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All Studies   Meta Analysis    Recent:   

Epidemiological and Clinical Characteristics, and Virologic Features of COVID-19 Patients in Kazakhstan: a Nation-Wide, Retrospective, Cohort Study

Yegerov et al., medRxiv, doi:10.1101/2021.01.06.20249091
Jan 2021  
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Mortality 95% Improvement Relative Risk HCQ for COVID-19  Yegerov et al.  LATE TREATMENT Is late treatment with HCQ beneficial for COVID-19? Retrospective 1,072 patients in Kazakhstan Study underpowered to detect differences c19hcq.org Yegerov et al., medRxiv, January 2021 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
Retrospective 1,072 hospitalized patients in Kazakhstan showing no mortality for HCQ treated patients, however only 23 patients received treatment - this result is not statistically significant.
This study is excluded in the after exclusion results of meta analysis: unadjusted results with no group details.
risk of death, 95.3% lower, RR 0.05, p = 1.00, treatment 0 of 23 (0.0%), control 20 of 1,049 (1.9%), NNT 52, relative risk is not 0 because of continuity correction due to zero events (with reciprocal of the contrasting arm).
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Yegerov et al., 8 Jan 2021, retrospective, Kazakhstan, preprint, 8 authors, average treatment delay 1.0 days.
This PaperHCQAll
Epidemiological and Clinical Characteristics, and Virologic Features of COVID-19 Patients in Kazakhstan: a Nation-Wide, Retrospective, Cohort Study
PhD Sergey Yegorov, MD Maiya Goremykina, MD Raifa Ivanova, Sara V Good, PhD Dmitriy Babenko, MD 3^ Alexandr Shevtsov, MD Kelly S Macdonald, MD Yersin Zhunussov
doi:10.1101/2021.01.06.20249091
Background: The earliest coronavirus disease-2019 (COVID-19) cases in Central Asia were announced in March 2020 by Kazakhstan. Despite the implementation of aggressive measures to curb infection spread, gaps remain in the understanding of the clinical and epidemiologic features of the regional pandemic. Methods: We did a retrospective, observational cohort study of patients with laboratoryconfirmed COVID-19 in Kazakhstan between February and April 2020. We compared demographic, clinical, laboratory and radiological data of patients with different COVID-19 severities on admission. Univariable and multivariable logistic regression was used to assess factors associated with disease severity and death. Whole-genome SARS-CoV-2 analysis was performed in 53 patients without a recent history of international travel. Findings: Of the 1072 patients with laboratory-confirmed COVID-19 in March-April 2020, the median age was 36 years (IQR 24-50) and 484 (45%) were male. On admission, 683 (64%) participants had mild, 341 (32%) moderate, and 47 (4%) severe-to-critical COVID-19 manifestation; 20 deaths (1.87%) were reported at study exit. Multivariable regression indicated increasing odds of severe disease associated with older age (odds ratio 1.05, 95% CI 1.03-1.07, per year increase; p<0.001), the presence of comorbidities (2.13, 95% CI 1.07-4.23; p<0.031) and elevated white blood cell count (WBC, 1.14, 95% CI 1.01-1.28; p<0.032) on admission, while older age (1.09, 95% CI 1.06-1.12, per year increase; p<0.001) and male sex (5.97, 95% CI 1.95-18.32; p<0.002) were associated with increased odds of death. The Kazakhstan SARS-CoV-2 isolates grouped into seven distinct lineages
Supplementary information All supplementary information can be found in the Appendix. Figure 3
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Despite the implementation of aggressive measures to curb infection ' 'spread, gaps remain in the understanding of the clinical and epidemiologic features of the ' 'regional pandemic.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>We ' 'did a retrospective, observational cohort study of patients with laboratory-confirmed ' 'COVID-19 in Kazakhstan between February and April 2020. We compared demographic, clinical, ' 'laboratory and radiological data of patients with different COVID-19 severities on admission. ' 'Univariable and multivariable logistic regression was used to assess factors associated with ' 'disease severity and death. Whole-genome SARS-CoV-2 analysis was performed in 53 patients ' 'without a recent history of international ' 'travel.</jats:p></jats:sec><jats:sec><jats:title>Findings</jats:title><jats:p>Of the 1072 ' 'patients with laboratory-confirmed COVID-19 in March-April 2020, the median age was 36 years ' '(IQR 24–50) and 484 (45%) were male. On admission, 683 (64%) participants had mild, 341 (32%) ' 'moderate, and 47 (4%) severe-to-critical COVID-19 manifestation; 20 deaths (1.87%) were ' 'reported at study exit. Multivariable regression indicated increasing odds of severe disease ' 'associated with older age (odds ratio 1.05, 95% CI 1.03-1.07, per year increase; p&lt;0.001), ' 'the presence of comorbidities (2.13, 95% CI 1.07-4.23; p&lt;0.031) and elevated white blood ' 'cell count (WBC, 1.14, 95% CI 1.01-1.28; p&lt;0.032) on admission, while older age (1.09, 95% ' 'CI 1.06-1.12, per year increase; p&lt;0.001) and male sex (5.97, 95% CI 1.95-18.32; ' 'p&lt;0.002) were associated with increased odds of death. The Kazakhstan SARS-CoV-2 isolates ' 'grouped into seven distinct lineages O/B.4.1, S/A.2, S/B.1.1, G/B.1, GH/B.1.255, GH/B.1.3 and ' 'GR/B.1.1.10.</jats:p></jats:sec><jats:sec><jats:title>Interpretation</jats:title><jats:p>Older ' 'age, comorbidities, increased WBC count, and male sex were risk factors for COVID-19 disease ' 'severity and mortality in Kazakhstan. The broad SARS-CoV-2 diversity suggests multiple ' 'importations and community-level amplification, likely predating the declaration of state ' 'emergency. 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Late treatment
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