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Determinants of Outcome Among Critically Ill Police Personnel With COVID-19: A Retrospective Observational Study From Andhra Pradesh, India

Jamir et al., Cureus, doi:10.7759/cureus.20394
Dec 2021  
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Mortality 8% Improvement Relative Risk Remdesivir for COVID-19  Jamir et al.  ICU PATIENTS Is very late treatment with remdesivir beneficial for COVID-19? Retrospective 266 patients in India (June - October 2020) No significant difference in mortality c19early.org Jamir et al., Cureus, December 2021 Favorsremdesivir Favorscontrol 0 0.5 1 1.5 2+
Retrospective 266 COVID-19 ICU patients in India, showing significantly lower mortality with PVP-I oral gargling and topical nasal use, and non-statistically significant higher mortality with ivermectin and lower mortality with remdesivir.
Gérard, Zhou, Wu, Kamo, Choi, Kim show significantly increased risk of acute kidney injury with remdesivir.
Remdesivir efficacy disappears with longer followup. Mixed-effects meta-regression of efficacy as a function of followup duration across all remdesivir studies shows decreasing efficacy with longer followup7. This may reflect antiviral efficacy being offset by serious adverse effects of treatment.
Followup duration (days) Efficacy Remdesivir mortality efficacy decreases with longer followup 0 15 30 45 60 75 90 105 -25% 0% 25% 50% c19early.org December 2024 mixed-effects meta-regression slope -0.58 [95% CI -0.92 to -0.24] p=0.00089
Study covers ivermectin, povidone-iodine, and remdesivir.
risk of death, 8.0% lower, HR 0.92, p = 0.77, treatment 60 of 181 (33.1%), control 41 of 85 (48.2%), NNT 6.6, adjusted per study, multivariable, Cox proportional hazards.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Jamir et al., 13 Dec 2021, retrospective, India, peer-reviewed, 6 authors, study period June 2020 - October 2020. Contact: limalemj@gmail.com.
This PaperRemdesivirAll
Determinants of Outcome Among Critically Ill Police Personnel With COVID-19: A Retrospective Observational Study From Andhra Pradesh, India
Limalemla Jamir, Mukesh Tripathi, Sumita Shankar, Rakesh Kakkar, Ravishankar Ayyanar, Rajeev Aravindakshan
Cureus, doi:10.7759/cureus.20394
Background and Aims: Police personnel have been key frontline workers throughout the coronavirus disease 2019 pandemic. This study was conducted to assess the correlates and outcomes of critically ill police personnel. Methods: This retrospective observational study analyzed key parameters of hospitalized police personnel who were critically ill with COVID-19 in Andhra Pradesh, India, between June and October 2020. Survival was analyzed for correlation with body mass index, ABO/Rh blood group, co-morbidities, treatment (oxygen therapy, prone positioning, mechanical ventilation, remdesivir, Ivermectin, oral and nasal topical povidoneiodine). We also performed Cox proportional hazard analysis with relevant function plots. Results: The majority of the 266 patients were male (n = 259; 97.4%) and obese (75.2%). The overall mortality of patients was 38% (n = 101). COVID-19 mortality increased significantly with age (p = 0.019) and BMI (p = 0.030) in the bivariate analysis. There was no significant difference between blood group (p = 0.297), comorbidity (p = 0.582) and COVID-19 outcome. Multivariable-adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) of the risk factors for COVID-19 mortality were males (HR 4.89, 95% CI: 1.020-23.430) and ventilator therapy (HR 7.5, 95% CI: 4.527-12.296). The protective factors were symptom onset to reverse transcription polymerase chain reaction (RT-PCR) report interval (HR 0.36, 95% CI: 0.158-0.814), prone positioning (HR 0.43, 95% CI: 0.197-0.915), and use of povidone iodine (HR 0.43; 95% CI: 0.273-0.692). Conclusion: COVID-19 mortality among critically ill hospitalized police personnel was reduced by time to diagnostic test result, prone positioning, and povidone-iodine use and increased with male gender and mechanical ventilation.
Additional Information Disclosures Human subjects: Consent was obtained or waived by all participants in this study. All India Institute of Medical Sciences (AIIMS), Mangalagiri, Andhra Pradesh issued approval IEC-AIIMS/Mangalagiri/2020-21/40. The committee after critical review and discussion of the documents approved the Research Study in All India institute Of Medical Sciences, Mangalagiri vide IEC-AIIMS/Mangalagiri/2020-21/40 dated 12.06.2021. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.
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J Mycol Med. 2018, ' '28:122-7. 10.1016/j.mycmed.2017.11.006', 'journal-title': 'J Mycol Med'}], 'container-title': ['Cureus'], 'original-title': [], 'language': 'en', 'link': [ { 'URL': 'https://www.cureus.com/articles/73667-determinants-of-outcome-among-critically-ill-police-personnel-with-covid-19-a-retrospective-observational-study-from-andhra-pradesh-india', 'content-type': 'unspecified', 'content-version': 'vor', 'intended-application': 'similarity-checking'}], 'deposited': { 'date-parts': [[2021, 12, 13]], 'date-time': '2021-12-13T18:19:59Z', 'timestamp': 1639419599000}, 'score': 1, 'subtitle': [], 'short-title': [], 'issued': {'date-parts': [[2021, 12, 13]]}, 'references-count': 30, 'URL': 'http://dx.doi.org/10.7759/cureus.20394', 'relation': {}, 'ISSN': ['2168-8184'], 'issn-type': [{'value': '2168-8184', 'type': 'print'}], 'subject': ['Aerospace Engineering'], 'published': {'date-parts': [[2021, 12, 13]]}}
Late treatment
is less effective
Please send us corrections, updates, or comments. c19early involves the extraction of 100,000+ datapoints from thousands of papers. Community updates help ensure high accuracy. Treatments and other interventions are complementary. All practical, effective, and safe means should be used based on risk/benefit analysis. No treatment or intervention is 100% available and effective for all current and future variants. We do not provide medical advice. Before taking any medication, consult a qualified physician who can provide personalized advice and details of risks and benefits based on your medical history and situation. FLCCC and WCH provide treatment protocols.
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