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0 0.5 1 1.5 2+ Mortality 47% Improvement Relative Risk HCQ for COVID-19  Mikami et al.  LATE TREATMENT Is late treatment with HCQ beneficial for COVID-19? Retrospective 6,000 patients in the USA Lower mortality with HCQ (p=0.0000012) Mikami et al., J. Gen. Intern. Med., Jun 2020 Favors HCQ Favors control

Risk Factors for Mortality in Patients with COVID-19 in New York City

Mikami et al., J. Gen. Intern. Med., doi:10.1007/s11606-020-05983-z
Jun 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 decreases mortality, HR 0.53 (CI 0.41–0.67). IPTW adjustment does not significantly change HR 0.53 (0.41-0.68). Retrospective 6,000 patients in New York City.
risk of death, 47.0% lower, HR 0.53, p < 0.001, treatment 575 of 2,077 (27.7%), control 231 of 743 (31.1%), adjusted per study.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Mikami et al., 30 Jun 2020, retrospective, USA, peer-reviewed, 7 authors.
This PaperHCQAll
Risk Factors for Mortality in Patients with COVID-19 in New York City
M.D Takahisa Mikami, M.D Hirotaka Miyashita, M.D Takayuki Yamada, M.D Matthew Harrington, M.D Daniel Steinberg, M.D Andrew Dunn, M.D Evan Siau
Journal of General Internal Medicine, doi:10.1007/s11606-020-05983-z
BACKGROUND: New York City emerged as an epicenter of the coronavirus disease 2019 (COVID-19) pandemic. OBJECTIVE: To describe the clinical characteristics and risk factors associated with mortality in a large patient population in the USA. DESIGN: Retrospective cohort study. PARTICIPANTS: 6493 patients who had laboratoryconfirmed COVID-19 with clinical outcomes between March 13 and April 17, 2020, who were seen in one of the 8 hospitals and/or over 400 ambulatory practices in the New York City metropolitan area MAIN MEASURES: Clinical characteristics and risk factors associated with in-hospital mortality. KEY RESULTS: A total of 858 of 6493 (13.2%) patients in our total cohort died: 52/2785 (1.9%) ambulatory patients and 806/3708 (21.7%) hospitalized patients. Cox proportional hazard regression modeling showed an increased risk of in-hospital mortality associated with age older than 50 years (hazard ratio [HR] 2.34, CI 1.47-3.71), systolic blood pressure less than 90 mmHg (HR 1.38, CI 1.06-1.80), a respiratory rate greater than 24 per min (HR 1.43, CI 1.13-1.83), peripheral oxygen saturation less than 92% (HR 2.12, CI 1.56-2.88), estimated glomerular filtration rate less than 60 mL/min/1.73m 2 (HR 1.80, CI 1.60-2.02), IL-6 greater than 100 pg/mL (HR 1.50, CI 1.12-2.03), D-dimer greater than 2 mcg/mL (HR 1.19, CI 1.02-1.39), and troponin greater than 0.03 ng/mL (HR 1.40, CI 1.23-1.62). Decreased risk of in-hospital mortality was associated with female sex (HR 0.84, CI 0.77-0.90), African American race (HR 0.78 CI 0.65-0.95), and hydroxychloroquine use (HR 0.53, CI 0.41-0.67). CONCLUSIONS: Among patients with COVID-19, older age, male sex, hypotension, tachypnea, hypoxia, impaired renal function, elevated D-dimer, and elevated troponin were associated with increased in-hospital mortality and hydroxychloroquine use was associated with decreased in-hospital mortality.
Conflict of Interest: The authors declare that they do not have a conflict of interest. Publisher's Note: Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
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Late treatment
is less effective
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