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All Studies   Meta Analysis    Recent:   

Outcomes of Hydroxychloroquine Treatment Among Hospitalized COVID-19 Patients in the United States- Real-World Evidence From a Federated Electronic Medical Record Network

Singh et al., medRxiv, doi:10.1101/2020.05.12.20099028
May 2020  
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Mortality 5% Improvement Relative Risk Ventilation 19% HCQ for COVID-19  Singh et al.  LATE TREATMENT Is late treatment with HCQ beneficial for COVID-19? Retrospective 1,820 patients in the USA Lower ventilation with HCQ (not stat. sig., p=0.26) c19hcq.org Singh et al., medRxiv, May 2020 FavorsHCQ Favorscontrol 0 0.5 1 1.5 2+
HCQ for COVID-19
1st treatment shown to reduce risk in March 2020
 
*, now with p < 0.00000000001 from 411 studies, recognized in 46 countries.
No treatment is 100% effective. Protocols combine treatments. * >10% efficacy, ≥3 studies.
4,300+ studies for 75 treatments. c19hcq.org
EHR analysis of 3,372 hospitalized COVID-19 patients not showing a significant difference for mortality or the risk of mechanical ventilation. Subject to the limitations of EHR analysis. Misclassification is possible. Confounding by indication is likely.
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, 5.0% lower, RR 0.95, p = 0.72, treatment 104 of 910 (11.4%), control 109 of 910 (12.0%), NNT 182.
risk of mechanical ventilation, 19.0% lower, RR 0.81, p = 0.26, treatment 46 of 910 (5.1%), control 57 of 910 (6.3%), NNT 83.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Singh et al., 19 May 2020, retrospective, database analysis, USA, preprint, 4 authors.
This PaperHCQAll
Abstract: Federated Electronic Medical Record Network Shailendra Singh, Ahmad Khan, Monica Chowdhry, Arka Chatterjee Authors Shailendra Singh M.D 1. Division of Gastroenterology, West Virginia University Health Sciences Center Charleston Division, Charleston, WV. 2. Charleston Area Medical Center Health System, Charleston, WV. Ahmad Khan M.D Department of Medicine, West Virginia University Health Sciences Center Charleston Division, Charleston, WV. Monica Chowdhry M.D Department of Medicine, West Virginia University Health Sciences Center Charleston Division, Charleston, WV. Arka Chatterjee M.D Division of Cardiovascular Disease, University of Alabama at Birmingham. medRxiv preprint doi: https://doi.org/10.1101/2020.05.12.20099028; this version posted May 19, 2020. The copyright holder for this preprint (which was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. It is made available under a CC-BY-NC-ND 4.0 International license . NOTE: This preprint reports new research that has not been certified by peer review and should not be used to guide clinical practice. Outcomes of Hydroxychloroquine Treatment Among Hospitalized COVID-19 Patients in the United States- Real-World Evidence From a Shailendra Singh M.D Charleston Area Medical Center Health System, Charleston, WV Email: Shail121@gmail.com Phone no: 304-342-0821 Fax: 304-345-6679 Acknowledgment We acknowledge the West Virginia Clinical and Translational Science Institute to provide us access, and training to the TriNETX global healthcare network. We also acknowledge the TriNETX (Cambridge, MA, USA) healthcare network for design assistance to complete this project. The authors received no financial support or grants for the research, authorship, and publication of this article. Shailendra Singh, Ahmad Khan, Monica Chowdhry and Arka Chatterjee declare that they have no conflict of interest. medRxiv preprint doi: https://doi.org/10.1101/2020.05.12.20099028; this version posted May 19, 2020. The copyright holder for this preprint (which was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. It is made available under a CC-BY-NC-ND 4.0 International license . Corresponding Author On March 28, 2020, in response to the rapidly accelerating COVID-19 pandemic, U.S FDA issued emergency use authorization for hydroxychloroquine (HCQ) in hospitalized COVID-19 patients based on limited in-vitro and anecdotal clinical data1,2. Analysis of the accumulated real-world data utilizing electronic medical records (EMR) could indicate HCQ therapy benefits as we await the results of clinical trials. However, any such analysis of retrospective observational data should account for variables such as demographics and comorbidities that could affect treatment strategies or outcomes. Therefore, we report the outcomes of HCQ treatment in a propensity-matched cohort of COVID-19 hospitalized patients. Methods and Findings Using the TriNetX (Cambridge, MA, USA), a global federated health research network, we performed a real-time search and analysis of EMR of more than 40 million patients from 34 healthcare organizations (HCOs) in the United States. TriNETX recently fast-tracked data inflow to incorporate COVID-19 specific diagnosis and terminology following the World Health Organization (WHO) and Centers for Disease Control (CDC) criteria. As a federated network,..
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Late treatment
is less effective
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