2/18 Late treatment study
et al., American Journal of Health-System Pharmacy, doi:10.1093/ajhp/zxab056 (Peer Reviewed)
Impact of hydroxychloroquine on disease progression and ICU admissions in patients with SARS-CoV-2 infection
Impact of hydroxychloroquine on disease progression and ICU admissions in patients with SARS-CoV-2 infection
This paper has inconsistent values - the number of treatment and control patients differs in the text and Table 1, we have used treatment 188 and control 148. Retrospective 336 hospitalized patients in the USA showing higher mortality, ICU admission, and intubation with treatment. Confounding by indication is likely. Time varying confounding is also likely due to declining usage over the early period when overall treatment protocols were also improving dramatically. Authors and reviewers appear to be unfamiliar with either of these.
Awad et al., 2/18/2021, retrospective, USA, North America, peer-reviewed, 4 authors.
risk of death, 19.1% higher, RR 1.19, p = 0.60, treatment 56 of 188 (29.8%), control 37 of 148 (25.0%).
risk of mechanical ventilation, 460.7% higher, RR 5.61, p < 0.001, treatment 64 of 188 (34.0%), control 9 of 148 (6.1%), adjusted per study, odds ratio converted to relative risk.
risk of ICU admission, 463.4% higher, RR 5.63, p < 0.001, treatment 67 of 188 (35.6%), control 9 of 148 (6.1%), adjusted per study, odds ratio converted to relative risk.
This study is excluded in the after exclusion results of meta analysis: substantial time varying confounding likely due to declining usage over the early period when overall treatment protocols improved dramatically, substantial unadjusted confounding by indication likely.
Effect extraction follows pre-specified rules
prioritizing more serious outcomes. For an individual study the most serious
outcome may have a smaller number of events and lower statistical signficance,
however this provides the strongest evidence for the most serious outcomes
when combining the results of many trials.
Please send us corrections, updates, or comments. Vaccines and treatments are both extremely valuable and complementary. All
practical, effective, and safe means should be used. Elimination of COVID-19
is a race against viral evolution. No treatment, vaccine, or intervention is
100% available and effective for all current and future variants. Denying the
efficacy of any method increases the risk of COVID-19 becoming endemic; and
increases mortality, morbidity, and collateral damage. We do not provide
medical advice. Before taking any medication, consult a qualified physician
who can provide personalized advice and details of risks and benefits based
on your medical history and situation. Treatment protocols for physicians are
available from the FLCCC.