Hydroxychloroquine and Tocilizumab in the Treatment of COVID-19: A Longitudinal Observational Study

5/31 Late treatment study

Ramírez-García et al., Archivos de Medicina Universitaria (Peer Reviewed)
Hydroxychloroquine and Tocilizumab in the Treatment of COVID-19: A Longitudinal Observational Study

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Retrospective 403 hospitalized patients in Spain, showing lower mortality with treatment, however authors do not adjust for the differences between the groups. Confounding by indication is likely.

Ramírez-García et al., 5/31/2021, retrospective, Spain, Europe, peer-reviewed, 5 authors.

risk of death, 67.0% lower, RR 0.33, p < 0.001, treatment 48 of 350 (13.7%), control 22 of 53 (41.5%).

risk of ICU admission, 6.0% higher, RR 1.06, p = 1.00, treatment 35 of 350 (10.0%), control 5 of 53 (9.4%).

This study is excluded in meta analysis: excessive unadjusted differences between groups, 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.

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