I took a real quick look at page 1 and didn't see this, but it would be easy to miss.
From http://www.medpagetoday.com/blogs/revolutionandrevelation/86696:
From http://www.medpagetoday.com/blogs/revolutionandrevelation/86696:
Quote:
Last week, the largest observational study on the efficacy and safety of CQ and HCQ was published in The Lancet. This study evaluated the in-hospital outcomes of 96,032 patients with COVID-19 who were treated at 671 hospitals across 6 continents. The patients received CQ or HCQ (alone or in combination with azithromycin) as compared with none of these treatments. Patients on mechanical ventilation or who received remdesivir were not included in the analysis. The mortality was 9.3% in patients receiving neither drug, 16.4%-18.0% in those receiving CQ or HCQ, and 22.2-23.8% in patients receiving CQ or HCQ in combination with azithromycin. Use of CQ and HCQ did not prevent death in COVID-19 patients, but these drugs were independently associated with increased risk of death and increased risk of cardiac arrhythmia.
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Yet, the most important medical news regarding the treatment of COVID-19 last week was the publication of the NIH trial of remdesivir, a drug that has been shown to have antiviral activity against SARS-CoV-2.
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The results of the trial were posted online by the New England Journal of Medicine on May 22. A total of 1063 patients with COVID-19 were randomized (double-blind) to placebo or remdesivir after a median of 9 days after symptom onset. Remdesivir shortened the median time to recovery from 15 to 11 days (a 27% reduction), P<0.001. The magnitude of the benefit did not depend on whether patients had been randomized early or late after the onset of symptoms. However, patients in the trial who had advancing respiratory insufficiency -- which is believed to be related to cytokine storm rather than due to viral replication -- did not respond favorably to remdesivir.
Importantly, the risk of death was 30% lower in the remdesivir group than the placebo group at 14 days after randomization. The hazard ratio for death was 0.70 (95% CI 0.47-1.04). As per New England Journal of Medicine policy, no P value was provided, but it can be estimated at 0.06-0.08. The largest subgroup of the patients in the trial (comprising 40% of the study population) were those receiving supplemental oxygen without ventilatory support. The hazard ratio for mortality in this subgroup was 0.22 (95% CI 0.08-0.58), which was nominally significant. In this subgroup, 19 patients died in the placebo group and four died in the group receiving remdesivir. Although this reduction in mortality is impressive, it is based on a sparse number of events.
In the overall trial, there were 28 serious respiratory failure adverse events in the remdesivir group and 42 in the placebo group, a 35% risk reduction. The P value for this difference can also be estimated at 0.06-0.08.
