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0 0.5 1 1.5 2+ Mortality -25% Improvement Relative Risk Ventilation -41% ICU admission -17% c19hcq.org Lotfy et al. HCQ for COVID-19 LATE TREATMENT Is late treatment with HCQ beneficial for COVID-19? Retrospective 202 patients in Saudi Arabia Higher ventilation (p=0.34) and ICU admission (p=0.53), not stat. sig. Lotfy et al., Turk. Thorac. J., doi:10.5152/TurkThoracJ.2021.20180 Favors HCQ Favors control
Use of Hydroxychloroquine in Patients with COVID-19: A Retrospective Observational Study
Lotfy et al., Turk. Thorac. J., doi:10.5152/TurkThoracJ.2021.20180
Lotfy et al., Use of Hydroxychloroquine in Patients with COVID-19: A Retrospective Observational Study, Turk. Thorac. J., doi:10.5152/TurkThoracJ.2021.20180
Jan 2021   Source   PDF  
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Retrospective 202 patients in Saudi Arabia not showing significant differences with treatment. No information is provided on how patients were selected for treatment, there may be significant confounding by indication. Time varying confounding is also likely as HCQ became controversial during the period studied, therefore HCQ use was likely more frequent toward the beginning of the period, a time when overall treatment protocols were significantly worse. This study is excluded in the after exclusion results of meta analysis: substantial confounding by time likely due to declining usage over the early stages of the pandemic when overall treatment protocols improved dramatically; substantial unadjusted confounding by indication likely.
risk of death, 24.8% higher, RR 1.25, p = 0.76, treatment 6 of 99 (6.1%), control 5 of 103 (4.9%).
risk of mechanical ventilation, 41.2% higher, RR 1.41, p = 0.34, treatment 19 of 99 (19.2%), control 14 of 103 (13.6%).
risk of ICU admission, 16.5% higher, RR 1.17, p = 0.53, treatment 28 of 99 (28.3%), control 25 of 103 (24.3%).
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Lotfy et al., 1 Jan 2021, retrospective, Saudi Arabia, peer-reviewed, mean age 55.0, 3 authors.
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Abstract: DOI: 10.5152/TurkThoracJ.2021.20180 Turk Thorac J 2021; 22(1): 62-6 Original Article Use of Hydroxychloroquine in Patients with COVID-19: A Retrospective Observational Study Samah Mohamad Lotfy , Ahmad Abbas , Waheed Shouman Department of Chest Diseases, Zagazig University Hospitals, Zagazig, Egypt Cite this article as: Lotfy SM, Abbas A, Shouman W. Use of hydroxychloroquine in patients with COVID-19: A retrospective observational study. Turk Thorac J 2021; 22(1): 62-6. Abstract OBJECTIVE: There is no consensus on a certain drug therapy for COVID-19 infection. Growing reports argue about the potential benefits of hydroxychloroquine (HCQ) in reducing morbidity and mortality in patients hospitalized with COVID-19, but with inconsistent results. This study aimed to assess the potential benefits of HCQ on viral conversion, reducing the need for ICU or mechanical ventilation, and its impact on mortality. MATERIAL AND METHODS: This retrospective observational study was conducted enrolling confirmed SARS-CoV2 patients. They were subjected to plain CXR (HRCT of chest if needed), routine laboratory tests for COVID-19 (including CBC, CRP, LDH, D-Dimer, ferritin, and blood sugar), ECG, and blood gases. They were allocated to either HCQ or non-HCQ groups. Both groups were followed-up for symptoms resolution, need for ICU admission, non-invasive or invasive ventilation, duration till conversion, and mortality. RESULTS: A total of 202 patients with moderate COVID-19 were enrolled with a mean age of 55.05±10.15, out of whom 80% were male patients. The most common presenting symptom was fever (87.38% in the control group versus 92% in the HCQ group), followed by cough (82.52% versus 89.9%). In total, 24.27% of patients in the control group versus 28.3% in the HCQ group deteriorated and necessitated ICU admission (p=0.52), 13.6% of the control group versus 19.2% in the HCQ group required mechanical ventilation (p=0.28), and 69.9% of the control group versus 68.9% in the HCQ group converted negative on day 7 (p=0.85). No significant mortality difference between both groups was observed (4.9% versus 6.1%, p=0.47). CONCLUSION: This work did not support any benefits of using HCQ in patients with COVID-19, neither in reducing the need for ICU, mechanical ventilation, nor mortality. KEYWORDS: Hydroxychloroquine, COVID-19, SARS-CoV2, ICU, mortality Received: July 22, 2020 Accepted: October 1, 2020
Late treatment
is less effective
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