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0 0.5 1 1.5 2+ Mortality 41% unadjusted Improvement Relative Risk Zinc for COVID-19  Doocy et al.  LATE TREATMENT Is late treatment with zinc beneficial for COVID-19? Prospective study of 144 patients in multiple countries (Dec 2020 - Jun 2021) Lower mortality with zinc (not stat. sig., p=0.41) Doocy et al., PLOS Global Public Health, Oct 2022 Favors zinc Favors control

Clinical progression and outcomes of patients hospitalized with COVID-19 in humanitarian settings: A prospective cohort study in South Sudan and Eastern Democratic Republic of the Congo

Doocy et al., PLOS Global Public Health, doi:10.1371/journal.pgph.0000924, NCT04568499
Oct 2022  
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Prospective study of 144 hospitalized COVID-19 patients in the DRC and South Sudan, showing lower mortality with zinc treatment, without statistical significance. This study is excluded in the after exclusion results of meta analysis: unadjusted results with no group details.
This study includes vitamin A, zinc, and vitamin C.
risk of death, 40.8% lower, RR 0.59, p = 0.41, treatment 3 of 28 (10.7%), control 21 of 116 (18.1%), NNT 14, unadjusted.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Doocy et al., 19 Oct 2022, prospective, multiple countries, peer-reviewed, 6 authors, study period December 2020 - June 2021, trial NCT04568499 (history).
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Clinical progression and outcomes of patients hospitalized with COVID-19 in humanitarian settings: A prospective cohort study in South Sudan and Eastern Democratic Republic of the Congo
Shannon Doocy, Iris Bollemeijer, Eva Leidman, Abdou Sebushishe, Eta Ngole Mbong, Kathleen Page
PLOS Global Public Health, doi:10.1371/journal.pgph.0000924
Little information is available on COVID-19 in Africa and virtually none is from humanitarian and more resource-constrained settings. This study characterizes hospitalized patients in the African humanitarian contexts of Juba, South Sudan and North and South Kivu in Eastern Democratic Republic of the Congo. This observational cohort was conducted between December 2020 and June 2021. Patients presenting for care at five facilities or referred from home-based care by mobile medical teams were eligible for enrollment and followed until death or recovery. Disease progression was characterized for hospitalized patients using survival analysis and mixed effects regression model to estimate survival odds for patient characteristics and treatments received. 144 COVID-19 cases enrolled as hospitalized patients were followed to recovery/death. The observed mortality proportion among hospitalized patients was 16.7% (CI: 11.2-23.3%); mortality was three times higher in South Sudan, where patients presented later after symptom onset and in worse conditions. Age and diabetes history were the only patient characteristics associated with decreased survival; clinical status indicators associated with decreased survival included fever, low oxygen level, elevated respiratory and pulse rates. The only therapy associated with survival was non-invasive oxygen; invasive oxygen therapies and other specialized treatments were rarely received. Improving availability of oxygen monitoring and proven COVID-19 therapies in humanitarian and resource-poor settings is critical for health equity. Customizing training to reflect availability of specific medications, therapies and operational constraints is particularly important given the range of challenges faced by providers in these settings.
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Late treatment
is less effective
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