Analgesics
Antiandrogens
Antihistamines
Azvudine
Bromhexine
Budesonide
Colchicine
Conv. Plasma
Curcumin
Famotidine
Favipiravir
Fluvoxamine
Hydroxychlor..
Ivermectin
Lifestyle
Melatonin
Metformin
Minerals
Molnupiravir
Monoclonals
Naso/orophar..
Nigella Sativa
Nitazoxanide
PPIs
Paxlovid
Quercetin
Remdesivir
Thermotherapy
Vitamins
More

Other
Feedback
Home
Top
Results
Abstract
All ivermectin studies
Meta analysis
 
Feedback
Home
next
study
previous
study
c19ivm.org COVID-19 treatment researchIvermectinIvermectin (more..)
Melatonin Meta
Metformin Meta
Antihistamines Meta
Azvudine Meta Molnupiravir Meta
Bromhexine Meta
Budesonide Meta
Colchicine Meta Nigella Sativa Meta
Conv. Plasma Meta Nitazoxanide Meta
Curcumin Meta PPIs Meta
Famotidine Meta Paxlovid Meta
Favipiravir Meta Quercetin Meta
Fluvoxamine Meta Remdesivir Meta
Hydroxychlor.. Meta Thermotherapy Meta
Ivermectin Meta

All Studies   Meta Analysis       

Real-World Effectiveness of hydroxychloroquine, azithromycin, and ivermectin among hospitalized COVID-19 patients: Results of a target trial emulation using observational data from a nationwide Healthcare System in Peru

Soto-Becerra et al., medRxiv, doi:10.1101/2020.10.06.20208066
Oct 2020  
  Post
  Facebook
Share
  Source   PDF   All Studies   Meta AnalysisMeta
Mortality 17% Improvement Relative Risk Mortality (b) -39% primary Ivermectin  Soto-Becerra et al.  LATE TREATMENT Is late treatment with ivermectin beneficial for COVID-19? Retrospective 2,833 patients in Peru (April - July 2020) Significant unadjusted confounding likely, see notes c19ivm.org Soto-Becerra et al., medRxiv, October 2020 Favorsivermectin Favorscontrol 0 0.5 1 1.5 2+
Ivermectin for COVID-19
4th treatment shown to reduce risk in August 2020, now with p < 0.00000000001 from 105 studies, recognized in 23 countries.
No treatment is 100% effective. Protocols combine treatments.
5,100+ studies for 110 treatments. c19ivm.org
Retrospective database study of 5683 patients, 692 received HCQ/CQ+AZ, 200 received HCQ/CQ, 203 received ivermectin, 1600 received AZ, 358 received ivermectin+AZ, and 2630 received standard of care.
This study includes anyone with ICD-10 COVID-19 codes which includes asymptomatic PCR+ patients, therefore many patients in the control group are likely asymptomatic with regards to SARS-CoV-2, but in the hospital for another reason. For those that had symptomatic COVID-19, there is also likely significant confounding by indication.
In this study all medications show higher mortality at day 30, which is consistent with asymptomatic (for COVID-19) or mild condition patients being more common in the control group.
For ivermectin they show 30 day mortality aHR = 1.39 [0.88 - 2.22]. KM curves show that the treatment groups were in more serious condition, and also that after about day 35 survival became better with ivermectin. The last day available for ivermectin shows RR 0.83, p = 0.01. More than the total excess mortality happened on the first day. This is consistent with treated patients being in more serious condition, and with many of the control group patients being in hospital for something unrelated to COVID-19.
Authors use a machine learning based propensity scoring system that appears over-parameterized and likely to result in significant overfitting and inaccurate results. Essentially they test for all interactions between two and three covariates. The nature and large number of covariates means many random correlations may be found. COVID-19 severity is not used.
This study also does not compare treatments with a control group not receiving the treatment - authors put patients receiving treatments after 48 hours in the control group.
Authors state that outcomes within 24 hours were excluded, however KM curves show significant mortality at day 1 (only for the treatment groups).
Several protocol violations and missing data have also been reported in this study:1,2.
See also:3.
Ivermectin dosage details:4
This is the 10th of 105 COVID-19 controlled studies for ivermectin, which collectively show efficacy with p<0.0000000001 (1 in 774 quintillion).
52 studies are RCTs, which show efficacy with p=0.00000021.
This study is excluded in the after exclusion results of meta analysis: substantial unadjusted confounding by indication likely; includes PCR+ patients that may be asymptomatic for COVID-19 but in hospital for other reasons.
Study covers ivermectin and HCQ.
risk of death, 17.1% lower, HR 0.83, p = 0.01, treatment 92 of 203 (45.3%), control 1,438 of 2,630 (54.7%), NNT 11, IVM vs. control day 43 (last day available) weighted KM from figure 3, per the pre-specified rules, the last available day mortality results have priority.
risk of death, 39.0% higher, HR 1.39, p = 0.16, treatment 47 of 203 (23.2%), control 401 of 2,630 (15.2%), adjusted per study, day 30, Table 2, IVM wHR, primary outcome.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Soto-Becerra et al., 8 Oct 2020, retrospective, database analysis, Peru, preprint, median age 59.4, 4 authors, study period 1 April, 2020 - 19 July, 2020, dosage 200μg/kg single dose.
This PaperIvermectinAll
Real-world effectiveness of hydroxychloroquine, azithromycin, and ivermectin among hospitalized COVID-19 patients: results of a target trial emulation using observational data from a nationwide healthcare system in Peru
Percy Soto-Becerra, Carlos Culquichicón, Yamilee Hurtado-Roca, Roger V Araujo-Castillo
doi:10.1101/2020.10.06.20208066
Introduction: In Latin America, Peru is the most impacted country due to COVID-19 pandemic. Given the authorized nationwide use of hydroxychloroquine, azithromycin, ivermectin and dexamethasone in COVID-19 patients, we aimed to evaluate their effectiveness alone or combined to prevent 30-day mortality among COVID-19 hospitalized patients without life-threatening illness. Methods : Design. Retrospective cohort study using digital clinical records to emulate a target trial. Setting. Nationwide data of mid-and high-level complexity hospitals from the Peruvian Social Health Insurance (EsSalud) between April 1 and July 19, 2020. Participants. Patients aged 18 years with confirmed SARS-CoV-2 infection by PCR, and non-severe pneumonia at admission. Interventions. We compared five treatment groups to the standard of care treatment regimen (control group) within 48 hours of admission to hospital: hydroxychloroquine/chloroquine alone (HCQ), ivermectin alone (IVM), azithromycin alone (AZIT), HCQ + AZIT group, and IVM + AZIT group with doses recommended by the Peruvian Ministry of Health. Main outcomes measures. The primary outcome was all-cause mortality rate, the secondary outcomes were survival without ICU rate, and survival without oxygen prescription rate. Analyses were adjusted for confounding factors by inverse probability of treatment weighting. A doubly-adjustment method was done for sensitivity analysis. Results: Among 5683 patients eligible for analysis, 200 received hydroxychloroquine or chloroquine within 48 hours of hospital admission, 203 received ivermectin, 1600 received azithromycin, 692 received hydroxychloroquine or chloroquine plus azithromycin, 358 received ivermectin plus azithromycin and 2630 received standard of care. AZIT + HCQ group was associated with 84% higher all-cause mortality hazard rate compared to standard care (wHR = 1.84, 95% CI: 1.12-3.02). Consistently, AZIT + HCQ treatment was associated with survival without transfer to ICU (wHR = 1.49, 95% CI: 1.01-2.19) and survival without oxygen prescription (wHR = 1.70, 95% CI: 1.07-2.69). HCQ treatment was associated with 77% higher all-cause mortality or oxygen prescription hazard rate compared to standard treatment (wHR = 1.77, 95% CI: 1.01-3.11). Surprisingly, we observed that IVM treatment was associated with less survival rate without transfer to ICU in the weighted analysis (wHR = 1.58, 95% CI:1.11-2.25) By last, we did not find evidence of effect on reduce allcause mortality or increase survival rate without transfer to ICU or survival rate without oxygen prescription for AZIT group neither AZIT + IVM group in all analyses. .
Conflicts of interest: The authors declare no conflicts of interest regarding the subject of this scientific article. Origin of the health care center
References
Abella, Jolkovsky, Biney, Uspal, Hyman et al., Efficacy and Safety of Hydroxychloroquine vs Placebo for Pre-exposure SARS-CoV-2 Prophylaxis Among Health Care Workers: A Randomized Clinical Trial, JAMA Internal Medicine
Alizargar, Dangers of the Use of hydroxychloroquine and azithromycin combination in COVID-19 patients. Travel medicine and infectious disease
Arshad, Kilgore, Chaudhry, Jacobsen, Wang et al., Treatment with hydroxychloroquine, azithromycin, and combination in patients hospitalized with COVID-19
Austin, An Introduction to Propensity Score Methods for Reducing the Effects of Confounding in Observational Studies, Multivariate Behav Res
Austin, Stuart, Moving towards best practice when using inverse probability of weighting (IPTW) using the propensity score to estimate causal treatment effects in observational studies, Statistics in medicine
Baby, Maity, Mehta, Suresh, Nayak et al., Targeting SARS-CoV-2
Carvallo, Hirsch, Farinella, Safety and Efficacy of the combined use of ivermectin, dexamethasone, enoxaparin and aspirin against COVID-19, medRxiv
Coffman, Zhou, Cai, Comparison of methods for handling covariate missingness in propensity score estimation with a binary exposure, BMC medical research methodology
Desai, Franklin, Alternative approaches for confounding adjustment in observational studies using weighting based on the propensity score: a primer for practitioners, BMJ
Fiolet, Guihur, Rebeaud, Mulot, Peiffer-Smadja et al., Effect of hydroxychloroquine with or without azithromycin on the mortality of coronavirus disease 2019 (COVID-19) patients: a systematic review and meta-analysis, Society of Clinical Microbiology and Infectious Diseases
Furtado, Berwanger, Fonseca, Corrêa, Ferraz et al., Azithromycin in addition to standard of care versus standard of care alone in the treatment of patients admitted to the hospital with severe COVID-19 in Brazil (COALITION II): a randomised clinical trial, The Lancet
Gorial, Mashhadani, Sayaly, Dakhil, Almashhadani et al., Effectiveness of Ivermectin as add-on Therapy in COVID-19 Management, Pilot Trial
Hcq, Hydroxychloroquine or chloroquine, IVM: ivermectin , AZIT: azithromycin , AZIT + HCQ,: azithromycin plus hydroxychloroquine, AZIT + IVM: azithromycin plus ivermectin, ACEI: angiotensin converting enzyme inhibitor, ARB: angiotensin receptor blocker, SD: standard deviation; %: Percentage of column
Hernán, Robins, Using Big Data to Emulate a Target Trial When a Randomized Trial Is Not Available, American journal of epidemiology
Juul, Nielsen, Feinberg, Siddiqui, Jørgensen et al., Interventions for treatment of COVID-19: A living systematic review with meta-analyses and trial sequential analyses (The LIVING Project), PLOS Medicine
Labrecque, Swanson, Target trial emulation: teaching epidemiology and beyond
Lauriola, Pani, Ippoliti, Mortara, Milighetti et al., Effect of combination therapy of hydroxychloroquine and azithromycin on mortality in COVID-19 patients, Clinical and Translational Science
Lee, Lessler, Stuart, Improving propensity score weighting using machine learning, Statistics in medicine
Li, Zhao, Zhan, Quantitative proteomics reveals a broad-spectrum antiviral property of ivermectin, benefiting for COVID-19 treatment, Journal of Cellular Physiology
Mahévas, Tran, Roumier, Chabrol, Paule et al., Clinical efficacy of hydroxychloroquine in patients with covid-19 pneumonia who require oxygen: observational comparative study using routine care data, BMJ
Mccaffrey, Griffin, Almirall, Slaughter, Ramchand et al., A tutorial on propensity score estimation for multiple treatments using generalized boosted models, Statistics in medicine
Parast, Mccaffrey, Burgette, De La Guardia, Golinelli et al., Optimizing Variance-Bias Trade-off in the TWANG Package for Estimation of Propensity Scores, Health Serv Outcomes Res Methodol
Pearl, Invited Commentary: Understanding Bias Amplification, American Journal of Epidemiology
Platt, Zucker, Baldwin, Hripcsak, Observational Study of Hydroxychloroquine in Hospitalized Patients with Covid-19, The New England journal of medicine
Prevencion, diagnostico y tratamiento de personas afectadas por COVID-19 en el Peru: Peruvian Ministry of Health
Rajter, Sherman, Fatteh, Vogel, Sacks et al., ICON (Ivermectin in COvid Nineteen) study: Use of Ivermectin is Associated with Lower Mortality in Patients with COVID19, medRxiv
Richman, Antiviral Drug Discovery To Address the COVID-19 Pandemic, mBio
Ridgeway, Mccaffrey, Morral, Griffin, Burgette, Toolkit for Weighting and Analysis of Nonequivalent Groups: CRAN
Rodríguez-Molinero, Pérez-López, Gálvez-Barrón, Miñarro, Macho et al., Observational study of azithromycin in hospitalized patients with COVID-19, PloS one
Sato, Matsuyama, Marginal Structural Models as a Tool for Standardization, Epidemiology
Sekhavati, Jafari, Seyedalinaghi, Jamalimoghadamsiahkali, Sadr et al., Safety and effectiveness of azithromycin in patients with COVID-19: An open-label randomised trial, International journal of antimicrobial agents
Sohag, Hannan, Rahman, Hossain, Hasan et al., Revisiting potential druggable targets against SARS-CoV-2 and repurposing therapeutics under preclinical study and clinical trials: A comprehensive review, Drug Dev Res
Soto-Becerra, Efectividad Clínica Comparativa de Hidroxicloroquina en el Tratamiento de COVID-19 utilizando Datos Observacionales de Registros Clínicos Electrónicos de EsSalud, PRISA
Thomas, Lardenois, Lacrosse, Sarrazin, Azithromycin and Hydroxychloroquine Accelerate Recovery of Outpatients with Mild/Moderate COVID-19, AJMAH
Yu, Li, Wang, Duan, Yang et al., Techniques and strategies for the potential protein-targets discovery and active pharmaceutical molecules screening in Pandemic, Journal of Proteome Research
{ 'institution': [{'name': 'medRxiv'}], 'indexed': { 'date-parts': [[2023, 11, 25]], 'date-time': '2023-11-25T19:22:16Z', 'timestamp': 1700940136867}, 'posted': {'date-parts': [[2020, 10, 8]]}, 'group-title': 'Infectious Diseases (except HIV/AIDS)', 'reference-count': 45, 'publisher': 'Cold Spring Harbor Laboratory', 'content-domain': {'domain': [], 'crossmark-restriction': False}, 'accepted': {'date-parts': [[2020, 10, 14]]}, 'abstract': '<jats:title>ABSTRACT</jats:title><jats:sec><jats:title>Introduction</jats:title><jats:p>Peru ' 'is one of the most impacted countries due to COVID-19. Given the authorized use of ' 'hydroxychloroquine (HCQ), azithromycin (AZIT), and ivermectin (IVM), we aimed to evaluate ' 'their effectiveness alone or combined to reduce mortality among COVID-19 hospitalized ' 'patients without life-threatening ' 'illness.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>Retrospective ' 'cohort emulating a target trial, using nationwide data of mid- and high-level hospitals from ' 'the Peruvian Social Health Insurance 01/April/2020–19/July/2020. Patients 18 yo and above ' 'with PCR-confirmed SARS-CoV-2, and no life-threatening illness at admission were included. ' 'Five treatment groups (HCQ alone, IVM alone, AZIT alone, HCQ+AZIT, and IVM+AZIT within 48 ' 'hours of admission) were compared with standard of care alone. Primary outcome was all-cause ' 'mortality rate; secondary outcomes were all-cause death and/or ICU transfer, and all-cause ' 'death and/or oxygen prescription. Analyses were adjusted using inverse probability of ' 'treatment weighting. Propensity scores were estimated using machine learning boosting models. ' 'Weighted hazard ratios (wHR) were calculated using Cox ' 'regression.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>Among 5683 ' 'patients, 200 received HCT, 203 IVM, 1600 AZIT, 692 HCQ+AZIT, 358 IVM+AZIT, and 2630 standard ' 'of care. HCQ+AZIT was associated with 84% higher all-cause death hazard compared to standard ' 'care (wHR=1.84, 95%CI 1.12-3.02). Consistently, HCQ+AZIT was also associated with higher ' 'death and/or ICU transfer (wHR=1.49, 95%CI 1.01-2.19), and death and/or oxygen prescription ' '(wHR=1.70, 95%CI 1.07-2.69). HCQ only showed higher death and/or oxygen prescription hazard. ' 'No effect was found for AZIT or ' 'IVM+AZIT.</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>Our study ' 'reported no beneficial effects of hydroxychloroquine, ivermectin, azithromycin. The HCQ+AZIT ' 'treatment seems to increase risk for all-cause ' 'death.</jats:p></jats:sec><jats:sec><jats:title>Funding</jats:title><jats:p>Instituto de ' 'Evaluación de Tecnologías en Salud e Investigación – IETSI, EsSalud</jats:p></jats:sec>', 'DOI': '10.1101/2020.10.06.20208066', 'type': 'posted-content', 'created': {'date-parts': [[2020, 10, 8]], 'date-time': '2020-10-08T16:46:34Z', 'timestamp': 1602175594000}, 'source': 'Crossref', 'is-referenced-by-count': 5, 'title': 'Real-world effectiveness of hydroxychloroquine, azithromycin, and ivermectin among hospitalized ' 'COVID-19 patients: results of a target trial emulation using observational data from a ' 'nationwide healthcare system in Peru', 'prefix': '10.1101', 'author': [ { 'ORCID': 'http://orcid.org/0000-0001-5332-9254', 'authenticated-orcid': False, 'given': 'Percy', 'family': 'Soto-Becerra', 'sequence': 'first', 'affiliation': []}, { 'ORCID': 'http://orcid.org/0000-0001-5349-3521', 'authenticated-orcid': False, 'given': 'Carlos', 'family': 'Culquichicón', 'sequence': 'additional', 'affiliation': []}, { 'ORCID': 'http://orcid.org/0000-0003-1993-6223', 'authenticated-orcid': False, 'given': 'Yamilee', 'family': 'Hurtado-Roca', 'sequence': 'additional', 'affiliation': []}, { 'ORCID': 'http://orcid.org/0000-0002-3740-1962', 'authenticated-orcid': False, 'given': 'Roger V.', 'family': 'Araujo-Castillo', 'sequence': 'additional', 'affiliation': []}], 'member': '246', 'reference': [ { 'key': '2020102108250447000_2020.10.06.20208066v3.1', 'doi-asserted-by': 'crossref', 'unstructured': 'Baby K , Maity S , Mehta CH , Suresh A , Nayak UY , Nayak Y. Targeting ' 'SARS-CoV-2 Main Protease: A Computational Drug Repurposing Study. Arch ' 'Med Res. 2020.', 'DOI': '10.1016/j.arcmed.2020.09.013'}, { 'issue': '5', 'key': '2020102108250447000_2020.10.06.20208066v3.2', 'first-page': 'e02134', 'article-title': 'Antiviral Drug Discovery To Address the COVID-19 Pandemic', 'volume': '11', 'year': '2020', 'journal-title': 'mBio'}, { 'key': '2020102108250447000_2020.10.06.20208066v3.3', 'doi-asserted-by': 'crossref', 'unstructured': 'Yu H , Li C , Wang X , Duan J , Yang N , Xie L , et al. Techniques and ' 'strategies for the potential protein-targets discovery and active ' 'pharmaceutical molecules screening in Pandemic. Journal of Proteome ' 'Research. 2020.', 'DOI': '10.1021/acs.jproteome.0c00372'}, { 'key': '2020102108250447000_2020.10.06.20208066v3.4', 'doi-asserted-by': 'publisher', 'DOI': '10.1002/ddr.21709'}, { 'issue': '9', 'key': '2020102108250447000_2020.10.06.20208066v3.5', 'doi-asserted-by': 'crossref', 'first-page': 'e1003293', 'DOI': '10.1371/journal.pmed.1003293', 'article-title': 'Interventions for treatment of COVID-19: A living systematic review ' 'with meta-analyses and trial sequential analyses (The LIVING Project)', 'volume': '17', 'year': '2020', 'journal-title': 'PLOS Medicine'}, { 'key': '2020102108250447000_2020.10.06.20208066v3.6', 'doi-asserted-by': 'crossref', 'unstructured': 'Li N , Zhao L , Zhan X. Quantitative proteomics reveals a broad-spectrum ' 'antiviral property of ivermectin, benefiting for COVID-19 treatment. ' 'Journal of Cellular Physiology. 2020: .n/a(n/a).', 'DOI': '10.1002/jcp.30055'}, { 'key': '2020102108250447000_2020.10.06.20208066v3.7', 'doi-asserted-by': 'crossref', 'unstructured': 'Abella BS , Jolkovsky EL , Biney BT , Uspal JE , Hyman MC , Frank I , et ' 'al. Efficacy and Safety of Hydroxychloroquine vs Placebo for ' 'Pre-exposure SARS-CoV-2 Prophylaxis Among Health Care Workers: A ' 'Randomized Clinical Trial. JAMA Internal Medicine. 2020.', 'DOI': '10.1001/jamainternmed.2020.6319'}, { 'key': '2020102108250447000_2020.10.06.20208066v3.8', 'unstructured': 'Johns Hopkins University. Coronavirus resource center: COVID-19 ' 'Dashboard by the Center for Systems Science and Engineering (CSSE) at ' 'Johns Hopkins University (JHU); 2020 [Last accessed Oct 5, 2020]. ' 'Available from: https://coronavirus.jhu.edu/map.html.'}, { 'key': '2020102108250447000_2020.10.06.20208066v3.9', 'unstructured': 'Johns Hopkins University. Coronavirus resource center: Mortality in the ' 'most affected countries; 2020 [Last accessed Oct 5, 2020]. Available ' 'from: https://coronavirus.jhu.edu/data/mortality.'}, { 'key': '2020102108250447000_2020.10.06.20208066v3.10', 'unstructured': 'Peruvian Ministry of Health. Prevencion, diagnostico y tratamiento de ' 'personas afectadas por COVID-19 en el Peru; 2020 [Last accessed Oct 5, ' '2020]. Available from: ' 'https://www.gob.pe/institucion/minsa/informes-publicaciones/473587-prevencion-diagnostico-y-tratamiento-de-personas-afectadas-por-covid-19-en-el-peru.'}, { 'key': '2020102108250447000_2020.10.06.20208066v3.11', 'unstructured': 'Peruvian Ministry of Health. Manejo ambulatorio de personas afectadas ' 'por COVID-19 en el Peru; 2020 [Last accessed Oct 5, 2020]. Available ' 'from: ' 'https://cdn.www.gob.pe/uploads/document/file/830595/RM_375-2020-MINSA.PDF.'}, { 'key': '2020102108250447000_2020.10.06.20208066v3.12', 'doi-asserted-by': 'publisher', 'DOI': '10.1093/aje/kwv254'}, { 'issue': '6', 'key': '2020102108250447000_2020.10.06.20208066v3.13', 'doi-asserted-by': 'crossref', 'first-page': '473', 'DOI': '10.1007/s10654-017-0293-4', 'article-title': 'Target trial emulation: teaching epidemiology and beyond', 'volume': '32', 'year': '2017', 'journal-title': 'Eur J Epidemiol'}, { 'key': '2020102108250447000_2020.10.06.20208066v3.14', 'doi-asserted-by': 'publisher', 'DOI': '10.1136/bmj.m1844'}, { 'key': '2020102108250447000_2020.10.06.20208066v3.15', 'doi-asserted-by': 'publisher', 'DOI': '10.1002/sim.3782'}, { 'key': '2020102108250447000_2020.10.06.20208066v3.16', 'unstructured': 'Peruvian Social Health Insurance - EsSalud. EsSI EsSalud’s Digital ' 'Clinical Records; 2020.[Last accessed Oct 5, 2020]. Available from: ' 'https://essi.pe/.'}, { 'key': '2020102108250447000_2020.10.06.20208066v3.17', 'unstructured': 'PAHO. Covid-19 codification with ICD-10; 2020 [Last accessed Oct 5, ' '2020]. Available from: ' 'https://www.paho.org/arg/index.php?option=com_docman&view=download&alias=468-covid-cie-codigos-2020-03-25-espanol&category_slug=documentos&Itemid=624.'}, { 'key': '2020102108250447000_2020.10.06.20208066v3.18', 'doi-asserted-by': 'publisher', 'DOI': '10.1002/sim.6607'}, { 'key': '2020102108250447000_2020.10.06.20208066v3.19', 'doi-asserted-by': 'publisher', 'DOI': '10.1002/sim.5753'}, { 'key': '2020102108250447000_2020.10.06.20208066v3.20', 'doi-asserted-by': 'publisher', 'DOI': '10.1080/00273171.2011.568786'}, { 'key': '2020102108250447000_2020.10.06.20208066v3.21', 'doi-asserted-by': 'publisher', 'DOI': '10.1037/1082-989X.9.4.403'}, { 'issue': '1', 'key': '2020102108250447000_2020.10.06.20208066v3.22', 'doi-asserted-by': 'crossref', 'first-page': '168', 'DOI': '10.1186/s12874-020-01053-4', 'article-title': 'Comparison of methods for handling covariate missingness in propensity ' 'score estimation with a binary exposure', 'volume': '20', 'year': '2020', 'journal-title': 'BMC medical research methodology'}, { 'issue': '3-4', 'key': '2020102108250447000_2020.10.06.20208066v3.23', 'doi-asserted-by': 'crossref', 'first-page': '175', 'DOI': '10.1007/s10742-016-0168-2', 'article-title': 'Optimizing Variance-Bias Trade-off in the TWANG Package for Estimation ' 'of Propensity Scores', 'volume': '17', 'year': '2017', 'journal-title': 'Health Serv Outcomes Res Methodol'}, { 'key': '2020102108250447000_2020.10.06.20208066v3.24', 'unstructured': 'Ridgeway G , McCaffrey D , Morral A , Griffin BA , Burgette L M C. ' 'Toolkit for Weighting and Analysis of Nonequivalent Groups (TWANG): ' 'CRAN; 2020 [Last accessed Oct 5, 2020]. Available from: ' 'https://cran.r-project.org/web/packages/twang/.'}, { 'key': '2020102108250447000_2020.10.06.20208066v3.25', 'doi-asserted-by': 'crossref', 'unstructured': 'Sato T , Matsuyama Y. Marginal Structural Models as a Tool for ' 'Standardization. Epidemiology. 2003: 14(6).', 'DOI': '10.1097/01.EDE.0000081989.82616.7d'}, { 'key': '2020102108250447000_2020.10.06.20208066v3.26', 'first-page': '5657', 'article-title': 'Alternative approaches for confounding adjustment in observational ' 'studies using weighting based on the propensity score: a primer for ' 'practitioners', 'volume': '367', 'year': '2019', 'journal-title': 'BMJ'}, { 'key': '2020102108250447000_2020.10.06.20208066v3.27', 'doi-asserted-by': 'publisher', 'DOI': '10.1093/aje/kwr352'}, { 'key': '2020102108250447000_2020.10.06.20208066v3.28', 'unstructured': 'Greifer N. Covariate Balance Tables and Plots (cobalt): CRAN; 2020 [Last ' 'accessed Oct 5, 2020]. Available from: ' 'https://cran.r-project.org/web/packages/cobalt/index.html.'}, { 'key': '2020102108250447000_2020.10.06.20208066v3.29', 'unstructured': 'R Core Team - R: A language and environment for statistical computing: R ' 'Foundation for Statistical Computing; 2020 [Last accessed Oct 5, 2020]. ' 'Available from: https://www.R-project.org/.'}, { 'key': '2020102108250447000_2020.10.06.20208066v3.30', 'unstructured': 'Stata Statistical Software: Release 16. College Station, TX: StataCorp ' 'LLC: StataCorp 2019.'}, { 'key': '2020102108250447000_2020.10.06.20208066v3.31', 'unstructured': 'Soto-Becerra P. Efectividad Clínica Comparativa de Hidroxicloroquina en ' 'el Tratamiento de COVID-19 utilizando Datos Observacionales de Registros ' 'Clínicos Electrónicos de EsSalud.: PRISA; 2020 [Last accessed Oct 5, ' '2020]. Available from: ' 'https://www.ins.gob.pe/prisa/ver_investigacion.aspx?5A53F316-F127-41D6-B894-663E9C8C5E3C.'}, { 'key': '2020102108250447000_2020.10.06.20208066v3.32', 'doi-asserted-by': 'crossref', 'unstructured': 'Guérin V , Lévy P , Thomas J-L , Lardenois T , Lacrosse P , Sarrazin E , ' 'et al. Azithromycin and Hydroxychloroquine Accelerate Recovery of ' 'Outpatients with Mild/Moderate COVID-19. AJMAH 18(7):45–5.', 'DOI': '10.9734/ajmah/2020/v18i730224'}, { 'issue': '25', 'key': '2020102108250447000_2020.10.06.20208066v3.33', 'doi-asserted-by': 'crossref', 'first-page': '2411', 'DOI': '10.1056/NEJMoa2012410', 'article-title': 'Observational Study of Hydroxychloroquine in Hospitalized Patients with ' 'Covid-19', 'volume': '382', 'year': '2020', 'journal-title': 'The New England journal of medicine'}, { 'key': '2020102108250447000_2020.10.06.20208066v3.34', 'doi-asserted-by': 'crossref', 'first-page': '396', 'DOI': '10.1016/j.ijid.2020.06.099', 'article-title': 'Treatment with hydroxychloroquine, azithromycin, and combination in ' 'patients hospitalized with COVID-19', 'volume': '97', 'year': '2020', 'journal-title': 'Int J Infect Dis'}, { 'issue': '9', 'key': '2020102108250447000_2020.10.06.20208066v3.35', 'doi-asserted-by': 'crossref', 'first-page': 'e0238681', 'DOI': '10.1371/journal.pone.0238681', 'article-title': 'Observational study of azithromycin in hospitalized patients with ' 'COVID-19', 'volume': '15', 'year': '2020', 'journal-title': 'PloS one'}, { 'key': '2020102108250447000_2020.10.06.20208066v3.36', 'doi-asserted-by': 'crossref', 'unstructured': 'Fiolet T , Guihur A , Rebeaud ME , Mulot M , Peiffer-Smadja N , ' 'Mahamat-Saleh Y. Effect of hydroxychloroquine with or without ' 'azithromycin on the mortality of coronavirus disease 2019.(COVID-19) ' 'patients: a systematic review and meta-analysis. Clinical microbiology ' 'and infection: the official publication of the European Society of ' 'Clinical Microbiology and Infectious Diseases. 2020: ' 'S1198-743X(20)30505-X.', 'DOI': '10.1016/j.cmi.2020.08.022'}, { 'key': '2020102108250447000_2020.10.06.20208066v3.37', 'unstructured': 'RECOVERY Collaborative Group; Horby P , Mafham M , Linsell L , Bell JL , ' 'Staplin N , Emberson JR , et al. Effect of Hydroxychloroquine in ' 'Hospitalized Patients with Covid-19. New England Journal of Medicine. ' '2020.Oct 8. Online ahead of print.'}, { 'key': '2020102108250447000_2020.10.06.20208066v3.38', 'unstructured': 'Cavalcanti AB , Zampieri FG , Rosa RG , Azevedo LCP , Veiga VC , Avezum ' 'A , et al. Hydroxychloroquine with or without Azithromycin in ' 'Mild-to-Moderate Covid-19. The New England journal of medicine. 2020: ' 'NEJMoa2019014.'}, { 'issue': '10256', 'key': '2020102108250447000_2020.10.06.20208066v3.39', 'doi-asserted-by': 'crossref', 'first-page': '959', 'DOI': '10.1016/S0140-6736(20)31862-6', 'article-title': 'Azithromycin in addition to standard of care versus standard of care ' 'alone in the treatment of patients admitted to the hospital with severe ' 'COVID-19 in Brazil (COALITION II): a randomised clinical trial', 'volume': '396', 'year': '2020', 'journal-title': 'The Lancet'}, { 'issue': '4', 'key': '2020102108250447000_2020.10.06.20208066v3.40', 'doi-asserted-by': 'crossref', 'first-page': '106143', 'DOI': '10.1016/j.ijantimicag.2020.106143', 'article-title': 'Safety and effectiveness of azithromycin in patients with COVID-19: An ' 'open-label randomised trial', 'volume': '56', 'year': '2020', 'journal-title': 'International journal of antimicrobial agents'}, { 'key': '2020102108250447000_2020.10.06.20208066v3.41', 'doi-asserted-by': 'crossref', 'unstructured': 'Lauriola M , Pani A , Ippoliti G , Mortara A , Milighetti S , Mazen M , ' 'et al. Effect of combination therapy of hydroxychloroquine and ' 'azithromycin on mortality in COVID-19 patients. Clinical and ' 'Translational Science. 2020: n/a(n/a).', 'DOI': '10.1111/cts.12860'}, { 'key': '2020102108250447000_2020.10.06.20208066v3.42', 'doi-asserted-by': 'crossref', 'first-page': '101881', 'DOI': '10.1016/j.tmaid.2020.101881', 'article-title': 'Dangers of the Use of hydroxychloroquine and azithromycin combination ' 'in COVID-19 patients', 'volume': '38', 'year': '2020', 'journal-title': 'Travel medicine and infectious disease'}, { 'key': '2020102108250447000_2020.10.06.20208066v3.43', 'doi-asserted-by': 'crossref', 'unstructured': 'Rajter JC , Sherman M , Fatteh N , Vogel F , Sacks J , Rajter J-J. ICON ' '(Ivermectin in COvid Nineteen) study: Use of Ivermectin is Associated ' 'with Lower Mortality in Hospitalized Patients with COVID19. medRxiv. ' '2020: 2020.06.06.20124461.', 'DOI': '10.1101/2020.06.06.20124461'}, { 'key': '2020102108250447000_2020.10.06.20208066v3.44', 'doi-asserted-by': 'crossref', 'unstructured': 'Gorial FI , Mashhadani S , Sayaly HM , Dakhil BD , AlMashhadani MM , ' 'Aljabory AM , et al. Effectiveness of Ivermectin as add-on Therapy in ' 'COVID-19 Management (Pilot Trial).medRxiv. 2020.2020:07.07.20145979.', 'DOI': '10.1101/2020.07.07.20145979'}, { 'key': '2020102108250447000_2020.10.06.20208066v3.45', 'doi-asserted-by': 'crossref', 'unstructured': 'Carvallo HE , Hirsch RR , Farinella ME . Safety and Efficacy of the ' 'combined use of ivermectin, dexamethasone, enoxaparin and aspirin ' 'against COVID-19. medRxiv. 2020: 2020.09.10.20191619.', 'DOI': '10.1101/2020.09.10.20191619'}], 'container-title': [], 'original-title': [], 'link': [ { 'URL': 'https://syndication.highwire.org/content/doi/10.1101/2020.10.06.20208066', 'content-type': 'unspecified', 'content-version': 'vor', 'intended-application': 'similarity-checking'}], 'deposited': { 'date-parts': [[2020, 10, 21]], 'date-time': '2020-10-21T15:25:51Z', 'timestamp': 1603293951000}, 'score': 1, 'resource': {'primary': {'URL': 'http://medrxiv.org/lookup/doi/10.1101/2020.10.06.20208066'}}, 'subtitle': [], 'short-title': [], 'issued': {'date-parts': [[2020, 10, 8]]}, 'references-count': 45, 'URL': 'http://dx.doi.org/10.1101/2020.10.06.20208066', 'relation': {}, 'published': {'date-parts': [[2020, 10, 8]]}, 'subtype': 'preprint'}
Late treatment
is less effective
Please send us corrections, updates, or comments. c19early involves the extraction of 100,000+ datapoints from thousands of papers. Community updates help ensure high accuracy. Treatments and other interventions are complementary. All practical, effective, and safe means should be used based on risk/benefit analysis. No treatment or intervention is 100% available and effective for all current and future variants. We do not provide medical advice. Before taking any medication, consult a qualified physician who can provide personalized advice and details of risks and benefits based on your medical history and situation. FLCCC and WCH provide treatment protocols.
  or use drag and drop   
Submit