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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 preprint)
Apr 2020  
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Mortality 11% Improvement Relative Risk Mortality (b) 1% Mortality (c) -31% Mortality (d) -83% HCQ for COVID-19  Magagnoli et al.  LATE TREATMENT Is late treatment with HCQ beneficial for COVID-19? Retrospective 807 patients in the USA No significant difference in mortality c19hcq.org Magagnoli et al., Med, April 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 411 studies, recognized in 46 countries.
No treatment is 100% effective. Protocols combine treatments. * >10% efficacy, ≥3 studies.
4,300+ studies for 75 treatments. c19hcq.org
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:1
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.
This PaperHCQAll
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
Med, doi:10.1016/j.medj.2020.06.001
In this nationwide retrospective analysis of 807 patients hospitalized with COVID-19, 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.
References
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Late treatment
is less effective
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