Pandemic threat? Anyone else concerned?

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Hydroxychloroquine or chloroquine with or without a macrolide for treatment of COVID-19: a multinational registry analysis

Summary
Background
Hydroxychloroquine or chloroquine, often in combination with a second-generation macrolide, are being widely used for treatment of COVID-19, despite no conclusive evidence of their benefit. Although generally safe when used for approved indications such as autoimmune disease or malaria, the safety and benefit of these treatment regimens are poorly evaluated in COVID-19.
Methods
We did a multinational registry analysis of the use of hydroxychloroquine or chloroquine with or without a macrolide for treatment of COVID-19. The registry comprised data from 671 hospitals in six continents. We included patients hospitalised between Dec 20, 2019, and April 14, 2020, with a positive laboratory finding for SARS-CoV-2. Patients who received one of the treatments of interest within 48 h of diagnosis were included in one of four treatment groups (chloroquine alone, chloroquine with a macrolide, hydroxychloroquine alone, or hydroxychloroquine with a macrolide), and patients who received none of these treatments formed the control group. Patients for whom one of the treatments of interest was initiated more than 48 h after diagnosis or while they were on mechanical ventilation, as well as patients who received remdesivir, were excluded. The main outcomes of interest were in-hospital mortality and the occurrence of de-novo ventricular arrhythmias (non-sustained or sustained ventricular tachycardia or ventricular fibrillation).
Findings
96 032 patients (mean age 53·8 years, 46·3% women) with COVID-19 were hospitalised during the study period and met the inclusion criteria. Of these, 14 888 patients were in the treatment groups (1868 received chloroquine, 3783 received chloroquine with a macrolide, 3016 received hydroxychloroquine, and 6221 received hydroxychloroquine with a macrolide) and 81 144 patients were in the control group. 10 698 (11·1%) patients died in hospital. After controlling for multiple confounding factors (age, sex, race or ethnicity, body-mass index, underlying cardiovascular disease and its risk factors, diabetes, underlying lung disease, smoking, immunosuppressed condition, and baseline disease severity), when compared with mortality in the control group (9·3%), hydroxychloroquine (18·0%; hazard ratio 1·335, 95% CI 1·223–1·457), hydroxychloroquine with a macrolide (23·8%; 1·447, 1·368–1·531), chloroquine (16·4%; 1·365, 1·218–1·531), and chloroquine with a macrolide (22·2%; 1·368, 1·273–1·469) were each independently associated with an increased risk of in-hospital mortality. Compared with the control group (0·3%), hydroxychloroquine (6·1%; 2·369, 1·935–2·900), hydroxychloroquine with a macrolide (8·1%; 5·106, 4·106–5·983), chloroquine (4·3%; 3·561, 2·760–4·596), and chloroquine with a macrolide (6·5%; 4·011, 3·344–4·812) were independently associated with an increased risk of de-novo ventricular arrhythmia during hospitalisation.
Interpretation
We were unable to confirm a benefit of hydroxychloroquine or chloroquine, when used alone or with a macrolide, on in-hospital outcomes for COVID-19. Each of these drug regimens was associated with decreased in-hospital survival and an increased frequency of ventricular arrhythmias when used for treatment of COVID-19.
Funding
William Harvey Distinguished Chair in Advanced Cardiovascular Medicine at Brigham and Women's Hospital.
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Oceanslider said:
What is the name of that virus? :brainfart:
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I'm not laughing at Biden because having dementia is sad and not funny. But I'm LMAO at all the sheeple that would cast their vote to dementia president because of TDS which is like cutting off your nose to spite your face.
 
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Wuhan Flu Facts:
The virus can travel 6 feet, it cannot travel 6’1” or greater.
It can live on all surfaces except anything that comes in the mail from Amazon.
It does not live in Target, Walmart, Home Depot, Lowes or any Grocery Store.
It is always deadly in Bars, Restaurants, Small Businesses, Hair Salons and especially Churches.
And it can not live on your food as long as you get it to go.
 
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Arjun said:
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Vox also has some major failures of omission in their video, and they do have a major leftist bias as Oceanslider points out.
( talk about woke BS from vox... these are the folks that want to ban other people's freedom of expression if it is not woke enough.. )

What woke vox misses big time on that:
1) South Korea - masks are the defacto response to flus and sars in Asia.
2) South Korea Contact tracing.

Did the USA fumble multiple times on testing.. heck yes. Major screw up.
Did the USA fail on contact tracing.. heck yes.

Does this also apply to US States - yes of course, State's Rights = responsibility also. Can't have rights without responsibilities.
 
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I think every country had its drawbacks in the response against this pandemic. Travel should have been restricted immediately after the first cases starting popping up in Wuhan. Coming to the media, almost everyone one of them especially YouTube omit the finer details. Contact tracing is important but should be for the means of tracking the progression of this virus and not to interfere with people's daily lives.

mat200 said:
Vox also has some major failures of omission in their video, and they do have a major leftist bias as Oceanslider points out.
( talk about woke BS from vox... these are the folks that want to ban other people's freedom of expression if it is not woke enough.. )

What woke vox misses big time on that:
1) South Korea - masks are the defacto response to flus and sars in Asia.
2) South Korea Contact tracing.

Did the USA fumble multiple times on testing.. heck yes. Major screw up.
Did the USA fail on contact tracing.. heck yes.

Does this also apply to US States - yes of course, State's Rights = responsibility also. Can't have rights without responsibilities.
Click to expand...
 
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Arjun said:
I think every country had its drawbacks in the response against this pandemic. Travel should have been restricted immediately after the first cases starting popping up in Wuhan. Coming to the media, almost everyone one of them especially YouTube omit the finer details. Contact tracing is important but should be for the means of tracking the progression of this virus and not to interfere with people's daily lives.
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Indeed many countries have failed or had a poor response.

Taiwan however stands out as a stellar example. They've not had to really close shop...

Vox unfortunately is so far off a balanced view I no longer share their posts. Honestly, any media which wants to silence others automatically should be suspected.



What settings have been linked to SARS-CoV-2 transmission clusters? [version 1; peer review: 1 approved with reservations]

We found many examples of SARS-CoV-2 clusters linked to a
wide range of mostly indoor settings. Few reports came from schools, many
from households, and an increasing number were reported in hospitals and
elderly care settings across Europe.

 
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I agree that Vox is left-biased, pretty strongly so.

But I thought that article pretty much nailed it and wasn't itself biased.

As someone in the health care system with my wife and most friends attached to the health care system one way or another, I see the US response as pretty horrible one. There's lots of blame, including cultural norms here not supporting collective response to threat. It's not "anti-American" to point out where our response or culture didn't do well on this test. It would be un-American not to recognize these things, pull up our bootstraps and knock the shit out of it next time.
 
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