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0 0.5 1 1.5 2+ Mortality -81% Improvement Relative Risk HCQ for COVID-19  Mohandas et al.  LATE TREATMENT Is late treatment with HCQ beneficial for COVID-19? Retrospective 3,345 patients in India Higher mortality with HCQ (p=0.0067) Mohandas et al., , April 2021 Favors HCQ Favors control

Clinical review of COVID-19 patients presenting to a quaternary care private hospital in South India: A retrospective study

Mohandas et al.,
Apr 2021  
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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.
Retrospective 3,345 hospitalized patients in India, 11.5% treated with HCQ, showing unadjusted higher mortality with treatment. Confounding by indication and time based confounding (due to declining use over the period when overall treatment protocols improved dramatically) are likely.
This study is excluded in the after exclusion results of meta analysis: substantial unadjusted confounding by indication likely; unadjusted results with no group details; substantial confounding by time likely due to declining usage over the early stages of the pandemic when overall treatment protocols improved dramatically.
risk of death, 81.0% higher, RR 1.81, p = 0.007, treatment 27 of 384 (7.0%), control 115 of 2,961 (3.9%).
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Mohandas et al., 26 Apr 2021, retrospective, India, peer-reviewed, 6 authors.
This PaperHCQAll
Clinical review of COVID-19 patients presenting to a quaternary care private hospital in South India: A retrospective study
Prithvi Mohandas, Sathya Periasamy, Manimaran Marappan, Arun Sampath, Vanaja Kate Garfin Sundaram, Vijit Koshy Cherian
Clinical Epidemiology and Global Health, doi:10.1016/j.cegh.2021.100751
Background: Coronavirus disease 2019 (COVID-19) has been declared a global public-health crisis due to its impact on health, economy, and mental well-being. Here, we evaluated the clinical and epidemiological parameters associated with COVID-19 in South India. Methods: A retrospective, quaternary care hospital-based study that included COVID-19 positive patients admitted to MIOT International Hospital, Chennai between 8 April-7 August 2020. Cases were identified by reverse transcriptase-polymerase chain reaction. Epidemiological, demographic, clinical, and radiological findings were recorded and analyzed. The primary endpoint was stable discharge from hospital/patient recovery or death. Associations between risk factors and comorbidities were analyzed using Chi-Square/Fisher's exact test. Results: Of the 5264 cases reviewed, 3345 cases were included. The mean (standard deviation, SD) age of the patients was 47.58 (16.69) years with a median and range hospital stay of 5 (2-41) days. 69.20% of patients were male. The most frequent comorbidities were diabetes (37.10%) and hypertension (29.10%). Contact history was available for 58% of patients. The most common symptoms were cough (36.60%), fever (28.30%), and myalgia (15.40%). Abnormal chest radiography was reported in 16.9% of patients. Phase of admission, age ≥50 years, hypertension, diabetes, coronary artery disease, chronic kidney disease was significantly associated with mortality (p < 0.05). There were 142 (4.2%) deaths in this study. Conclusion: In this single centre hospital-based study, late presentation and more severe form of COVID pneumonia lead to higher mortality although it had lower mortality rate for COVID-19 in comparison. Late phase of the pandemic showed better outcomes vs. the early group.
Declaration of competing interest Authors declare no conflict of interest for this article. Appendix A. Supplementary data Supplementary data to this article can be found online at https://doi. org/10.1016/j.cegh.2021.100751.
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Late treatment
is less effective
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