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0 0.5 1 1.5 2+ Mortality 11% Improvement Relative Risk Mortality (b) 1% Mortality (c) -31% Mortality (d) -83% c19hcq.org Magagnoli et al. HCQ for COVID-19 LATE TREATMENT Is late treatment with HCQ beneficial for COVID-19? Retrospective 807 patients in the USA No significant difference in mortality Magagnoli et al., Med, doi:10.1016/j.medj.2020.06.001 Favors HCQ Favors control
Outcomes of hydroxychloroquine usage in United States veterans hospitalized with Covid-19
Magagnoli et al., Med (2020), doi:10.1016/j.medj.2020.06.001 (date from earlier preprint)
Magagnoli et al., Outcomes of hydroxychloroquine usage in United States veterans hospitalized with Covid-19, Med (2020), doi:10.1016/j.medj.2020.06.001 (date from earlier preprint)
Apr 2020   Source   PDF  
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Retrospective 807 hospitalized patients, no statistically significant reduction in mortality or the need for mechanical ventilation with HCQ or HCQ+AZ, or for death with HCQ+AZ, HR 1.83, p=0.009 for HCQ mortality.
The preprint notes that HCQ was more likely to be prescribed to patients with more severe disease, however this was deleted in the published version.
425 patients had dispositions of death or discharge by the end of the study period and thus did not encounter the issue of length-biased sampling and differential rates of right-censored observations among the groups.
Also see: [mediterranee-infection.com]
risk of death, 11.0% lower, HR 0.89, p = 0.74, treatment 39 of 148 (26.4%), control 18 of 163 (11.0%), adjusted per study, HCQ+AZ w/dispositions.
risk of death, 1.0% lower, HR 0.99, p = 0.98, treatment 30 of 114 (26.3%), control 18 of 163 (11.0%), adjusted per study, HCQ w/dispositions.
risk of death, 31.0% higher, HR 1.31, p = 0.28, treatment 49 of 214 (22.9%), control 37 of 395 (9.4%), adjusted per study, HCQ+AZ.
risk of death, 83.0% higher, HR 1.83, p = 0.009, treatment 38 of 198 (19.2%), control 37 of 395 (9.4%), adjusted per study, HCQ.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Magagnoli et al., 21 Apr 2020, retrospective, database analysis, USA, peer-reviewed, 7 authors.
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Abstract: ll Clinical Advances Outcomes of Hydroxychloroquine Usage in United States Veterans Hospitalized with COVID-19 Joseph Magagnoli, Siddharth Narendran, Felipe Pereira, Tammy H. Cummings, James W. Hardin, S. Scott Sutton, Jayakrishna Ambati sutton@cop.sc.edu (S.S.S.) ja9qr@virginia.edu (J.A.) HIGHLIGHTS Hydroxychloroquine (HC) use did not reduce the risk of ventilation or death HC with azithromycin (AZ) did not reduce the risk of ventilation or death HC, with or without AZ, was associated with longer length of hospital stay In this nationwide retrospective analysis of 807 patients hospitalized with COVID19, Magagnoli et al. report that, after adjusting for several COVID-19-relevant clinical and demographic characteristics, hydroxychloroquine use, with or without azithromycin, did not improve mortality or reduce the need for mechanical ventilation compared to no hydroxychloroquine use. Magagnoli et al., Med 1, 1–14 November 1, 2020 ª 2020 Elsevier Inc. https://doi.org/10.1016/j.medj.2020.06.001 Please cite this article in press as: Magagnoli et al., Outcomes of Hydroxychloroquine Usage in United States Veterans Hospitalized with COVID19, Med (2020), https://doi.org/10.1016/j.medj.2020.06.001 ll Clinical Advances Outcomes of Hydroxychloroquine Usage in United States Veterans Hospitalized with COVID-19 Joseph Magagnoli,1,2,8 Siddharth Narendran,4,5,8 Felipe Pereira,4,5,8 Tammy H. Cummings,1,2 James W. Hardin,1,3 S. Scott Sutton,1,2,* and Jayakrishna Ambati4,5,6,7,9,* SUMMARY Context and Significance Background: Despite limited and conflicting evidence, hydroxychloroquine, alone or in combination with azithromycin, is widely used in COVID-19 therapy. Methods: We performed a retrospective study of electronic health records of patients hospitalized with confirmed SARS-CoV-2 infection in US Veterans Health Administration medical centers between March 9, 2020 and April 29, 2020. Patients hospitalized within 24 h of diagnosis were classified based on their exposure to hydroxychloroquine alone (HC) or with azithromycin (HC+AZ) or no HC as treatments. The primary outcomes were mortality and use of mechanical ventilation. Findings: A total of 807 patients were evaluated. Compared to the no HC group, after propensity score adjustment for clinical characteristics, the risk of death from any cause was higher in the HC group (adjusted hazard ratio [aHR], 1.83; 95% confidence interval [CI], 1.16–2.89; p = 0.009), but not in the HC+AZ group (aHR, 1.31; 95% CI, 0.80–2.15; p = 0.28). Both the propensity-score-adjusted risks of mechanical ventilation and death after mechanical ventilation were not significantly different in the HC group (aHR, 1.19; 95% CI, 0.78–1.82; p = 0.42 and aHR, 2.11; 95% CI, 0.96–4.62; p = 0.06, respectively) or in the HC+AZ group (aHR, 1.09; 95% CI, 0.72–1.66; p = 0.69 and aHR, 1.25; 95% CI, 0.59–2.68; p = 0.56, respectively) compared to the no HC group. Conclusions: Among patients hospitalized with COVID-19, this retrospective study did not identify any significant reduction in mortality or in the need for mechanical ventilation with hydroxychloroquine treatment with or without azithromycin. Funding: University of Virginia Strategic Investment Fund Despite limited and conflicting evidence, hydroxychloroquine, with or without azithromycin, is extensively used to treat COVID19. Given the known side effects of these drugs, there is an urgent need to evaluate their effectiveness in COVID-19. In this nationwide retrospective..
Late treatment
is less effective
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