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Association of Treatment With Hydroxychloroquine or Azithromycin With In-Hospital Mortality in Patients With COVID-19 in New York State

Rosenberg et al., JAMA, May 11, 2020, doi:10.1001/jama.2020.8630

May 2020

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HCQ for COVID-19

1st treatment shown to reduce risk in March 2020

^*, now known with p < 0.00000000001 from 422 studies, recognized in 42 countries.

Lower risk for mortality, hospitalization, recovery, cases, and viral clearance.

No treatment is 100% effective. Protocols combine complementary and synergistic treatments. ^* >10% efficacy in meta analysis with ≥3 clinical studies.

4,100+ studies for 60+ treatments. c19hcq.org

Restrospective observational late stage study showing no significant differences but calling for clinical trials.

Zervos et al. ijidonline.com point out serious limitations that they say should be corrected on the record: patients receiving HCQ with or without AZ were overall sicker on presentation and had multiple other risk factors including much higher risk based on ethnicity; patients receiving HCQ were more likely to be obese, diabetic, have chronic lung disease, and cardiovascular conditions; yet these sicker patients had approximately the same mortality rates compared to patients with a milder course of the disease and less risk factors. However, the authors conclude that "there are no significant benefits." It is noteworthy that HCQ was associated with a significant survival benefit in a larger cohort of patients from New York City as reported by Mikami.

See also worldtribune.com.

1. ijidonline.com, www.ijidonline.com/article/S1201-9712(20)30604-4/fulltext.www.ijidonline.com/article/S1201-9712(20)30604-4/fulltext.

2. Mikami et al., Risk Factors for Mortality in Patients with COVID-19 in New York City, J. Gen. Intern. Med., doi:10.1007/s11606-020-05983-z.springer.com, doi.org.

3. worldtribune.com, www.worldtribune.com/effectiveness-of-hydroxychloroquine-was-hiding-in-plain-sight/.www.worldtribune.com/effectiveness-of-hydroxychloroquine-was-hiding-in-plain-sight/.

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risk of death, 35.0% higher, HR 1.35, p = 0.31, treatment 189 of 735 (25.7%), control 28 of 221 (12.7%), adjusted per study.

risk of death, 8.0% higher, HR 1.08, p = 0.79, treatment 54 of 271 (19.9%), control 28 of 221 (12.7%), adjusted per study.

Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates

Rosenberg et al., 11 May 2020, retrospective, USA, peer-reviewed, 14 authors.

This Paper HCQ All

Association of Treatment With Hydroxychloroquine or Azithromycin With In-Hospital Mortality in Patients With COVID-19 in New York State

PhD Eli S Rosenberg, MD Elizabeth M Dufort, PhD Tomoko Udo, MS Larissa A Wilberschied, DO; Jessica Kumar, PhD James Tesoriero, PA Patti Weinberg, MPH James Kirkwood, MPH Alison Muse, MD Jack Dehovitz, MD Debra S Blog, MPH Brad Hutton, PhD David R Holtgrave, MD Howard A Zucker

JAMA, doi:10.1001/jama.2020.8630

IMPORTANCE Hydroxychloroquine, with or without azithromycin, has been considered as a possible therapeutic agent for patients with coronavirus disease 2019 (COVID-19). However, there are limited data on efficacy and associated adverse events. OBJECTIVE To describe the association between use of hydroxychloroquine, with or without azithromycin, and clinical outcomes among hospital inpatients diagnosed with COVID-19. DESIGN, SETTING, AND PARTICIPANTS Retrospective multicenter cohort study of patients from a random sample of all admitted patients with laboratory-confirmed COVID-19 in 25 hospitals, representing 88.2% of patients with COVID-19 in the New York metropolitan region. Eligible patients were admitted for at least 24 hours between March 15 and 28, 2020. Medications, preexisting conditions, clinical measures on admission, outcomes, and adverse events were abstracted from medical records. The date of final follow-up was April 24, 2020.

Abbreviations: COVID-19, coronavirus disease 2019; ICU, intensive care unit; IQR, interquartile range. a Receipt of intensive care may not have been in a traditional critical care unit. b Based on open-text and ICD-10 fields for cause of death. Causes are not mutually exclusive. c Denominator is the total patient-days in the hospital experienced by the group. d Not applicable (NA) because there was only 1 patient in this group still admitted at analysis. ARTICLE INFORMATION

References

Borba, Val, Sampaio, Effect of high vs low doses of chloroquine diphosphate as adjunctive therapy for patients hospitalized with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection: a randomized clinical trial, JAMA Netw Open, doi:10.1001/jamanetworkopen.2020.8857?utm_campaign=articlePDF%26utm_medium=articlePDFlink%26utm_source=articlePDF%26utm_content=jama.2020.8630

Cdc Covid-, Preliminary estimates of the prevalence of selected underlying health conditions among patients with coronavirus disease 2019 -United States, February 12, MMWR Morb Mortal Wkly Rep, doi:10.15585/mmwr.mm6913e2

Chen, Hu, Zhang, Efficacy of hydroxychloroquine in patients with COVID-19: results of a randomized clinical trial. medRxiv, doi:10.1101/2020.03.22.20040758

Chorin, Dai, Shulman, The QT interval in patients with COVID-19 treated with hydroxychloroquine and azithromycin, Nat Med. Published online, doi:10.1038/s41591-020-0888-2

Colson, Rolain, Lagier, Brouqui, Raoult, Chloroquine and hydroxychloroquine as available weapons to fight COVID-19, Int J Antimicrob Agents, doi:10.1016/j.ijantimicag.2020.105932

Davis, Hyde, Bangdiwala, Nelson, An example of dependencies among variables in a conditional logistic regression

Fda, Fact sheet for health care providers: emergency use authorization (EUA) of hydroxychloroquine sulfate supplied from the strategic national stockpile for treatment of COVID-19 in certain hospitalized patients, Posted

Garg, Kim, Whitaker, Hospitalization rates and characteristics of patients hospitalized with laboratory-confirmed coronavirus disease 2019 -COVID-NET, 14 States, MMWR Morb Mortal Wkly Rep, doi:10.15585/mmwr.mm6915e3

Gautret, Lagier, Parola, Hydroxychloroquine and azithromycin as a treatment of COVID-19: results of an open-label non-randomized clinical trial, Int J Antimicrob Agents, doi:10.1016/j.ijantimicag.2020.105949

Geleris, Sun, Platt, Observational study of hydroxychloroquine in hospitalized patients with Covid-19, N Engl J Med. Published online, doi:10.1056/NEJMoa2012410

Gorgels, Gijsbers, De Vreede-Swagemakers, Lousberg, Wellens, Out-of-hospital cardiac arrest: the relevance of heart failure, Eur Heart J, doi:10.1016/S0195-668X(03)00191-X

Goyal, Choi, Pinheiro, Clinical characteristics of Covid-19 in New York City, N Engl J Med. Published online, doi:10.1056/NEJMc2010419

Hung, Wang, Lin, Wang, Chiou et al., Hydroxychloroquine may be associated with reduced risk of coronary artery diseases in patients with rheumatoid arthritis: A nationwide population-based cohort study, Int J Clin Pract, doi:10.1111/ijcp.13095

Lin, Wei, The Robust inference for the Cox proportional hazards model, J Am Stat Assoc, doi:10.1080/01621459.1989.10478874

Liu, Cao, Xu, Hydroxychloroquine, a less toxic derivative of chloroquine, is effective in inhibiting SARS-CoV-2 infection in vitro, Cell Discov, doi:10.1038/s41421-020-0156-0

Low, Kern, Importance of coronary artery disease in sudden cardiac death, J Am Heart Assoc, doi:10.1161/JAHA.114.001339

Magagnoli, Narendran, Pereira, Outcomes of hydroxychloroquine usage in United States veterans hospitalized with Covid-19. medRxiv, doi:10.1101/2020.04.16.20065920

Mahevas, Tran, Roumier, No evidence of clinical efficacy of hydroxychloroquine in patients hospitalized for COVID-19 infection with oxygen requirement: results of a study using routinely collected data to emulate a target trial. medRxiv, doi:10.1101/2020.04.10.20060699

Mcghie, Harvey, Su, Anderson, Tomlinson et al., Electrocardiogram abnormalities related to anti-malarials in systemic lupus erythematosus, Clin Exp Rheumatol

Petrilli, Jones, Yang, Factors associated with hospitalization and critical illness among 4,103 patients with COVID-19 disease in New York City. medRxiv, doi:10.1101/2020.04.08.20057794

Richardson, Hirsch, Narasimhan, and the Northwell COVID-19 Research Consortium. Presenting characteristics, comorbidities, and outcomes among 5700 patients hospitalized with COVID-19 in the New York City area, JAMA, doi:10.1001/jama.2020.6775?utm_campaign=articlePDF%26utm_medium=articlePDFlink%26utm_source=articlePDF%26utm_content=jama.2020.8630

Rosenberg, Dufort, Blog, COVID-19 testing, epidemic features, hospital outcomes, and household prevalence, New York State, Clin Infect Dis. Published online, doi:10.1093/cid/ciaa549

Tracker, None

Vanderweele, Ding, Sensitivity analysis in observational research: introducing the E-value, Ann Intern Med, doi:10.7326/M16-2607

Wang, Horby, Hayden, Gao, A novel coronavirus outbreak of global health concern, Lancet, doi:10.1016/S0140-6736(20)30185-9

Yancy, COVID-19 and African Americans, JAMA. Published online, doi:10.1001/jama.2020.6548?utm_campaign=articlePDF%26utm_medium=articlePDFlink%26utm_source=articlePDF%26utm_content=jama.2020.8630

Yao, Ye, Zhang, In vitro antiviral activity and projection of optimized dosing design of hydroxychloroquine for the treatment of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), Clin Infect Dis, doi:10.1093/cid/ciaa237

Zhou, Yu, Du, Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study, Lancet, doi:10.1016/S0140-6736(20)30566-3

Late treatment
is less effective

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