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On March 28, 2020, in response to the rapidly accelerating COVID-19 pandemic, U.S FDA issued emergency use authorization for hydroxychloroquine (HCQ) in hospitalized COVID-19 patients based on limited in-vitro and anecdotal clinical data. Analysis of the accumulated real-world data utilizing electronic medical records (EMR) could indicate HCQ therapy benefits as we await the results of clinical trials. However, any such analysis of retrospective observational data should account for variables such as demographics and comorbidities that could affect treatment strategies or outcomes. Therefore, we report the outcomes of HCQ treatment in a propensity-matched cohort of COVID-19 hospitalized patients. Our analysis of a large retrospective cohort of hospitalized COVID-19 patients treated with HCQ did not show benefits in mortality or the need for mechanical ventilation when compared to a matched cohort of patients who did not receive HCQ.

Introduction-Endoscopic Sleeve Gastroplasty (ESG) has gained momentum as a promising minimally invasive bariatric therapy worldwide.Objective-We performed the first comprehensive systematic review and meta-analysis of studies to evaluate the efficacy, safety, and procedural technique of ESG.

Importance COVID-19 epidemiological data show higher mortality rates among males compared to females. However, it remains unclear if the disparity in mortality is due to gender differences in high-risk characteristics. Objective To study the clinical characteristics of a large and diverse cohort of COVID-19 patients stratified by gender and determine the outcomes after matching for age and other high-risk characteristics. Design Retrospective cohort between January 20, 2020, and April 15, 2020 Setting TriNetX COVID-19 Research Network consisting of multiple healthcare organizations (HCOs) predominantly in the United States Participants and Exposure A cohort of male and female patients > 10 years of age diagnosed with COVID-19 identified with real-time analyses of electronic medical records of patients from participating HCOs. A 1:1 propensity score matching of cohorts was performed for age, race, nicotine use, and all possible confounding comorbidities. Main Outcome Risk of mortality, hospitalization and mechanical ventilation within 30 days after the diagnosis of COVID-19 Results A total of 5980 males and 7730 females diagnosed with COVID-19 were identified. Males were significantly older than females (54.9 (18.3) vs. 50.9 (18.4), p-value <0.0001). There were significant differences in patient characteristics, but after propensity matching, both groups (N=5350 each group) were balanced. Males had a significantly higher risk for mortality both before (Risk Ratio (RR) 2.1, 95% CI 1.8-2.4) and after matching (RR 1.4, 95% CI 1.2-1.7). Similarly, the risk of hospitalization (RR 1.3, 95%CI 1.2-1.4) and mechanical ventilation (RR 1.71, 95% CI 1.3-2.3) was significantly higher in males even after matching. On subanalysis, males age > 50 had higher mortality than matched females of similar age (RR 1.6, 95% CI 1.4-1.8), whereas the risk of mortality in matched groups < 40 years was similar (RR 1.00, 95% CI 0.4-2.4). Conclusion In conclusion, males are more severely affected and have higher mortality from COVID-19. This gender-specific risk is especially more pronounced in advanced age. Gender disparity in poor outcomes can only be partially explained by differences in high-risk behavior and comorbidities. Further research is needed to understand the causes of this disparity.

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T he coronavirus disease 2019 has caused an extraordinary burden on the healthcare system and has dramatically impacted the delivery of services. Many nonurgent gastrointestinal (GI) endoscopy services and in-person clinic visits have been deferred, and patients have also avoided visiting healthcare facilities because of the risk of exposure to COVID-19. 1 Data from the United Kingdom and Hong Kong have shown a drop in the number of patients diagnosed with various GI cancers. 2,3 However, the overall impact of the COVID-19 pandemic on common GI procedures and cancer diagnoses in the United States has not been thoroughly evaluated.