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0 0.25 0.5 0.75 1 1.25 1.5 1.75 2+ Mortality 27% Improvement Relative Risk Mortality (b) 93% c19hcq.com/smith.html Favors HCQ Favors control
31 May 2021 - Late treatment study
Observational Study on 255 Mechanically Ventilated Covid Patients at the Beginning of the USA Pandemic
Smith et al., medRxiv, doi:10.1101/2021.05.28.21258012 (Preprint)
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Retrospective 255 mechanical ventilation patients in USA, showing that weight-adjusted HCQ+AZ improved survival by over 100%. QTc prolongation did not correlate with cumulative HCQ dose or HCQ serum level.
Although authors mention immortal time bias, full details on the timing of HCQ administration is not provided and this is not fully addressed. Survival curves indicate immortal time bias will significantly change results, although the observed benefit appears to exceed the potential bias.
risk of death, 27.2% lower, RR 0.73, p = 0.002, treatment 19 of 37 (51.4%), control 182 of 218 (83.5%), NNT 3.1, odds ratio converted to relative risk, >3g HCQ and >1g AZ, multivariable cox proportional hazard regression.
risk of death, 92.9% lower, RR 0.07, p < 0.001, ≥80mg/kg HCQ and >1g AZ, RR approximated with OR.
Effect extraction follows pre-specified rules prioritizing more serious outcomes.
This study is excluded in the after exclusion results of meta analysis: immortal time bias may significantly affect results.
Smith et al., 5/31/2021, retrospective, USA, North America, preprint, 4 authors.
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