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0 0.5 1 1.5 2+ Mortality -70% Improvement Relative Risk McGrail et al. HCQ for COVID-19 LATE TREATMENT Is late treatment with HCQ beneficial for COVID-19? Retrospective 75 patients in the USA Study underpowered to detect differences McGrail et al., medRxiv, doi:10.1101/2020.07.17.20156521 Favors HCQ Favors control
COVID-19 Case Series at UnityPoint Health St. Luke’s Hospital in Cedar Rapids, IA
McGrail et al., medRxiv, doi:10.1101/2020.07.17.20156521 (Preprint)
McGrail et al., COVID-19 Case Series at UnityPoint Health St. Luke’s Hospital in Cedar Rapids, IA, medRxiv, doi:10.1101/2020.07.17.20156521 (Preprint)
Jul 2020   Source   PDF  
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HCQ+AZ early in the epidemic had a fairly good success rate with few complications, 86% of HCQ patients survived and 92% of HCQ+AZ patients. Patients not receiving either had 93% survival but were not considered comparable because the treated groups were significantly more ill (100% hypoxic at admission vs. 59%) and this study does not adjust for the differences.
Transition from an early intubation strategy to aggressive utilization of high flow nasal cannula and noninvasive ventilation (i.e, BiPAP) was successful in freeing up ICU resources. This study is excluded in the after exclusion results of meta analysis: excessive unadjusted differences between groups.
risk of death, 70.0% higher, RR 1.70, p = 0.69, treatment 4 of 33 (12.1%), control 3 of 42 (7.1%).
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
McGrail et al., 19 Jul 2020, retrospective, USA, preprint, 2 authors.
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This PaperHCQAll
Abstract: medRxiv preprint doi:; this version posted July 19, 2020. The copyright holder for this preprint (which was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. It is made available under a CC-BY-ND 4.0 International license . COVID-19 Case Series at UnityPoint Health St. Luke’s Hospital in Cedar Rapids, IA Dianna Edwards, MD - Unity Point St. Luke’s Hospital, Daniel McGrail, MD - His Hands Free Clinic 7/17/2020 Abstract A retrospective, descriptive study of all patients tested for SARS-CoV2 on admission for illness to a community hospital in Iowa from 3/21/20 thru 6/14/20 consisted of evaluation as to demographics, presentation and hospital course. Ninety-one patients were SARS-CoV2 PCR+ with 63% being male and a median age of 60. Cardiovascular disease was a significant comorbidity in the PCR+ group. Fever, cough, dyspnea, nausea, emesis, diarrhea, headache and myalgias were significantly more common in that group, as was an elevated CRP, LDH, serum ferritin and transaminases. Overall survival of the COVID-19 patients was 88%, 77% in the critically ill, 59% of those mechanically ventilated and 33% of those requiring new dialysis. Survival was 93% in those not receiving any antivirals. Survival of those treated with hydroxychloroquine-azithromycin was 92%, compared to 86% of those treated with hydroxychloroquine alone. The latter two groups were significantly more ill than the untreated group. A transition from an early intubation strategy to aggressive utilization of high flow nasal cannula and noninvasive ventilation(i.e BiPAP) was successful in freeing up ICU resources.
Late treatment
is less effective
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