': '2020', 'journal-title': 'Obesity (Silver Spring)'}, { 'issue': '10236', 'key': 'ioi200056r22', 'doi-asserted-by': 'publisher', 'first-page': '1544', 'DOI': '10.1016/S0140-6736(20)31024-2', 'article-title': 'Obesity could shift severe COVID-19 disease to younger ages.', 'volume': '395', 'author': 'Kass', 'year': '2020', 'journal-title': 'Lancet'}, { 'key': 'ioi200056r23', 'doi-asserted-by': 'crossref', 'DOI': '10.1056/NEJMsa2011686', 'article-title': 'Hospitalization and mortality among black patients and white patients ' 'with Covid-19.', 'author': 'Price-Haywood', 'year': '2020', 'journal-title': 'N Engl J Med'}, { 'issue': '10', 'key': 'ioi200056r24', 'doi-asserted-by': 'publisher', 'first-page': '1054', 'DOI': '10.1016/j.jclinepi.2011.01.001', 'article-title': 'Administrative database research infrequently used validated diagnostic ' 'or procedural codes.', 'volume': '64', 'author': 'van Walraven', 'year': '2011', 'journal-title': 'J Clin Epidemiol'}, { 'key': 'ioi200056r25', 'article-title': 'Individualizing risk prediction for positive COVID-19 testing: results ' 'from 11,672 patients.', 'author': 'Jehi', 'year': '2020', 'journal-title': 'Chest'}, { 'key': 'ioi200056r1', 'unstructured': 'Johns Hopkins University. Coronavirus Resource Center. Accessed June 19, ' '2020. https://coronavirus.jhu.edu/'}, { 'key': 'ioi200056r8', 'unstructured': 'Mohamed? MMB, Lukitsch? I, Torres-Ortiz? AE, . Acute kidney injury ' 'associated with coronavirus disease 2019 in urban New Orleans. ' 'Kidney360. Published online May 13, 2020. Accessed July 9, 2020. ' 'https://kidney360.asnjournals.org/content/early/2020/05/13/KID.0002652020'}], 'container-title': 'JAMA Internal Medicine', 'original-title': [], 'language': 'en', 'link': [ { 'URL': 'https://jamanetwork.com/journals/jamainternalmedicine/articlepdf/2768602/jamainternal_gupta_2020_oi_200056_1623354050.32983.pdf', 'content-type': 'unspecified', 'content-version': 'vor', 'intended-application': 'similarity-checking'}], 'deposited': { 'date-parts': [[2021, 6, 14]], 'date-time': '2021-06-14T15:02:27Z', 'timestamp': 1623682947000}, 'score': 1, 'resource': { 'primary': { 'URL': 'https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2768602'}}, 'subtitle': [], 'short-title': [], 'issued': {'date-parts': [[2020, 11, 1]]}, 'references-count': 25, 'journal-issue': {'issue': '11', 'published-print': {'date-parts': [[2020, 11, 1]]}}, 'URL': 'http://dx.doi.org/10.1001/jamainternmed.2020.3596', 'relation': {}, 'ISSN': ['2168-6106'], 'subject': ['Internal Medicine'], 'container-title-short': 'JAMA Intern Med', 'published': {'date-parts': [[2020, 11, 1]]}}
Late treatment
is less effective
Please send us corrections, updates, or comments. c19early involves the extraction of 100,000+ datapoints from thousands of papers. Community updates help ensure high accuracy. Treatments and other interventions are complementary. All practical, effective, and safe means should be used based on risk/benefit analysis. No treatment or intervention is 100% available and effective for all current and future variants. We do not provide medical advice. Before taking any medication, consult a qualified physician who can provide personalized advice and details of risks and benefits based on your medical history and situation. FLCCC and WCH provide treatment protocols.
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