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Comorbidity and Sociodemographic determinants in COVID-19 Mortality in an US Urban Healthcare System

Wang et al., medRxiv, doi:10.1101/2020.06.11.20128926
Jun 2020  
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Mortality 6% Improvement Relative Risk HCQ for COVID-19  Wang et al.  LATE TREATMENT Is late treatment with HCQ beneficial for COVID-19? Retrospective 7,592 patients in the USA No significant difference in mortality c19hcq.org Wang et al., medRxiv, June 2020 FavorsHCQ Favorscontrol 0 0.5 1 1.5 2+
HCQ for COVID-19
1st treatment shown to reduce risk in March 2020, now with p < 0.00000000001 from 419 studies, recognized in 46 countries.
No treatment is 100% effective. Protocols combine treatments.
5,000+ studies for 109 treatments. c19hcq.org
Database analysis of 7,592 patients in NYC, showing adjusted HCQ mortality odds ratio OR 0.96, p = 0.82, and HCQ+AZ OR 0.94, p = 0.63
This study is excluded in the after exclusion results of meta analysis: confounding by indication is likely and adjustments do not consider COVID-19 severity at baseline.
risk of death, 5.8% lower, RR 0.94, p = 0.63, treatment 1,866, control 5,726, odds ratio converted to relative risk.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Wang et al., 10 Jun 2020, retrospective, database analysis, USA, preprint, 3 authors.
This PaperHCQAll
Comorbidity and Sociodemographic determinants in COVID-19 Mortality in an US Urban Healthcare System
PhD An-Li Wang, DrPH Xiaobo Zhong, PhD Yasmin L Hurd
doi:10.1101/2020.06.11.20128926
All rights reserved. No reuse allowed without permission. (which was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity.
References
Food, a Clinical Trial Due to Risk of Heart Rhythm Problems
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
Goyal, Choi, Pinheiro, Clinical Characteristics of Covid-19 in New York City, N Engl J Med
Grasselli, Zangrillo, Zanella, Baseline Characteristics and Outcomes of 1591 Patients Infected With SARS-CoV-2 Admitted to ICUs of the Lombardy Region, Italy, JAMA
Guan, Liang, Zhao, Comorbidity and its impact on 1590 patients with Covid-19 in China: A Nationwide Analysis, Eur Respir J
Guan, Ni, Hu, Clinical Characteristics of Coronavirus Disease 2019 in China, N Engl J Med
Jackson, Busse, Bacharier, Association of Respiratory Allergy, Asthma and Expression of the SARS-CoV-2 Receptor, ACE2, J Allergy Clin Immunol
Richardson, Hirsch, Narasimhan, Presenting Characteristics, Comorbidities, and Outcomes Among 5700 Patients Hospitalized With COVID-19 in the New York City Area, JAMA
Rosenberg, Dufort, Udo, Association of Treatment With Hydroxychloroquine or Azithromycin With In-Hospital Mortality in Patients With COVID-19 in New York State, JAMA
Savarino, Boelaert, Cassone, Majori, Cauda, Effects of chloroquine on viral infections: an old drug against today's diseases?, Lancet Infect Dis
Society Of Infectious, Centers For Disease, Analysis on 54 Mortality Cases of Coronavirus Disease 2019 in the Republic of Korea from January 19 to March 10, 2020, J Korean Med Sci
Wang, Hu, Hu, Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China, JAMA
Yao, Ye, Zhang, 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
Zhang, Dong, Cao, Clinical characteristics of 140 patients infected with SARS-CoV-2 in Wuhan, China, Allergy
Zhou, Yu, Du, Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study, Lancet
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It is not known to what degree medical ' 'comorbidity and sociodemographic determinants impact COVID-19 mortality in the ' 'US.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>Evaluation of ' 'de-identified electronic health records of 7,592 COVID-19 patients confirmed by SARS-CoV-2 ' 'lab tests in New York City. Medical comorbidites and outcome of mortality, and other ' 'covariates, including clinical, sociodemographic, and medication measures were assessed by ' 'bivariate and multivariate logistic regression ' 'models.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>Of common ' 'comorbid conditions (hypertension, chronic kidney disease, chronic obstructive pulmonary ' 'disease, asthma, obesity, diabetes, HIV, cancer), when adjusted for covariates, chronic ' 'kidney disease remained significantly associated with increased odds of mortality. Patients ' 'who had more than one comorbidities, former smokers, treated with Azithromycin without ' 'Hydroxychloroquine, reside within the boroughs of Brooklyn and Queens Higher had higher odds ' 'of death.</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>Increasing ' 'numbers of comorbid factors increase COVID-19 mortality, but several clinical and ' 'sociodemographic factors can mitigate risk. Continued evaluation of COVID-19 in large diverse ' 'populations is important to characterize individuals at risk and improve clinical ' 'outcomes.</jats:p></jats:sec>', 'DOI': '10.1101/2020.06.11.20128926', 'type': 'posted-content', 'created': {'date-parts': [[2020, 6, 12]], 'date-time': '2020-06-12T22:45:11Z', 'timestamp': 1592001911000}, 'source': 'Crossref', 'is-referenced-by-count': 10, 'title': 'Comorbidity and Sociodemographic determinants in COVID-19 Mortality in an US Urban Healthcare ' 'System', 'prefix': '10.1101', 'author': [ { 'ORCID': 'http://orcid.org/0000-0003-0938-5157', 'authenticated-orcid': False, 'given': 'An-Li', 'family': 'Wang', 'sequence': 'first', 'affiliation': []}, {'given': 'Xiaobo', 'family': 'Zhong', 'sequence': 'additional', 'affiliation': []}, {'given': 'Yasmin L', 'family': 'Hurd', 'sequence': 'additional', 'affiliation': []}], 'member': '246', 'reference': [ { 'key': '2021010205300523000_2020.06.11.20128926v1.1', 'unstructured': 'City of New York. COVID-19: Data. Available at: ' 'https://www1.nyc.gov/site/doh/covid/covid-19-data.page.'}, { 'key': '2021010205300523000_2020.06.11.20128926v1.2', 'unstructured': 'World Health Organization. Coronavirus disease (COVID-19) Pandemic. ' 'Available at: ' 'https://www.who.int/emergencies/diseases/novel-coronavirus-2019.'}, { 'key': '2021010205300523000_2020.06.11.20128926v1.3', 'doi-asserted-by': 'crossref', 'unstructured': 'Grasselli G , Zangrillo A , Zanella A , et al. Baseline Characteristics ' 'and Outcomes of 1591 Patients Infected With SARS-CoV-2 Admitted to ICUs ' 'of the Lombardy Region, Italy. JAMA 2020.', 'DOI': '10.1001/jama.2020.5394'}, { 'key': '2021010205300523000_2020.06.11.20128926v1.4', 'doi-asserted-by': 'crossref', 'unstructured': 'Guan WJ , Liang WH , Zhao Y , et al. Comorbidity and its impact on 1590 ' 'patients with Covid-19 in China: A Nationwide Analysis. 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Late treatment
is less effective
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