Observational Study of Hydroxychloroquine in Hospitalized Patients with Covid-19
https://www.nejm.org/doi/full/10.1056/NEJMoa2012410
https://www.nejm.org/doi/full/10.1056/NEJMoa2012410
Corona 2020
- Thread starter TreeFrogTrader
- Start date
Might as well provide the Abstract of this study...
Background
Hydroxychloroquine has been widely administered to patients with Covid-19 without robust evidence supporting its use.
Methods
We examined the association between hydroxychloroquine use and intubation or death at a large medical center in New York City. Data were obtained regarding consecutive patients hospitalized with Covid-19, excluding those who were intubated, died, or discharged within 24 hours after presentation to the emergency department (study baseline). The primary end point was a composite of intubation or death in a time-to-event analysis. We compared outcomes in patients who received hydroxychloroquine with those in patients who did not, using a multivariable Cox model with inverse probability weighting according to the propensity score.
Results
Of 1446 consecutive patients, 70 patients were intubated, died, or discharged within 24 hours after presentation and were excluded from the analysis. Of the remaining 1376 patients, during a median follow-up of 22.5 days, 811 (58.9%) received hydroxychloroquine (600 mg twice on day 1, then 400 mg daily for a median of 5 days); 45.8% of the patients were treated within 24 hours after presentation to the emergency department, and 85.9% within 48 hours. Hydroxychloroquine-treated patients were more severely ill at baseline than those who did not receive hydroxychloroquine (median ratio of partial pressure of arterial oxygen to the fraction of inspired oxygen, 223 vs. 360). Overall, 346 patients (25.1%) had a primary end-point event (180 patients were intubated, of whom 66 subsequently died, and 166 died without intubation). In the main analysis, there was no significant association between hydroxychloroquine use and intubation or death (hazard ratio, 1.04, 95% confidence interval, 0.82 to 1.32). Results were similar in multiple sensitivity analyses.
Conclusions
In this observational study involving patients with Covid-19 who had been admitted to the hospital, hydroxychloroquine administration was not associated with either a greatly lowered or an increased risk of the composite end point of intubation or death. Randomized, controlled trials of hydroxychloroquine in patients with Covid-19 are needed. (Funded by the National Institutes of Health.)
Well here is another activity that is going to be locked down...
Coronavirus found in men's semen
https://www.cnn.com/2020/05/07/health/coronavirus-semen-china-health/index.html
Coronavirus found in men's semen
https://www.cnn.com/2020/05/07/health/coronavirus-semen-china-health/index.html
Travelers from NYC spread coronavirus around US, scientists say
https://nypost.com/2020/05/07/travelers-from-nyc-spread-coronavirus-around-us-scientists/
New research shows that the Big Apple’s coronavirus outbreak fueled infections around the United States — as thousand of people traveled in and out of the city in late February and early March, according to a report.
A wave of infections swept from New York City to Louisiana, Texas, Arizona and as far away as the West Coast, before state and city leaders set restrictions to curb the outbreak, The New York Times reported Thursday.
“We now have enough data to feel pretty confident that New York was the primary gateway for the rest of the country,” Nathan Grubaugh, an epidemiologist at the Yale School of Public Health, told The Times.
Geneticists analyzed more than 2,000 samples from infected people across the country, tracing a mutation of the virus back to New York.
The travel histories of patients and models of the outbreak by infectious disease experts also support the idea that New York fueled outbreaks in other states.
“New York acted as the Grand Central Station for this virus, with the opportunity to move from there in so many directions, to so many places,” David Engelthaler, head of the infectious disease branch of the Translational Genomics Research Institute in Arizona, told the paper.
Inaction by New York’s political leaders during crucial weeks in early March helped the virus get a head start in its spread, the researchers said.
(More at above url)
https://nypost.com/2020/05/07/travelers-from-nyc-spread-coronavirus-around-us-scientists/
New research shows that the Big Apple’s coronavirus outbreak fueled infections around the United States — as thousand of people traveled in and out of the city in late February and early March, according to a report.
A wave of infections swept from New York City to Louisiana, Texas, Arizona and as far away as the West Coast, before state and city leaders set restrictions to curb the outbreak, The New York Times reported Thursday.
“We now have enough data to feel pretty confident that New York was the primary gateway for the rest of the country,” Nathan Grubaugh, an epidemiologist at the Yale School of Public Health, told The Times.
Geneticists analyzed more than 2,000 samples from infected people across the country, tracing a mutation of the virus back to New York.
The travel histories of patients and models of the outbreak by infectious disease experts also support the idea that New York fueled outbreaks in other states.
“New York acted as the Grand Central Station for this virus, with the opportunity to move from there in so many directions, to so many places,” David Engelthaler, head of the infectious disease branch of the Translational Genomics Research Institute in Arizona, told the paper.
Inaction by New York’s political leaders during crucial weeks in early March helped the virus get a head start in its spread, the researchers said.
(More at above url)
Interesting the way the testing scenario has evolved in just the last few weeks, all the complaints from the tards rooting for failure being noted.
We have gone from tests being unreliable and not sufficiently sensitive to being able to possibly test in combined batches. In reading through I doubted that the tests would be sensitive enough, but they say yes. I don't know but thinking and experimenting are definitely allowed in my mind. It isnt that hard to confirm so if it looks good, it may be good.
FROM THE NEW YORK TIMES
Five People. One Test. This Is How You Get There.
Nebraska is testing more people with the tests it has. The technique is simple.
By Jordan Ellenberg
Mr. Ellenberg is a professor of mathematics.
A nurse administering a test for the coronavirus in Omaha this month.Credit...Nati Harnik/Associated Press
Once we’ve beaten back the first wave of Covid-19 infections, the next phase of the fight against the pandemic begins. And that requires testing, lots of testing, much more testing than we’re doing right now in the United States, so we can isolate the sick from the well and keep the curve from kicking upward again. Researchers at Harvard say we need to triple our current capacity to test.
found that the PCR test reliably returns a positive result when one positive sample is mixed with four negatives. Researchers in Germany and Israel have gotten similar results.
Subscribe to The Times
Peter Iwen, the director of the Nebraska lab and an author of the new study, reports that his lab is using 50 to 60 percent less testing material and technician time than it would if it were testing every sample individually. (And subjects don’t have to come back for another swab up the nose; each sample yields enough material for retesting if needed.) The Nebraska lab is testing 1,300 specimens a week, which is a drop in the bucket compared to the national totals we need, but it’s just one lab in one small state. (Group testing is also being used in German hospitals.)
Why aren’t we doing this already? For one thing, it’s not exactly allowed. Group testing doesn’t fall within the manufacturer’s guidelines for use of the Covid-19 tests. Professor Iwen’s lab had to get special permission from Nebraska’s governor.
In addition, in some parts of the United States there aren’t enough of the swabs required for the test, creating a bottleneck. Group testing is good for reducing the number of tests you need, but there’s no way of getting around the fact that swabs aren’t for sharing. You need one per person.
Prevalence is also an issue. When 2 percent of the population you’re testing is infected, group testing has a big payoff. But if it’s 20 percent, the chance that a pool of five samples will test negative is only one in three. In that case, most of your groups are going to have to be retested, and you’re not much better off than if you’d tested people one by one. (You can make the pool smaller than five, of course, but that gives away much of your gains, too.)
So far, most testing in the United States has been done on people at high risk for infection, and about one in six tests have come back positive. In a population with that high an infection rate, group testing doesn’t make sense. But as we move into the next phase of broad testing and contact tracing, we’ll be testing people much less likely to be infected, and the usefulness of group testing will increase.
There is no test fairy. Keeping the curve flat, having gone through so much pain to flatten it, is going to require a level of infection reconnaissance we don’t yet know how to achieve. We’ll need improvements in manufacturing, we’ll need more people to do the tracing work a test can’t, and we’ll need to get more out of the materials we have.
For the last of those goals, group testing is a promising way forward.
We have gone from tests being unreliable and not sufficiently sensitive to being able to possibly test in combined batches. In reading through I doubted that the tests would be sensitive enough, but they say yes. I don't know but thinking and experimenting are definitely allowed in my mind. It isnt that hard to confirm so if it looks good, it may be good.
FROM THE NEW YORK TIMES
Five People. One Test. This Is How You Get There.
Nebraska is testing more people with the tests it has. The technique is simple.
By Jordan Ellenberg
Mr. Ellenberg is a professor of mathematics.
A nurse administering a test for the coronavirus in Omaha this month.Credit...Nati Harnik/Associated Press
Once we’ve beaten back the first wave of Covid-19 infections, the next phase of the fight against the pandemic begins. And that requires testing, lots of testing, much more testing than we’re doing right now in the United States, so we can isolate the sick from the well and keep the curve from kicking upward again. Researchers at Harvard say we need to triple our current capacity to test.
found that the PCR test reliably returns a positive result when one positive sample is mixed with four negatives. Researchers in Germany and Israel have gotten similar results.
Subscribe to The Times
Peter Iwen, the director of the Nebraska lab and an author of the new study, reports that his lab is using 50 to 60 percent less testing material and technician time than it would if it were testing every sample individually. (And subjects don’t have to come back for another swab up the nose; each sample yields enough material for retesting if needed.) The Nebraska lab is testing 1,300 specimens a week, which is a drop in the bucket compared to the national totals we need, but it’s just one lab in one small state. (Group testing is also being used in German hospitals.)
Why aren’t we doing this already? For one thing, it’s not exactly allowed. Group testing doesn’t fall within the manufacturer’s guidelines for use of the Covid-19 tests. Professor Iwen’s lab had to get special permission from Nebraska’s governor.
In addition, in some parts of the United States there aren’t enough of the swabs required for the test, creating a bottleneck. Group testing is good for reducing the number of tests you need, but there’s no way of getting around the fact that swabs aren’t for sharing. You need one per person.
Prevalence is also an issue. When 2 percent of the population you’re testing is infected, group testing has a big payoff. But if it’s 20 percent, the chance that a pool of five samples will test negative is only one in three. In that case, most of your groups are going to have to be retested, and you’re not much better off than if you’d tested people one by one. (You can make the pool smaller than five, of course, but that gives away much of your gains, too.)
So far, most testing in the United States has been done on people at high risk for infection, and about one in six tests have come back positive. In a population with that high an infection rate, group testing doesn’t make sense. But as we move into the next phase of broad testing and contact tracing, we’ll be testing people much less likely to be infected, and the usefulness of group testing will increase.
There is no test fairy. Keeping the curve flat, having gone through so much pain to flatten it, is going to require a level of infection reconnaissance we don’t yet know how to achieve. We’ll need improvements in manufacturing, we’ll need more people to do the tracing work a test can’t, and we’ll need to get more out of the materials we have.
For the last of those goals, group testing is a promising way forward.
Just having any people from New York come to your area - with or without corona- is a plague of sorts.
Yeh, I know. That was a cheap shot and totally uncalled for- but if you are from Maine or a Southerner it is in your DNA.
Same is true down here in North Carolina with their attitude towards Yankees. New Yorker's are viewed as the worst.
You know, some of this New York data is beginning to come around bigtime and starting to look good.
Scroll down on this link to: Daily Counts.
https://www1.nyc.gov/site/doh/covid/covid-19-data.page
Scroll down on this link to: Daily Counts.
https://www1.nyc.gov/site/doh/covid/covid-19-data.page
Fortunately New York is improving and appears to be on the backside of the this COVID-19 wave. Most other states are still having rising cases, hospitalizations, and deaths -- so from an entire country perspective things are not looking real good.