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0 0.5 1 1.5 2+ Mortality 20% Improvement Relative Risk Ivermectin  Elavarasi et al.  LATE TREATMENT Is late treatment with ivermectin beneficial for COVID-19? Retrospective 1,758 patients in India Lower mortality with ivermectin (not stat. sig., p=0.12) Elavarasi et al., medRxiv, August 2021 Favors ivermectin Favors control

Clinical features, demography and predictors of outcomes of SARS-CoV-2 infection in a tertiary care hospital in India - a cohort study

Elavarasi et al., medRxiv, doi:10.1101/2021.08.10.21261855
Aug 2021  
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Retrospective 2017 hospitalized patients in India, showing lower mortality with ivermectin treatment in unadjusted results. No group details are provided and this result is subject to confounding by indication.
This is the 61st of 99 COVID-19 controlled studies for ivermectin, which collectively show efficacy with p<0.0000000001 (1 in 2 sextillion). 46 studies are RCTs, which show efficacy with p=0.00000014. This study is excluded in the after exclusion results of meta analysis: unadjusted results with no group details.
This study includes ivermectin and zinc.
risk of death, 19.6% lower, RR 0.80, p = 0.12, treatment 48 of 283 (17.0%), control 311 of 1,475 (21.1%), NNT 24, unadjusted.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Elavarasi et al., 12 Aug 2021, retrospective, India, preprint, 26 authors, dosage not specified.
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Clinical features, demography and predictors of outcomes of SARS-CoV-2 infection in a tertiary care hospital in India-A cohort study
Arunmozhimaran Elavarasi, Hari Krishna Raju Sagiraju, Rohit Kumar Garg, Saurav Sekhar Paul, Brajesh Ratre, Prashant Sirohiya, Nishkarsh Gupta, Rakesh Garg, Anuja Pandit, Saurabh Vig, Ram Singh, Balbir Kumar, Ved Prakash Meena, Naveet Wig, Saurabh Mittal, Saurabh Pahuja, Karan Madan, Tanima Dwivedi, Nupur Das, Ritu Gupta, Ashima Jain Vidyarthi, Arghya Das, Rama Chaudhary, Laxmitej Wundawalli, Angel Rajan Singh, Sheetal Singh, Manisha Pandey, Abhinav Mishra, Karanvir Singh Matharoo, Sunil Kumar, Anant Mohan, Randeep Guleria, Sushma Bhatnagar
Background The 'second wave' of the COVID-19 pandemic hit India from early April 2021 to June 2021 and more than 400,000 cases per day were reported in the country. We describe the clinical features, demography, treatment trends, baseline laboratory parameters of a cohort of patients admitted at the All India Institute of Medical Sciences, New Delhi with SARS-CoV-2 infection and their association with the outcome. Methods This was a retrospective cohort study describing the clinical, laboratory and treatment patterns of consecutive patients admitted with SARS-CoV-2 infection. Multivariate logistic regression models were fitted to identify the clinical and biochemical predictors of developing hypoxia, deterioration during the hospital stay and death. Findings A total of 2080 patients were included in the study. The case fatality rate was 19.5%. Amongst the survivors, the median duration of hospital stay was 8 (5-11) days. Out of 853 (42.3%%) of patients who had COVID-19 Acute respiratory distress syndrome at presentation, 340 (39.9%) died. Patients aged 45-60 years [OR (95% CI): 1.8 (1.2-2.6)p =0.003] and those aged >60 years [OR (95%CI): 3.4 (2.3-5.2), p<0.001] had a higher odds of death as compared to the 18-44 age group. Vaccination reduced the odds of death by 30% [OR (95% CI): 0.7 (0.5-0.9), p=0.036]. Patients with hyper inflammation at baseline as suggested by leucocytosis [OR (95% CI): 2.1 (1.4-3.10), p <0.001], raised d-dimer >500 mg/dL [OR (95% CI): 3.2 (2.2-4.6), p <0.001] and raised C-reactive peptide >0.5 mg/L [OR (95% CI): 3.8 (1.1-13), p=0.037] had higher odds of death. Patients who were admitted in the second week had lower odds of death and those admitted in the third week had higher odds of death. Interpretation This is the largest cohort of patients admitted with COVID-19 from India reported to date and has shown that vaccination status and early admission during the inflammatory phase can change the course of illness of these patients. Strategies should be made to improve vaccination rates and early admission of patients with moderate and severe COVID-19 to improve outcomes.
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Late treatment
is less effective
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