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Clinical Disease Characteristics and Treatment Trajectories Associated with Mortality among COVID-19 Patients in Punjab, Pakistan

Munir et al., Healthcare, doi:10.3390/healthcare11081192

Apr 2023

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Ivermectin for COVID-19

4th treatment shown to reduce risk in August 2020

^*, now known with p < 0.00000000001 from 102 studies, recognized in 22 countries.

Lower risk for mortality, ventilation, ICU admission, hospitalization, recovery, cases, and viral clearance.

No treatment is 100% effective. Protocols combine complementary and synergistic treatments. ^* >10% efficacy in meta analysis with ≥3 clinical studies.

4,100+ studies for 60+ treatments. c19ivm.org

Retrospective 1,000 hospitalized COVID-19 patients in Pakistan, showing lower mortality with ivermectin without statistical significance.

Although the 48% lower mortality is not statistically significant, it is consistent with the significant 49% lower mortality [35‑60%] from meta analysis of the 51 mortality results to date.

This is the 97th of 102 COVID-19 controlled studies for ivermectin, which collectively show efficacy with p<0.0000000001 (1 in 560 quintillion).

49 studies are RCTs, which show efficacy with p=0.00000038.

Important missing comments or errors? Let us know.

risk of death, 48.2% lower, OR 0.52, p = 0.13, treatment 92, control 908, adjusted per study, multivariable, RR approximated with OR.

Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates

Munir et al., 21 Apr 2023, retrospective, Pakistan, peer-reviewed, 3 authors, study period March 2021 - March 2022, dosage not specified.

This Paper Ivermectin All

Clinical Disease Characteristics and Treatment Trajectories Associated with Mortality among COVID-19 Patients in Punjab, Pakistan

Muhammad Zeeshan Munir, Amer Hayat Khan, Tahir Mehmood Khan

doi:10.3390/healthcare11081192

Background: Data on Pakistani COVID-19 patient mortality predictors is limited. It is essential to comprehend the relationship between disease characteristics, medications used, and mortality for better patient outcomes. Methods: The medical records of confirmed cases in the Lahore and Sargodha districts were examined using a two-stage cluster sampling from March 2021 to March 2022. Demographics, signs and symptoms, laboratory findings, and pharmacological medications as mortality indicators were noted and analyzed. Results: A total of 288 deaths occurred out of the 1000 cases. Death rates were higher for males and people over 40. Most of those who were mechanically ventilated perished (OR: 124.2). Dyspnea, fever, and cough were common symptoms, with a significant association amid SpO2 < 95% (OR: 3.2), RR > 20 breaths/min (OR: 2.5), and mortality. Patients with renal (OR: 2.3) or liver failure (OR: 1.5) were at risk. Raised C-reactive protein (OR: 2.9) and D-dimer levels were the indicators of mortality (OR: 1.6). The most prescribed drugs were antibiotics, (77.9%), corticosteroids (54.8%), anticoagulants (34%), tocilizumab (20.3%), and ivermectin (9.2%). Conclusions: Older males having breathing difficulties or signs of organ failure with raised C-reactive protein or D-dimer levels had high mortality. Antivirals, corticosteroids, tocilizumab, and ivermectin had better outcomes; antivirals were associated with lower mortality risk.

Author Contributions: Elements of this work including the conception of ideas, literature search, study designs, clinical data collections, statistical data analysis, data interpretation, manuscript drafting, and paper writing were done by M.Z.M., T.M.K. and A.H.K. Supervised and performed project administration, critical revisions of the paper, final editing, agreed to submit the manuscript to this journal, gave the final approval for the submitted version, and agreed to be accountable for all aspects of the work. All authors have read and agreed to the published version of the manuscript. Conflicts of Interest: The authors declare no conflict of interest.

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