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All Studies   Meta Analysis    Recent:   
0 0.5 1 1.5 2+ Mortality -63% Improvement Relative Risk HCQ for COVID-19  Psevdos et al.  LATE TREATMENT Is late treatment with HCQ beneficial for COVID-19? Retrospective 67 patients in the USA Higher mortality with HCQ (not stat. sig., p=0.52) c19hcq.org Psevdos et al., Open Forum Infectious .., Dec 2020 Favors HCQ Favors control

Corona Virus Disease-19 (COVID-19) in a Veterans Affairs Hospital at Suffolk County, Long Island, New York

Psevdos et al., Open Forum Infectious Diseases, doi:10.1093/ofid/ofaa439.721
Dec 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.
4,100+ studies for 60+ treatments. c19hcq.org
Retrospective 67 hospitalized patients in the USA showing non-statistically significant unadjusted increased mortality with HCQ. Confounding by indication is likely.
Time varying confounding is likely. HCQ became controversial and was suspended during the end of the period studied, therefore HCQ use was likely more frequent toward the beginning of the study period, a time when overall treatment protocols were significantly worse.
This study is excluded in the after exclusion results of meta analysis: unadjusted results with no group details; no treatment details; substantial confounding by time likely due to declining usage over the early stages of the pandemic when overall treatment protocols improved dramatically; substantial unadjusted confounding by indication likely.
risk of death, 63.5% higher, RR 1.63, p = 0.52, treatment 17 of 52 (32.7%), control 3 of 15 (20.0%).
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Psevdos et al., 31 Dec 2020, retrospective, USA, peer-reviewed, 3 authors.
This PaperHCQAll
S330 • OFID 2020:7 (Suppl 1) • Poster Abstracts
Conclusion: Mortality in our HIV COVID-19 population was 18%, significantly lower than the 33% in COVID-19 patients overall at our institution. 39 patients with HIV were admitted for confirmed COVID-19 infections, which only amounts to 6.5% of the DAC population, although it is possible that our patients were admitted to other facilities for COVID-19. In our patients, compliance, viral suppression, and CD4+ counts did not correlate with outcomes. Although our mortality was significantly lower than the overall hospital mortality, larger studies are needed to fully evaluate the mortality relationship and determine the protective effects of antiviral therapy and/or decreased immune response in HIV patients with COVID-19.
Poster Abstracts • OFID 2020:7 (Suppl 1) • S331 influenza or other respiratory viruses were identified. The deceased group was older 77.5 vs 71 years P 0.007, had lower oxygen saturation and higher respiratory rate on presentation, had longer length of stay P 0.091, more likely to be in ICU and intubated, had lower bicarbonate levels, higher SAPS P < 0.001, higher lactate dehydrogenase, blood urea nitrogen, potassium levels, and higher peak procalcitonin, CRP, ferritin, ESR levels. There was no difference between recovered and deceased in terms of comorbidities except atrial fibrillation. Also, no difference in use of ACE inhibitors, statins, famotidine, hydroxychloroquine (HCQ), azithromycin, doxycycline, steroids. Beta lactam antibiotics and tocilizumab were given more in the deceased group. HCQ was stopped in 1 patient due to QTc prolongation. No bacteremia identified in the recovered group contrary to two occasions in the deceased, E. faecalis and S. mitis. Six pneumonias in intubated deceased patients were identified (3 had received steroids and one tocilizumab) and 4 in recovered (2 intubated/steroids and 1 tocilizumab). 12 recovered patients had persistent positive nasopharyngeal PCR for SARS-CoV-2 for average 29 days ( 14 Methods: We performed a retrospective chart review of all pediatric patients (< 21 years of age) with ≥ 2 nasopharyngeal specimens tested for SARS-CoV-2 by reverse transcription-polymerase chain reaction (rt-PCR) and at least one positive..
{ 'DOI': '10.1093/ofid/ofaa439.721', 'ISSN': ['2328-8957'], 'URL': 'http://dx.doi.org/10.1093/ofid/ofaa439.721', 'abstract': '<jats:title>Abstract</jats:title>\n' ' <jats:sec>\n' ' <jats:title>Background</jats:title>\n' ' <jats:p>The area of New York was hit hard by the COVID 19 pandemic with ' 'Suffolk county in Long Island numbering &amp;gt;40 thousand cases and 1900 deaths by the end ' 'of May 2020. The Veterans Affairs Medical Center (VAMC) at Northport NY serves over 30000 ' 'Veterans. We report our institution’s experience during the COVID 19 outbreak</jats:p>\n' ' </jats:sec>\n' ' <jats:sec>\n' ' <jats:title>Methods</jats:title>\n' ' <jats:p>Retrospective chart review of hospitalized Veterans (VETS) with ' 'COVID-19 from March 1st to May 31st 2020 at Northport VAMC</jats:p>\n' ' </jats:sec>\n' ' <jats:sec>\n' ' <jats:title>Results</jats:title>\n' ' <jats:p>A total of 141 VETS had laboratory confirmed SARS-CoV-2 infection, ' '67 got hospitalized, and 20/67 died. The median age of the hospitalized cohort was 73 years ' '(33 to 94). Figure 1 shows the dates of tests, Tables 1 &amp;2 summarize the demographic ' 'characteristics, medical history and laboratory findings. No co-infection with influenza or ' 'other respiratory viruses were identified. The deceased group was older 77.5 vs 71 years P ' '0.007, had lower oxygen saturation and higher respiratory rate on presentation, had longer ' 'length of stay P 0.091, more likely to be in ICU and intubated, had lower bicarbonate levels, ' 'higher SAPS P &amp;lt; 0.001, higher lactate dehydrogenase, blood urea nitrogen, potassium ' 'levels, and higher peak procalcitonin, CRP, ferritin, ESR levels. There was no difference ' 'between recovered and deceased in terms of comorbidities except atrial fibrillation. Also, no ' 'difference in use of ACE inhibitors, statins, famotidine, hydroxychloroquine (HCQ), ' 'azithromycin, doxycycline, steroids. Beta lactam antibiotics and tocilizumab were given more ' 'in the deceased group. HCQ was stopped in 1 patient due to QTc prolongation. No bacteremia ' 'identified in the recovered group contrary to two occasions in the deceased, E. faecalis and ' 'S. mitis. Six pneumonias in intubated deceased patients were identified (3 had received ' 'steroids and one tocilizumab) and 4 in recovered (2 intubated/steroids and 1 tocilizumab). 12 ' 'recovered patients had persistent positive nasopharyngeal PCR for SARS-CoV-2 for average 29 ' 'days (14 to 79 days), and 4 of them were checked and had detectable IgG antibody</jats:p>\n' ' <jats:p>Dates of Tests for Hospitalized Veterans with COVID-19</jats:p>\n' ' <jats:p />\n' ' <jats:p>Comparison of Demographic Data and Comorbidities in Recovered vs ' 'Diseased Hospitalized Veterans with COVID - 19</jats:p>\n' ' <jats:p />\n' ' <jats:p>Comparison of Laboratory Data in Recovered vs Diseased Hospitalized ' 'Veterans with COVID - 19</jats:p>\n' ' <jats:p />\n' ' </jats:sec>\n' ' <jats:sec>\n' ' <jats:title>Conclusion</jats:title>\n' ' <jats:p>The inpatient mortality of hospitalized VETS with COVID-19 in our ' 'institution was 30%. Mortality was associated with older age. Ongoing monitoring of outcomes ' 'in hospitalized patients will be important to understand the evolving epidemiology of ' 'COVID-19 among US VETS.</jats:p>\n' ' </jats:sec>\n' ' <jats:sec>\n' ' <jats:title>Disclosures</jats:title>\n' ' <jats:p>All Authors: No reported disclosures</jats:p>\n' ' </jats:sec>', 'author': [ { 'affiliation': [{'name': 'Northport VA, North Port, New York'}], 'family': 'Psevdos', 'given': 'George', 'sequence': 'first'}, { 'affiliation': [{'name': 'Stony Brook University Hospital, Port Jefferson, New York'}], 'family': 'Papamanoli', 'given': 'Aikaterini', 'sequence': 'additional'}, { 'affiliation': [{'name': 'Northport VA, North Port, New York'}], 'family': 'Lobo', 'given': 'Zeena', 'sequence': 'additional'}], 'container-title': 'Open Forum Infectious Diseases', 'content-domain': {'crossmark-restriction': False, 'domain': []}, 'created': {'date-parts': [[2021, 1, 2]], 'date-time': '2021-01-02T08:19:41Z', 'timestamp': 1609575581000}, 'deposited': { 'date-parts': [[2021, 1, 2]], 'date-time': '2021-01-02T08:19:41Z', 'timestamp': 1609575581000}, 'indexed': {'date-parts': [[2023, 5, 16]], 'date-time': '2023-05-16T14:16:57Z', 'timestamp': 1684246617762}, 'is-referenced-by-count': 1, 'issue': 'Supplement_1', 'issued': {'date-parts': [[2020, 10, 1]]}, 'journal-issue': {'issue': 'Supplement_1', 'published-print': {'date-parts': [[2020, 12, 31]]}}, 'language': 'en', 'license': [ { 'URL': 'http://creativecommons.org/licenses/by-nc-nd/4.0/', 'content-version': 'vor', 'delay-in-days': 93, 'start': { 'date-parts': [[2021, 1, 2]], 'date-time': '2021-01-02T00:00:00Z', 'timestamp': 1609545600000}}], 'link': [ { 'URL': 'http://academic.oup.com/ofid/article-pdf/7/Supplement_1/S330/35338131/ofaa439.721.pdf', 'content-type': 'application/pdf', 'content-version': 'vor', 'intended-application': 'syndication'}, { 'URL': 'http://academic.oup.com/ofid/article-pdf/7/Supplement_1/S330/35338131/ofaa439.721.pdf', 'content-type': 'unspecified', 'content-version': 'vor', 'intended-application': 'similarity-checking'}], 'member': '286', 'original-title': [], 'page': 'S330-S331', 'prefix': '10.1093', 'published': {'date-parts': [[2020, 10, 1]]}, 'published-online': {'date-parts': [[2020, 12, 31]]}, 'published-other': {'date-parts': [[2020, 10, 1]]}, 'published-print': {'date-parts': [[2020, 12, 31]]}, 'publisher': 'Oxford University Press (OUP)', 'reference-count': 0, 'references-count': 0, 'relation': {}, 'resource': {'primary': {'URL': 'https://academic.oup.com/ofid/article/7/Supplement_1/S330/6057008'}}, 'score': 1, 'short-title': [], 'source': 'Crossref', 'subject': ['Infectious Diseases', 'Oncology'], 'subtitle': [], 'title': '527. Corona Virus Disease-19 (COVID-19) in a Veterans Affairs Hospital at Suffolk County, Long ' 'Island, New York', 'type': 'journal-article', 'volume': '7'}
Late treatment
is less effective
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