et al., Int. J. Infectious Diseases, doi:10.1016/j.ijid.2020.07.056 (Letter)
HCQ+AZ adjusted death HR 0.44, p
=0.009. Propensity scores include baseline COVID-19 disease severity, age, gender, number of comorbidities, cardio-vascular disease, duration of symptoms, date of admission, baseline plasma CRP. IPW censoring. Retrospective study of 539 COVID-19 hospitalized patients in Milan, with treatment a median of 1 day after admission. HCQ 197 patients, HCQ+AZ 94, control 92. Control group received various other treatments. Authors excluded people receiving other drugs which could have biased the effect of HCQ when used in combination. Residual confounding is possible (e.g., people with CVD were more frequent in control), however people in the control group were more likely to require mechanical ventilation.
D'Arminio Monforte et al., 7/29/2020, retrospective, Italy, Europe, preprint, 5 authors.
risk of death, 34.0% lower, RR 0.66, p = 0.12, treatment 53 of 197 (26.9%), control 47 of 92 (51.1%), adjusted per study.
HCQ+AZ, 56.0% lower, RR 0.44, p = 0.009, treatment 22 of 94 (23.4%), control 47 of 92 (51.1%), adjusted per study.
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.