et al., Autoimmunity Reviews, 19:7, July 2020, doi:10.1016/j.autrev.2020.102566 (Peer Reviewed)
Very small study of rheumatic disease/autoimmune disorder patients showing no significant difference but with only 3 chronic HCQ patient cases. Only considers people tested at a time when primarily symptomatic cases were tested.
Other research shows that the risk of COVID-19 for systemic autoimmune disease patients is much higher overall, Ferri et al. show OR 4.42, p
<0.001 , which is the observed real-world risk, taking into account factors such as these patients potentially being more careful to avoid exposure.
Adjusting for the difference in baseline risk using the result in Ferri et al. shows substantial benefit for HCQ, RR 0.211, but with only 3 HCQ cases the result is inconclusive. More recent studies with rheumatic disease/autoimmune condition patients provide higher confidence.
Gendelman et al., 5/5/2020, retrospective, database analysis, Israel, Middle East, peer-reviewed, 5 authors.
risk of COVID-19 case, 8.1% lower, RR 0.92, p = 0.88, treatment 3 of 36 (8.3%), control 1314 of 14484 (9.1%).
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.
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