Clinical course and outcome of COVID-19 acute respiratory distress syndrome: data from a national repository

10/20 Late treatment study

Solh et al., medRxiv, doi:10.1101/2020.10.16.20214130 (Preprint)
Clinical course and outcome of COVID-19 acute respiratory distress syndrome: data from a national repository

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Retrospective database analysis of 7,816 Veterans Affairs hospitalized patients analyzing progression to ARDS and 30-day mortality from ARDS. Confounding by indication is likely. Chronological bias is likely, with HCQ more likely to be used earlier on, before significant improvements in overall treatment.

No results are provided for HCQ for progression to ARDS.

Solh et al., 10/20/2020, retrospective, database analysis, USA, North America, preprint, 5 authors.

risk of death, 18.0% higher, RR 1.18, p = 0.17, treatment 131 of 265 (49.4%), control 134 of 378 (35.4%), adjusted per study.

This study is excluded in meta analysis: very late stage, >50% on oxygen/ventilation at baseline, 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.

All 344 studies Meta Analysis

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