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All Studies   Meta Analysis    Recent:   
0 0.5 1 1.5 2+ Mortality -70% Improvement Relative Risk HCQ for COVID-19  McGrail et al.  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, July 2020 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
Jul 2020  
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HCQ for COVID-19
1st treatment shown to reduce risk in March 2020
*, now known with p < 0.00000000001 from 422 studies, recognized in 42 countries.
No treatment is 100% effective. Protocols combine complementary and synergistic treatments. * >10% efficacy in meta analysis with ≥3 clinical studies.
4,000+ studies for 60+ treatments.
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.
This PaperHCQAll
COVID-19 Case Series at UnityPoint Health St. Luke’s Hospital in Cedar Rapids, IA
Dianna Edwards, Daniel Mcgrail
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.
Arnetz, Characteristics and Outcomes of 21 Critically Ill Patients With COVID-19 in Washington State, JAMA, doi:10.1001/jama.2020.4326
Bhatraju, Ghassemieh, COVID-19 in Critically Ill Patients in the Seattle Region-Cse Series, NEJM, doi:10.1056/NEJMoa2004500
Fantini, Synergistic antiviral effect of hydroxychloroquine and azithromycin in combination against SARS-CoV-2: what molecular dynamics studies of virus-host interactions reveal, International Journal of Antimicrobial Agents
Gautreta, Hydroxychloroquine and azithromycin as a treatment of COVID-19 -results of an open label non-randomized clinical trial, International Journal of Antimicrobial Agents
Glantz, Primer of Biostatictics -The Program
Grasselli, Baseline Characteristics and Outcomes of 1591 Patients Infected With SARS-CoV-2 Admitted to ICUs of the Lombardy Region, Italy, JAMA, doi:10.1001/jama.2020.5394
Guotao, SARS-CoV-2 infection presenting with hematochezia, Med Mal Infect
Gustafson, Epistat, Gustafson, None
Huang, Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China, Lancet
Okour, Hydroxychloroquine and azithromycin as potential treatments for COVID-19 -clinical status impacts the outcome, Journal of Pharmacokinetics and Pharmacodynamics, doi:10.1007/s10928-020-09689-x
Richardson, Presenting Characteristics, Comorbidities, and Outcomes Among 5700 Patients Hospitalized with COVID-19 in the New York City Area, JAMA, doi:10.1001/jama.2020.6775
Rodriguez, Dozens of Iowans traveled on cruise ships linked to coronavirus cases, Gov. Reynolds says, Des Moines Register Star
Saleh, The Effect of Chloroquine, Hydroxychloroquine and Azithromycin on the Corrected QT Interval in Patients with SARS-CoV-2 Infection, Circulation -Arrhythmia and Electrophysiology
Whittle, Pavlov, Respiratory Support for Adult Patients with COVID -19, Journal of American College of Emergency Physicians, doi:10.1002/emp2.12071
Wu, Mcgoogan, Characteristics of and important lessons from the coronavirus disease 2019(COVID-19) outbreak in China: summary of a report of 72314 cases from the Chinese Center for Disease Control and Prevention, JAMA, doi:10.1001/jama.2020.2648
Young, Ong, Kalimuddin, Novel Coronavirus Outbreak Research Team. Epidemiologic features and clinical course of patients infected with SARS-CoV-2 in Singapore, JAMA, doi:10.1001/jama.2020.3204
Late treatment
is less effective
Please send us corrections, updates, or comments. c19early involves the extraction of 100,000+ datapoints from thousands of papers. Community updates help ensure high accuracy. Treatments and other interventions are complementary. All practical, effective, and safe means should be used based on risk/benefit analysis. No treatment or intervention is 100% available and effective for all current and future variants. We do not provide medical advice. Before taking any medication, consult a qualified physician who can provide personalized advice and details of risks and benefits based on your medical history and situation. FLCCC and WCH provide treatment protocols.
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