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0 0.5 1 1.5 2+ Mortality -79% Improvement Relative Risk Texeira et al. HCQ for COVID-19 LATE TREATMENT Is late treatment with HCQ beneficial for COVID-19? Retrospective 161 patients in the USA Higher mortality with HCQ (not stat. sig., p=0.1) Texeira et al., Open Forum Infectious Diseases, doi:10.1093/ofid/ofaa439.560 Favors HCQ Favors control
Characteristics and outcomes of COVID-19 patients admitted to a regional health system in the southeast
Texeira et al., Open Forum Infectious Diseases, doi:10.1093/ofid/ofaa439.560
Texeira et al., Characteristics and outcomes of COVID-19 patients admitted to a regional health system in the southeast, Open Forum Infectious Diseases, doi:10.1093/ofid/ofaa439.560
Dec 2020   Source   PDF  
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Retrospective 161 hospitalized patients in the USA showing non-statistically significant unadjusted increased mortality with HCQ. Confounding by indication is likely.
Time varying confounding is likely. HCQ became controversial and was suspended towards the end of the period studied, therefore HCQ use was likely more frequent toward the beginning of the study period, a time when overall treatment protocols were significantly worse. This study is excluded in the after exclusion results of meta analysis: unadjusted results with no group details; no treatment details; substantial confounding by time likely due to declining usage over the early stages of the pandemic when overall treatment protocols improved dramatically; substantial unadjusted confounding by indication likely.
risk of death, 79.3% higher, RR 1.79, p = 0.10, treatment 17 of 65 (26.2%), control 14 of 96 (14.6%).
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Texeira et al., 31 Dec 2020, retrospective, USA, peer-reviewed, 6 authors.
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This PaperHCQAll
Abstract: Conclusion: Our study suggests that PLWH do not have a worse prognosis than their matched controls for the most significant comorbid conditions affecting outcome in COVID-19 disease. Further studies with a larger sample size are urgently needed to confirm this finding. Disclosures: Jihad Slim, MD, Abbvie (Speaker’s Bureau)Gilead (Speaker’s Bureau)Jansen (Speaker’s Bureau)Merck (Speaker’s Bureau)ViiV (Speaker’s Bureau) 362. A Modified Early Warning Score Predicts Decompensation in COVID-19 Patients Joanna S. Cavalier, MD1; Benjamin Goldstein, PhD2; Cara L. O’Brien, MD1; Armando Bedoya, MD, MMCi1; 1Duke University School of Medicine, Durham, North Carolina; 2Duke University, Durham, NC Session: P-12. COVID-19 Complications, Co-infections, and Clinical Outcomes 363. Acute Kidney Injury and Renal Replacement Therapy in Hospitalized COVID-19 Patients in the United States and Other Geographic Regions Shannon NovosadShannon NovosadLeah Gilbert, MD, MSPH1; Ibironke W. Apata, MD1; Rahsaan Overton, MPH1; Shikha Garg, MD, MPH1; Lindsey Kim, MD1; Brendan R. Jackson, MD, MPH1; Priti Patel, MD, MPH1; 1Centers for Disease Control and Prevention, Atlanta, Georgia CDC COVID-19 Clinical Team and COVID-NET Investigators Session: P-12. COVID-19 Complications, Co-infections, and Clinical Outcomes Background: Acute kidney injury (AKI) is a complication that has been described among severely ill patients with COVID-19 and may be more common in those with underlying chronic kidney disease (CKD). Some patients with AKI require renal replacement therapy (RRT), including continuous RRT (CRRT). During the COVID-19 pandemic, some US areas experienced CRRT supply shortages. We sought to describe the percent of hospitalized COVID-19 patients who developed AKI or needed RRT to inform patient care and resource planning. Methods: We searched for studies in the literature and public health investigations that described CKD, AKI, and/or RRT in COVID-19 patients from January 2020 onward. Studies were excluded if no CKD, AKI, or RRT information was provided. We abstracted counts of hospitalized COVID-19 patients, including those admitted to intensive care units (ICU) who developed AKI, underwent RRT, and/ or had CKD. Data were pooled across cohorts by geographic region with available data (US, China, or United Kingdom [UK]). We compared proportions using Chisquare tests. Results: A total of 311 studies were identified; 23 studies (US n=11; China n=11; UK n=1) that described kidney disease and/or kidney-related outcomes in hospitalized COVID-19 patients were included. Underlying CKD prevalence was higher in US cohorts (10.3%) compared with China (2.5%) or UK (1.5%) (p< 0.0001). AKI was markedly higher among hospitalized (31.3% vs. 6.4%; p < 0 .001) and ICU patients (55.4% vs. 18.2%; p< 0.0001) in the US compared to China. The percent of ICU patients requiring RRT in the US (16.8%) was significantly different from that reported in China (12.5%) and the UK (23.9%) (p< 0.0001). Limitations include differences in CKD and RRT definitions across studies. Conclusion: AKI is a frequent outcome among US COVID-19 patients, affecting almost one third of hospitalized and more than half of ICU patients. AKI was reported more frequently in the US than China. The percent of ICU patients who received RRT was higher in the US and UK than in China. Understanding the occurrence of kidney-related outcomes among patients with COVID-19 including the impact of underlying CKD and regional..
Late treatment
is less effective
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