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0 0.5 1 1.5 2+ Mortality -240% Improvement Relative Risk Sammartino et al. HCQ for COVID-19 LATE TREATMENT Is late treatment with HCQ beneficial for COVID-19? PSM retrospective 328 patients in the USA Higher mortality with HCQ (p=0.002) Sammartino et al., PLOS One, doi:10.1371/journal.pone.0251262 Favors HCQ Favors control
Predictors for inpatient mortality during the first wave of the SARS-CoV-2 pandemic: A retrospective analysis
Sammartino et al., PLOS One, doi:10.1371/journal.pone.0251262
Sammartino et al., Predictors for inpatient mortality during the first wave of the SARS-CoV-2 pandemic: A retrospective analysis, PLOS One, doi:10.1371/journal.pone.0251262
May 2021   Source   PDF  
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Retrospective 1,108 hospitalized patients in New York showing significantly higher mortality with HCQ treatment.
Time based confounding is very likely because HCQ became increasingly controversial and less used over the time covered (Mar - Jun 2020), while overall treatment protocols during this period improved dramatically, i.e., more control patients likely come later in the period when treatment protocols were greatly improved. Authors note that for every week or month later that a person was admitted, their risk of death dropped by 16% and 49%, respectively, yet they do not consider time based confounding. This study is excluded in the after exclusion results of meta analysis: 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, 240.0% higher, OR 3.40, p = 0.002, treatment 137, control 191, PSM, model 1a, RR approximated with OR.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Sammartino et al., 10 May 2021, retrospective, propensity score matching, USA, peer-reviewed, 7 authors.
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Abstract: PLOS ONE RESEARCH ARTICLE Predictors for inpatient mortality during the first wave of the SARS-CoV-2 pandemic: A retrospective analysis Daniel Sammartino ID1☯*, Farrukh Jafri1☯, Brennan Cook2☯, Lisa La1☯, Hyemin Kim1☯, John Cardasis1☯, Joshua Raff ID1☯ 1 White Plains Hospital, White Plains, New York, United States of America, 2 Rutgers Robert Wood Johnson School of Medicine, New Brunswick, New Jersey, United States of America a1111111111 a1111111111 a1111111111 a1111111111 a1111111111 ☯ These authors contributed equally to this work. * Abstract Background OPEN ACCESS Citation: Sammartino D, Jafri F, Cook B, La L, Kim H, Cardasis J, et al. (2021) Predictors for inpatient mortality during the first wave of the SARS-CoV-2 pandemic: A retrospective analysis. PLoS ONE 16(5): e0251262. pone.0251262 Editor: Aleksandar R. Zivkovic, Heidelberg University Hospital, GERMANY Received: January 14, 2021 The coronavirus disease 2019 (COVID-19) pandemic overwhelmed healthcare systems, highlighting the need to better understand predictors of mortality and the impact of medical interventions. Methods This retrospective cohort study examined data from every patient who tested positive for COVID-19 and was admitted to White Plains Hospital between March 9, 2020, and June 3, 2020. We used binomial logistic regression to analyze data for all patients, and propensity score matching for those treated with hydroxychloroquine and convalescent plasma (CP). The primary outcome of interest was inpatient mortality. Accepted: April 23, 2021 Published: May 10, 2021 Results Peer Review History: PLOS recognizes the benefits of transparency in the peer review process; therefore, we enable the publication of all of the content of peer review and author responses alongside final, published articles. The editorial history of this article is available here: 1,108 admitted patients with COVID-19 were available for analysis, of which 124 (11.2%) were excluded due to incomplete data. Of the 984 patients included, 225 (22.9%) died. Risk for death decreased for each day later a patient was admitted [OR 0.970, CI 0.955 to 0.985; p < 0.001]. Elevated initial C-reactive protein (CRP) value was associated with a higher risk for death at 96 hours [OR 1.007, 1.002 to 1.012; p = 0.006]. Hydroxychloroquine and CP administration were each associated with increased mortality [OR 3.4, CI 1.614 to 7.396; p = 0.002, OR 2.8560, CI 1.361 to 6.160; p = 0.006 respectively]. Copyright: © 2021 Sammartino et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Data Availability Statement: All relevant data are within the manuscript and its Supporting Information files. Conclusions Elevated CRP carried significant odds of early death. Hydroxychloroquine and CP were each associated with higher risk for death, although CP was without titers and was administered at a median of five days from admission. Randomized or controlled studies will better describe the impact of CP. Mortality decreased as the pandemic progressed, suggesting PLOS ONE | May 10, 2021 1 / 13 PLOS ONE Funding: The authors received no specific funding for this work. Predictors for..
Late treatment
is less effective
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