Early Outpatient Treatment of Symptomatic, High-Risk COVID-19 Patients that Should be Ramped-Up Immediately as Key to the Pandemic Crisis
More than 1.6 million Americans have
been infected with SARS-CoV-2 and >10 times that number carry
antibodies to it. High-risk patients presenting with progressing
symptomatic disease have only hospitalization treatment with its high
mortality. An outpatient treatment that prevents hospitalization is desperately needed. Two candidate medications have been widely discussed: remdesivir, and hydroxychloroquine+ azithromycin.
Remdesivir has shown mild effectiveness
in hospitalized inpatients, but no trials have been registered in
outpatients. Hydroxychloroquine +azithromycin has been widely
misrepresented in both clinical reports and public media, and outpatient
trials results are not expected until September.
Early outpatient illness is very
different than later hospitalized florid disease and the treatments
differ. Evidence about use of hydroxychloroquine alone, or of
hydroxychloroquine+azithromycin in inpatients, is irrelevant concerning
efficacy of the pair in early high-risk outpatient disease. Five
studies, including two controlled clinical trials, have demonstrated
significant major outpatient treatment efficacy. Hydroxychloroquine
+azithromycin has been used as standard-of-care in more than 300,000
older adults with multicomorbidities, with estimated proportion
diagnosed with cardiac arrhythmias attributable to the medications
47/100,000 users, of which estimated mortality is <20%, 9/100,000
users, compared to the 10,000 Americans now dying each week. These
medications need to be widely available and promoted immediately for
physicians to prescribe.
Read full report here.
Dr. Harvey A Risch, Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, Connecticut
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The original source of this article is American Journal of Epidemiology
Copyright © Dr. Harvey Risch, American Journal of Epidemiology, 2020
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