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0 0.5 1 1.5 2+ Mortality -37% Improvement Relative Risk Salazar et al. HCQ for COVID-19 LATE TREATMENT Is late treatment with HCQ beneficial for COVID-19? Retrospective 903 patients in the USA Higher mortality with HCQ (not stat. sig., p=0.28) Salazar et al., The American J. Pathology, doi:10.1016/j.ajpath.2020.10.008 Favors HCQ Favors control
Significantly Decreased Mortality in a Large Cohort of Coronavirus Disease 2019 (COVID-19) Patients Transfused Early with Convalescent Plasma Containing High-Titer Anti–Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Spike Protein IgG
Salazar et al., The American Journal of Pathology, doi:10.1016/j.ajpath.2020.10.008
Salazar et al., Significantly Decreased Mortality in a Large Cohort of Coronavirus Disease 2019 (COVID-19) Patients Transfused.., The American Journal of Pathology, doi:10.1016/j.ajpath.2020.10.008
Nov 2020   Source   PDF  
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Convalescent plasma study also showing mortality based on HCQ treatment, unadjusted hazard ratio uHR 1.37, p = 0.28. Confounding by indication is 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.
risk of death, 37.0% higher, RR 1.37, p = 0.28, treatment 12 of 92 (13.0%), control 80 of 811 (9.9%).
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Salazar et al., 4 Nov 2020, retrospective, USA, peer-reviewed, 19 authors.
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Abstract: The American Journal of Pathology, Vol. 191, No. 1, January 2021 IMMUNOPATHOLOGY AND INFECTIOUS DISEASES Significantly Decreased Mortality in a Large Cohort of Coronavirus Disease 2019 (COVID-19) Patients Transfused Early with Convalescent Plasma Containing High-Titer AntieSevere Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Spike Protein IgG Eric Salazar,*y Paul A. Christensen,* Edward A. Graviss,*z Duc T. Nguyen,z Brian Castillo,* Jian Chen,* Bevin V. Lopez,x Todd N. Eagar,*y Xin Yi,*y Picheng Zhao,* John Rogers,* Ahmed Shehabeldin,* David Joseph,* Faisal Masud,{ Christopher Leveque,* Randall J. Olsen,*yz David W. Bernard,*y Jimmy Gollihar,k and James M. Musser*yz From the Departments of Pathology and Genomic Medicine* and Anesthesiology and Critical Care,{ Houston Methodist Hospital, Houston, Texas; the Department of Pathology and Laboratory Medicine,y Weill Cornell Medical College, New York, New York; the Center for Molecular and Translational Human Infectious Diseasesz and the Academic Office of Clinical Trials,x Houston Methodist Research Institute, Houston, Texas; and the The Combat Capabilities Development Command Army Research Laboratory-South,k University of Texas at Austin, Austin, Texas Accepted for publication October 28, 2020. Address correspondence to James M. Musser, M.D., Ph.D., 6565 Fannin St., Suite B490, Houston, TX 77030. E-mail: jmmusser@ Coronavirus disease 2019 (COVID-19) convalescent plasma has emerged as a promising therapy and has been granted Emergency Use Authorization by the US Food and Drug Administration for hospitalized COVID-19 patients. We recently reported results from interim analysis of a propensity scoreematched study suggesting that early treatment of COVID-19 patients with convalescent plasma containing hightiter anti-spike protein receptor binding domain (RBD) IgG significantly decreases mortality. We herein present results from a 60-day follow-up of a cohort of 351 transfused hospitalized patients. Prospective determination of enzyme-linked immunosorbent assay anti-RBD IgG titer facilitated selection and transfusion of the highest titer units available. Retrospective analysis by the Ortho VITROS IgG assay revealed a median signal/cutoff ratio of 24.0 for transfused units, a value far exceeding the recent US Food and Drug Administrationerequired cutoff of 12.0 for designation of high-titer convalescent plasma. With respect to altering mortality, our analysis identified an optimal window of 44 hours after hospitalization for transfusing COVID-19 patients with high-titer convalescent plasma. In the aggregate, the analysis confirms and extends our previous preliminary finding that transfusion of COVID-19 patients soon after hospitalization with high-titer anti-spike protein RBD IgG present in convalescent plasma significantly reduces mortality. (Am J Pathol 2021, 191: 90e107; j.ajpath.2020.10.008) Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has caused massive societal disruption and death globally. As of September 27, 2020, there have been >33 million COVID-19 cases, causing in excess of 1,000,000 deaths worldwide.1 The United States has many areas where rising case rates continue to threaten multiple populations. Few effective treatments exist (, last accessed September 24, 2020), in spite of hundreds of ongoing..
Late treatment
is less effective
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