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DrEricDing's profile
Eric Feigl-Ding
Eric Feigl-Ding
Eric Feigl-Ding
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@DrEricDing

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Eric Feigl-DingVerified account

@DrEricDing

Epidemiologist & health economist. Senior Fellow @FAScientists. Former 16 years @Harvard. @JohnsHopkins alum. COVID updates since Jan '20: http://nym.ag/3olszuo 

Washington DC & Virginia
fas.org/expert/eric-fe…
Joined January 2009

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    Eric Feigl-Ding‏Verified account @DrEricDing 22 May 2020

    ⚠️BREAKING: huge Chloroquine and Hydroxychloroquine study of 96,000 patients at 671 hospitals found: 📌Increased risk of DEATH by 33-45% 📌Increased risk of ventricular arrhythmia by 2.3x to 5x. 📌Not a trial but a large longitudinal study. 🧵#COVID19 https://www.washingtonpost.com/health/2020/05/22/hydroxychloroquine-coronavirus-study/ …pic.twitter.com/GPAulxCwNw

    5:49 AM - 22 May 2020
    • 5,831 Retweets
    • 8,637 Likes
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    521 replies 5,831 retweets 8,637 likes
      1. New conversation
      2. Eric Feigl-Ding‏Verified account @DrEricDing 22 May 2020

        2) “It’s one thing not to have benefit, but this shows distinct harm,” said Eric Topol, a cardiologist and director of the Scripps Research Translational Institute. “If there was ever was hope for this drug, this is the death of it.” 🔥

        39 replies 662 retweets 1,805 likes
        Show this thread
      3. Eric Feigl-Ding‏Verified account @DrEricDing 22 May 2020

        3) Patients studied from existing patient registries (important because it was pre recorded). Patients all strictly given HCQ or CQ within 48 hours of #covid19 diagnosis after hospitalization. Excluded if delayed.pic.twitter.com/ce722eMZYa

        17 replies 152 retweets 516 likes
        Show this thread
      4. Eric Feigl-Ding‏Verified account @DrEricDing 22 May 2020

        4) “The treatment groups included 1868 patients who were given chloroquine alone, 3016 given hydroxychloro- quine alone, 3783 given chloroquine w/ macrolide and 6221 given hydroxychloroquine and macrolide. The median time from hospitalisation to diagnosis of COVID-19 was 2 days.

        12 replies 112 retweets 406 likes
        Show this thread
      5. Eric Feigl-Ding‏Verified account @DrEricDing 22 May 2020

        5) “The mean daily dose and duration: chloroquine alone, 765 mg (SD 308) and 6·6 days (2·4); hydroxychloroquine alone, 596 mg (126) and 4·2 days (1·9); chloroquine w/ macrolide, 790 mg (320) and 6·8 days (2·5); and hydroxychloroquine w/ macrolide, 597 mg (128) and 4·3 days (2·0)”

        9 replies 97 retweets 334 likes
        Show this thread
      6. Eric Feigl-Ding‏Verified account @DrEricDing 22 May 2020

        6) “No significant between-group differences were found among baseline characteristics or comorbidities.” ➡️THIS IS QUITE REMARKABLE. Balanced means no baseline confounding. Akin to what you might see in a trial usually, except it wasn’t. Very reassuring.pic.twitter.com/ITMJcnzQ1z

        12 replies 115 retweets 404 likes
        Show this thread
      7. Eric Feigl-Ding‏Verified account @DrEricDing 22 May 2020

        7) “Analyses using propensity score matching by treatment group... indicated that associations between drug regimens and mortality, need for mechanical ventilation, length of stay, and the occurrence of de-novo ventricular arrhythmias were consistent with the primary analysis.”

        2 replies 86 retweets 301 likes
        Show this thread
      8. Eric Feigl-Ding‏Verified account @DrEricDing 22 May 2020

        8) “David Maron, director of preventive cardiology at the Stanford University School of Medicine, said that “these findings provide absolutely no reason for optimism that these drugs might be useful in the prevention or treatment of covid-19.”

        8 replies 139 retweets 403 likes
        Show this thread
      9. Eric Feigl-Ding‏Verified account @DrEricDing 22 May 2020

        9) Nearly 15,000 of the 96,000 patients in the analysis were treated with hydroxychloroquine or chloroquine alone or in combination with a type of antibiotics known as a macrolide, such as azithromycin, within 48 hours of their diagnosis.

        7 replies 88 retweets 298 likes
        Show this thread
      10. Eric Feigl-Ding‏Verified account @DrEricDing 22 May 2020

        10) The mean age was 54 years, and 53 percent were men. Those who were on mechanical ventilators or who received remdesivir, an antiviral drug made by Gilead Sciences that has shown promise in decreasing recovery times, were excluded.

        2 replies 83 retweets 316 likes
        Show this thread
      11. Eric Feigl-Ding‏Verified account @DrEricDing 22 May 2020

        11) For those given hydroxychloroquine, there was 34% increase in risk of mortality & 137% increased risk of serious heart arrhythmias. For those receiving hydroxychloroquine +antibiotic — there was 45% increased risk of death & 411% increased risk of serious heart arrhythmias.

        19 replies 222 retweets 456 likes
        Show this thread
      12. Eric Feigl-Ding‏Verified account @DrEricDing 22 May 2020

        12) “Those given chloroquine had a 37% increased risk of death and a 256% increased risk of serious heart arrhythmias. For those taking chloroquine and an antibiotic, there was a 37% increased risk of death and a 301% increased risk of serious heart arrhythmias.”

        18 replies 180 retweets 393 likes
        Show this thread
      13. Eric Feigl-Ding‏Verified account @DrEricDing 22 May 2020

        13) Clarification of “increased risk” nomenclature: hazard ratio of 5.0 denotes “inc risk by 5x” (drug user risk = 5*non user risk), or can also be described as a “400% increased risk of outcome”. In 1st post, I used the 5x language, which is same as 400% inc risk of X language.

        5 replies 75 retweets 255 likes
        Show this thread
      14. Eric Feigl-Ding‏Verified account @DrEricDing 22 May 2020

        14) Amazing that data came together from 671 hospitals across 6 continents!pic.twitter.com/znerDGeFgA

        13 replies 131 retweets 353 likes
        Show this thread
      15. Eric Feigl-Ding‏Verified account @DrEricDing 22 May 2020

        15) In appendix, they also present results of a COMPOSITE endpoint if either mechanical ventilation or death (whichever came first in the Cox PH analysis). Results mostly same as the mortality endpoint, and even moderately stronger than death alone.pic.twitter.com/59P42Ncp82

        6 replies 65 retweets 238 likes
        Show this thread
      16. Eric Feigl-Ding‏Verified account @DrEricDing 22 May 2020

        16) Other risk factors that stand out for higher risk of death: 📌Men 📌Adiposity (BMI) 📌Blacks and Hispanics vs White 📌Heart disease 📌Diabetes 📌Hypertension 📌High cholesterol 📌Smoking 📌⚠️Non-users of ACE inhibitor* 🔥⚠️Non-users of statins* *Neat but need confirmation.pic.twitter.com/XMUIglGTwt

        12 replies 138 retweets 324 likes
        Show this thread
      17. Eric Feigl-Ding‏Verified account @DrEricDing 22 May 2020

        17) the strong findings of lower risk death for ACE inhibitors and statin users is interesting. But they area already drugs that are well known to lower risk of death. But do they lower even more among COVID patients? Unclear.

        7 replies 75 retweets 249 likes
        Show this thread
      18. Eric Feigl-Ding‏Verified account @DrEricDing 22 May 2020

        18) And racial data, I don’t want to overinterpret yet, because I don’t know if Blacks in Africa should be compared to whites in US/Europe. Prefer data on African Americans vs Whites in NA & African Europeans vs Whites in Europe w/in any continent. Same for Asians and Hispanics.

        7 replies 51 retweets 217 likes
        Show this thread
      19. Eric Feigl-Ding‏Verified account @DrEricDing 22 May 2020

        19) BOTTOMLINE: this study demonstrating CQ & HCQ increasing risk of death is an epic body of work representing amazing collaboration of 671 hospitals. Though not trial, it’s hospital registry data that is quite strong longitudinal design. ➡️ Do NOT take HCQ or CQ at this time!

        23 replies 141 retweets 395 likes
        Show this thread
      20. End of conversation

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