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0 0.5 1 1.5 2+ Mortality 1% Improvement Relative Risk Ip et al. HCQ for COVID-19 LATE TREATMENT Is late treatment with HCQ beneficial for COVID-19? Retrospective 2,512 patients in the USA No significant difference in mortality Ip et al., PLoS ONE, doi:10.1371/journal.pone.0237693 Favors HCQ Favors control
Hydroxychloroquine and Tocilizumab Therapy in COVID-19 Patients - An Observational Study
Ip et al., Hydroxychloroquine and Tocilizumab Therapy in COVID-19 Patients - An Observational Study, PLoS ONE, doi:10.1371/journal.pone.0237693
May 2020   Source   PDF  
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Retrospective study of late stage use on 2,512 hospitalized patients showing no significant differences in associated mortality for patients receiving any HCQ during the hospitalization (HR, 0.99 [95% CI, 0.80-1.22]), HCQ alone (HR, 1.02 [95% CI, 0.83-1.27]), or HCQ+AZ (HR, 0.98 [95% CI, 0.75-1.28]). Misclassification is possible due to manual abstraction of EHR data. They observed a change in the prescribing patterns of HCQ during the study timeframe. Confounding by indication.
risk of death, 1.0% lower, HR 0.99, p = 0.93, treatment 432 of 1,914 (22.6%), control 115 of 598 (19.2%), adjusted per study.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Ip et al., 25 May 2020, retrospective, database analysis, USA, peer-reviewed, 32 authors, average treatment delay 5.0 days.
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Abstract: PLOS ONE RESEARCH ARTICLE Hydroxychloroquine and tocilizumab therapy in COVID-19 patients—An observational study a1111111111 a1111111111 a1111111111 a1111111111 a1111111111 Andrew Ip ID1, Donald A. Berry2,3, Eric Hansen4, Andre H. Goy5, Andrew L. Pecora5, Brittany A. Sinclaire5, Urszula Bednarz5, Michael Marafelias5, Scott M. Berry2, Nicholas S. Berry2, Shivam Mathura4, Ihor S. Sawczuk6, Noa Biran5, Ronaldo C. Go ID6, Steven Sperber6, Julia A. Piwoz6, Bindu Balani6, Cristina Cicogna6, Rani Sebti6, Jerry Zuckerman6, Keith M. Rose6, Lisa Tank6, Laurie G. Jacobs6, Jason Korcak6, Sarah L. Timmapuri6, Joseph P. Underwood6, Gregory Sugalski6, Carol Barsky6, Daniel W. Varga6, Arif Asif6, Joseph C. Landolfi6, Stuart L. Goldberg ID1* 1 Division of Outcomes and Value Research, John Theurer Cancer Center at Hackensack University Medical Center, Hackensack, New Jersey, United States of America, 2 Berry Consultants LLC, Austin, Texas, United States of America, 3 M.D. Anderson Cancer Center of the University of Texas, Houston, Texas, United States of America, 4 COTA, Boston, Massachusetts, United States of America, 5 John Theurer Cancer Center at Hackensack University Medical Center, Hackensack, New Jersey, United States of America, 6 Hackensack Meridian Health, Hackensack New Jersey and Hackensack Meridian School of Medicine, Nutley, New Jersey, United States of America * OPEN ACCESS Citation: Ip A, Berry DA, Hansen E, Goy AH, Pecora AL, Sinclaire BA, et al. (2020) Hydroxychloroquine and tocilizumab therapy in COVID-19 patients—An observational study. PLoS ONE 15(8): e0237693. Editor: Chiara Lazzeri, Azienda Ospedaliero Universitaria Careggi, ITALY Received: May 21, 2020 Accepted: August 1, 2020 Published: August 13, 2020 Copyright: © 2020 Ip et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Data Availability Statement: The study involves a review of the electronic medical records of patients infected with SARSCoV- 2. The research data set has removed most, but not all protected health information (for example: actual dates of infection were included as needed for analysis, but would be considered PHI). The dataset is also considered property of Hackensack Meridian Health and not owned by the investigators. Therefore, for both reasons, the dataset cannot be made openly available. However, upon request we are willing to share portions of the data for appropriate review. Abstract Hydroxychloroquine has been touted as a potential COVID-19 treatment. Tocilizumab, an inhibitor of IL-6, has also been proposed as a treatment of critically ill patients. In this retrospective observational cohort study drawn from electronic health records we sought to describe the association between mortality and hydroxychloroquine or tocilizumab therapy among hospitalized COVID-19 patients. Patients were hospitalized at a 13-hospital network spanning New Jersey USA between March 1, 2020 and April 22, 2020 with positive polymerase chain reaction results for SARS-CoV-2. Follow up was through May 5, 2020. Among 2512 hospitalized patients with COVID-19 there have been 547 deaths (22%), 1539 (61%) discharges and 426 (17%) remain hospitalized. 1914 (76%) received at least one dose of hydroxychloroquine..
Late treatment
is less effective
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