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0 0.5 1 1.5 2+ Mortality 26% Improvement Relative Risk Discharge 26% Hospitalization time -25% HCQ  Sarhan et al.  LATE TREATMENT  RCT Is late treatment with HCQ beneficial for COVID-19? RCT 108 patients in Egypt (October 2020 - March 2021) Trial compares with remdesivir, results vs. placebo may differ Lower mortality (p=0.39) and higher discharge (p=0.39), not sig. Sarhan et al., J. Infection and Public.., Nov 2021 Favors HCQ Favors remdesivir

Efficacy of the early treatment with tocilizumab-hydroxychloroquine and tocilizumab-remdesivir in severe COVID-19 Patients

Sarhan et al., Journal of Infection and Public Health, doi:10.1016/j.jiph.2021.10.024, NCT04779047
Nov 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 421 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.
3,800+ studies for 60+ treatments.
Small 108 patient RCT comparing HCQ vs. remdesivir in very late stage treatment. All patients received tocilizumab. There were significant unadjusted baseline differences in ventilation and ICU admission. NCT04779047 (history). REC-H-PhBSU-21011.
Although the 26% lower mortality is not statistically significant, it is consistent with the significant 24% lower mortality [20‑29%] from meta analysis of the 249 mortality results to date.
This study is excluded in the after exclusion results of meta analysis: very late stage, >50% on oxygen/ventilation at baseline; significant unadjusted differences between groups.
risk of death, 25.7% lower, RR 0.74, p = 0.39, treatment 12 of 56 (21.4%), control 15 of 52 (28.8%), NNT 13.
risk of no hospital discharge, 25.7% lower, RR 0.74, p = 0.39, treatment 12 of 56 (21.4%), control 15 of 52 (28.8%), NNT 13.
hospitalization time, 25.0% higher, relative time 1.25, p = 0.06, treatment 56, control 52.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Sarhan et al., 2 Nov 2021, Randomized Controlled Trial, Egypt, peer-reviewed, 8 authors, study period 1 October, 2020 - 10 March, 2021, this trial compares with another treatment - results may be better when compared to placebo, trial NCT04779047 (history).
This PaperHCQAll
Efficacy of the early treatment with tocilizumab-hydroxychloroquine and tocilizumab-remdesivir in severe COVID-19 Patients
Rania M Sarhan, Hadeer S Harb, Ahmed E Abou Warda, Mounir M Salem-Bekhit, Faiyaz Shakeel, Sami Ali Alzahrani, Yasmin M Madney, Marian S Boshra
Journal of Infection and Public Health, doi:10.1016/j.jiph.2021.10.024
This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.
Declarations of interest None Author contributions Original J o u r n a l P r e -p r o o f
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Late treatment
is less effective
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