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0 0.5 1 1.5 2+ Mortality -8% Improvement Relative Risk Rosenthal et al. HCQ for COVID-19 LATE TREATMENT Is late treatment with HCQ beneficial for COVID-19? Retrospective study in the USA No significant difference in mortality Rosenthal et al., JAMA Network Open, doi:10.1001/jamanetworkopen.2020.29058 Favors HCQ Favors control
Risk Factors Associated With In-Hospital Mortality in a US National Sample of Patients With COVID-19
Rosenthal et al., JAMA Network Open, doi:10.1001/jamanetworkopen.2020.29058
Rosenthal et al., Risk Factors Associated With In-Hospital Mortality in a US National Sample of Patients With COVID-19, JAMA Network Open, doi:10.1001/jamanetworkopen.2020.29058
Dec 2020   Source   PDF  
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Retrospective database analysis of 64,781 hospitalized patients in the USA, showing lower mortality with vitamin C or vitamin D (authors do not distinguish between the two), and higher mortality with zinc and HCQ, statistically significant for zinc. Authors excluded hospital-based outpatient visits, without explanation. Confounding by indication is likely, adjustments do not appear to include any information on COVID-19 severity at baseline. This study is excluded in the after exclusion results of meta analysis: confounding by indication is likely and adjustments do not consider COVID-19 severity at baseline.
risk of death, 8.0% higher, OR 1.08, p = 0.13, adjusted per study, multivariable, RR approximated with OR.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Rosenthal et al., 10 Dec 2020, retrospective, database analysis, USA, peer-reviewed, 5 authors.
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Abstract: Original Investigation | Infectious Diseases Risk Factors Associated With In-Hospital Mortality in a US National Sample of Patients With COVID-19 Ning Rosenthal, MD, MPH, PhD; Zhun Cao, PhD; Jake Gundrum, MS; Jim Sianis, PharmD, MBA; Stella Safo, MD, MPH Abstract Key Points IMPORTANCE Coronavirus disease 2019 (COVID-19) has infected more than 8.1 million US residents and killed more than 221 000. There is a dearth of research on epidemiology and clinical outcomes in US patients with COVID-19. Question What are the epidemiologic characteristics of patients with coronavirus disease 2019 (COVID-19) treated in US hospitals, and what risk OBJECTIVES To characterize patients with COVID-19 treated in US hospitals and to examine risk factors are associated with mortality? Findings In this cohort study of 64 781 factors associated with in-hospital mortality. patients with COVID-19 treated in 592 DESIGN, SETTING, AND PARTICIPANTS This cohort study was conducted using Premier US hospitals during April and May 2020, Healthcare Database, a large geographically diverse all-payer hospital administrative database the in-hospital mortality rate was 20.3% including 592 acute care hospitals in the United States. Inpatient and hospital-based outpatient visits among inpatients, and severe with a principal or secondary discharge diagnosis of COVID-19 (International Classification of complications were common. Receipt of Diseases, Tenth Revision, Clinical Modification diagnosis code, U07.1) between April 1 and May 31, statin, angiotensin-converting enzyme 2020, were included. inhibitors, and calcium channel blockers were associated with decreased odds EXPOSURES Characteristics of patients were reported by inpatient/outpatient and survival status. of mortality, but the combination use of Risk factors associated with death examined included patient characteristics, acute complications, hydroxychloroquine and azithromycin comorbidities, and medications. was associated with increased odds of mortality. MAIN OUTCOMES AND MEASURES In-hospital mortality, intensive care unit (ICU) admission, use of invasive mechanical ventilation, total hospital length of stay (LOS), ICU LOS, acute complications, and treatment patterns. Meaning In this study, COVID-19 was associated with severe complications and deaths among patients hospitalized in the United States; certain medications RESULTS Overall, 64 781 patients with COVID-19 (29 479 [45.5%] outpatients; 35 302 [54.5%] inpatients) were analyzed. The median (interquartile range [IQR]) age was 46 (33-59) years for may be associated with decreased odds of mortality. outpatients and 65 (52-77) years for inpatients; 31 968 (49.3%) were men, 25 841 (39.9%) were White US residents, and 14 340 (22.1%) were Black US residents. In-hospital mortality was 20.3% among inpatients (7164 patients). A total of 5625 inpatients (15.9%) received invasive mechanical ventilation, and 6849 (19.4%) were admitted to the ICU. Median (IQR) inpatient LOS was 6 (3-10) days. Median (IQR) ICU LOS was 5 (2-10) days. Common acute complications among inpatients + Supplemental content Author affiliations and article information are listed at the end of this article. included acute respiratory failure (19 706 [55.8%]), acute kidney failure (11 971 [33.9%]), and sepsis (11 910 [33.7%]). Older age was the risk factor most strongly associated with death (eg, age ⱖ80 years vs 18-34 years: odds ratio [OR], 16.20; 95% CI,..
Late treatment
is less effective
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