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COVID-19 research briefs: anosmia common in SARS-CoV-2 infection, and a negative trial of hydroxychloroquine
Clinical Question
What is the incidence of anosmia in patients with COVID-19? Can hydroxychloroquine with or without azithromycin improve outcomes in patients hospitalized with the virus?
Bottom line
Although the loss of the sense of smell is a feature of sinus infections, the rate of anosmia appears to be higher in patients with COVID-19 than would ordinarily be the case with other viral respiratory infections. Retrospective data suggest no benefit of hydroxychloroquine with or without azithromycin in patients in US Veterans Health Administration medical centers. 4
Reference
Study design: Other
Funding:
Setting: Other
Synopsis
Research Brief #14: An alteration in taste and smell has been informally reported in patients with COVID-19. The virus attaches selectively to angiotensin-converting enzyme 2 receptors, which are numerous in the nasal epithelium. This Italian study identified adults who had a positive test result for SARS-CoV-2 during a 4-day period at the regional hospital in Treviso. Of the total 374 patients, 283 had contact information and 202 completed a telephone survey. Two-thirds of the patients (n = 130) reported any alteration in taste or smell, which was described as 'moderate,' 'severe,' or 'as bad as it can be' by 102 patients (78%). In 101 of 130 patients, the onset of the anosmia was concomitant with or followed the onset of other symptoms. Although there is no comparison with patients who have noncoronavirus respiratory infections, the rate of anosmia appears to be higher in patients with COVID-19 than would ordinarily be the case with other viral respiratory infections. Research Brief #15: This is the first published evaluation of hydroxychloroquine (HCQ) with or without azithromycin (AZ) in US patients. The authors identified patients who were hospitalized with COVID-19 in all US Veterans Health Administration medical centers. They identified 97 patients who had been given HCQ, 113 who had been given HCQ plus AZ, and 158 who had not received HCQ. They used propensity score matching to identify patients who looked similar other than the treatment received. In the unadjusted analysis, the risk of death was 27.8% in the HCQ group, 22.1% in the HCQ plus AZ group, and 11.4% in the no HCQ group. After propensity score matching, the adjusted hazard ratio for death was 2.61 (95% CI 1.10 - 6.17) for HCQ compared with no HCQ. However, the risk of death was not significantly increased for patients given the combination HCQ and AZ compared with those receiving no HCQ (adjusted hazard ratio 1.14; 0.56 - 2.32). There was no significant difference between groups with regard to the need for mechanical ventilation in the adjusted analysis.
Reviewer
Mark H. Ebell, MD, MS
Professor
University of Georgia
Athens, GA
Comments
I might have to discontinue receiving these Poems.
Too many of them report on EXTREMELY flawed studies, with misleading and harmful titles. The title can end up being, and often is, the take-home message.
This study is a prime example of what I’m talking about.
Headline "negative trial of hydroxychloroquine”, followed by a brief synopsis of a non-peer reviewed totally useless retrospective study by an author with EXTREME competing interests. To find this out is relatively simple in this digital age & requires the same diligence and time I use on debunking the rubbish my non-science friends post on social media or send to me for my opinion. Please could your organization do this work for us and NOT publish this dangerous rubbish. These poems are meant to be a quick take away of useful information but with the current lack of vigilance are instead a source of misinformation and harm.
For you reference:
https://www.medrxiv.org/content/10.1101/2020.04.16.20065920v2
(Please note the declared major competing interest, and learned comments below the abstract)
Also:
https://www.mediterranee-infection.com/wp-content/uploads/2020/04/Respo…
(which is admittedly written by someone who may have their own vested interest in the topic)
I am not a conspiracy theorist, but your Poems do make me wonder about the competing interests of their (your) publisher. The Poems are too often the opposite of Patient-Oriented Evidence that Matters.
PS:
Your link for CPD points reports only ‘invalid parameters’.
100% agree with above comment
Many of these poems are failing the profession and the role of the CMA that is clearly becoming less relevant. This is so disappointing. Will the CMA be the architect of its extinction or will it use its $2.6 billion war chest to carry on in futility until the money is squandered away? At least be part of good research.