See the full study here: https://www.medrxiv.org/content/10.1101/2020.07.17.20155960v1.full.pdf
View ORCID Profile Nikolas Bernaola, Raquel Mena, Ander Bernaola, Antonio Lara, Cesar Carballo, View ORCID Profile Pedro Larranaga, View ORCID Profile Concha Bielzadoi: https://doi.org/10.1101/2020.07.17.20155960
This article is a preprint and has not been certified by peer review [what does this mean?]. It reports new medical research that has yet to be evaluated and so should not be used to guide clinical practice.
Background Many different treatments were heavily administered to patients with COVID-19 during the peak of the pandemic in Madrid without robust evidence supporting them. Methods We examined the association between sixteen treatments in four groups (steroids, antivirals, antibiotics and immunomodulators) and intubation or death.
Data were obtained from patients that were admitted to an HM hospital with suspicion of COVID-19 until 24/04/2020, excluding unconfirmed diagnosis, those who were admitted before the epidemic started in Madrid, had an outcome that was not discharge or death or died within 24 hours of presentation.
We compared outcomes between treated and untreated patients using propensity-score caliper matching. Results Of 2,307 patients in the dataset, 679 were excluded. Of the remaining 1,645 patients, 263 (16%) died and 311 (18.9%) died or were intubated. Except for hydroxychloroquine and prednisone, patients that were treated with any of the medications were more likely to go through an outcome of death or intubation at baseline.
After propensity matching we found an association between treatment with hydroxychloroquine and prednisone and better outcomes (hazard ratios with 95% CI of 0.83 +- 0.06 and 0.85 +- 0.03). Results were similar in multiple sensitivity analyses. Conclusions In this multicenter study of patients admitted with COVID-19 hydroxychloroquine and prednisone administration was found to be associated with improved outcomes. Other treatments were associated with no effect or worse outcomes. Randomized, controlled trials of these medications in patients with COVID-19 are needed to avoid heavy administration of treatments with no strong evidence to support them.
Competing Interest Statement
The authors have declared no competing interest.
This work was not funded
I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.
The details of the IRB/oversight body that provided approval or exemption for the research described are given below:
Ethics approval was obtained by the hospital network collecting the data. Ethics board from UPM exempted us from asking for approval due to the anonymized nature of the data.
All necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived.
I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).
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Paper in collection COVID-19 SARS-CoV-2 preprints from medRxiv and bioRxiv
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