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0 0.5 1 1.5 2+ Mortality 99% Improvement Relative Risk c19hcq.org Mitchell et al. HCQ for COVID-19 PrEP Is pre-exposure prophylaxis with HCQ beneficial for COVID-19? Retrospective 2,400,000,000 patients in multiple countries Lower mortality with HCQ (p=0.0001) Mitchell et al., SSRN, doi:10.2139/ssrn.3586954 Favors HCQ Favors control
Markedly Lower Rates of Coronavirus Infection and Fatality in Malaria-Endemic Regions – A Clue As to Treatment?
Mitchell et al., SSRN, doi:10.2139/ssrn.3586954 (Preprint)
Mitchell et al., Markedly Lower Rates of Coronavirus Infection and Fatality in Malaria-Endemic Regions – A Clue As to.., SSRN, doi:10.2139/ssrn.3586954 (Preprint)
May 2020   Source   PDF  
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Analysis of COVID-19 amongst 2.4B people shows a wide counterintuitive disparity between well-developed and less-developed countries, with more affluent countries about one hundred times more likely to be infected and die due to COVID-19. They find the effect is most apparent when comparing to countries with the highest rates of endemic malaria. Since travelers to malaria-endemic countries are likely to be taking antimalarial prophylaxis and there is evidence of efficacy with COVID-19, authors find the data highly probative for the hypothesis that prophylactic antimalarial use by incoming visitors markedly attenuates a country’s COVID-19 fatality rate. While authors do not adjust for age differences, those adjustments can only account for a small fraction of the observed difference. This study is excluded in the after exclusion results of meta analysis: excessive unadjusted differences between groups.
risk of death, 99.0% lower, RR 0.01, p < 0.001.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Mitchell et al., 5 May 2020, retrospective, multiple countries, preprint, 2 authors.
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Abstract: Markedly Lower Rates of Coronavirus Infection and Fatality in Malaria-Endemic Regions – A Clue to Treatment? Abstract This comparative analysis of coronavirus infection and death among 2.4 billion persons around the world demonstrates a wide (two orders of magnitude or one hundred-fold) disparity in coronavirus fatality rates between well-developed and less-developed countries. The difference is backward or counterintuitive. The current data demonstrates the surprising fact that those in more affluent countries are about one hundred times more likely to become infected with coronavirus infection and die. This effect is most apparent when these countries are compared to countries with the highest rates of endemic malaria. It is known that the novel coronavirus, also known as COVID-19, originated in Wuhan China and is transmitted from one country to another by travelers from a coronavirus-infested area. It is also known that travelers to malaria-endemic countries are likely to be taking antimalarial prophylaxis. There is also evidence that antimalarials, notably hydroxychloroquine, may have some efficacy in the treatment of coronavirus. In light of these facts, the mortality data presented here is highly probative for the hypothesis that prophylactic antimalarial use by its incoming visitors markedly attenuates a country’s coronavirus fatality rate. Keywords coronavirus, COVID-19, mortality, antimalarial, decrease, Africa, death, disparity, protective, treatment, malaria, SARS-CoV-2, epidemiology, statistics, migration, pharmacology
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