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Article ; Online: Mortality, viral clearance, and other clinical outcomes of hydroxychloroquine in COVID-19 patients: A systematic review and meta-analysis of randomized controlled trials.

Kashour, Zakariya / Kashour, Tarek / Gerberi, Danielle / Tleyjeh, Imad M

2021 Volume 14, Issue 3, Page(s) 1101–1112

Abstract: Many meta-analyses have been published about the efficacy of hydroxychloroquine (HCQ) in coronavirus disease 2019 (COVID-19). Most of them included observational studies, and few have assessed HCQ as a prophylaxis or evaluated its safety profile. We ... ...

Abstract	Many meta-analyses have been published about the efficacy of hydroxychloroquine (HCQ) in coronavirus disease 2019 (COVID-19). Most of them included observational studies, and few have assessed HCQ as a prophylaxis or evaluated its safety profile. We searched multiple databases and preprint servers for randomized controlled trials (RCTs) that assessed HCQ for the treatment or prevention of COVID-19. We summarized the effect of HCQ on mortality, viral clearance, and other clinical outcomes. Out of 768 papers screened, 21 RCTs with a total of 14,138 patients were included. A total of 9 inpatient and 3 outpatient RCTs assessed mortality in 8596 patients with a pooled risk difference of 0.01 (95% confidence interval [CI] 0.00-0.03, I
MeSH term(s)	COVID-19/mortality ; COVID-19/virology ; Humans ; Hydroxychloroquine/adverse effects ; Hydroxychloroquine/pharmacology ; Hydroxychloroquine/therapeutic use ; Randomized Controlled Trials as Topic ; SARS-CoV-2 ; Viral Load ; COVID-19 Drug Treatment
Chemical Substances	Hydroxychloroquine (4QWG6N8QKH)
Language	English
Publishing date	2021-05-02
Publishing country	United States
Document type	Journal Article ; Meta-Analysis ; Systematic Review
ZDB-ID	2433157-0
ISSN	1752-8062 ; 1752-8054
ISSN (online)	1752-8062
ISSN	1752-8054
DOI	10.1111/cts.13001
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Mortality, viral clearance, and other clinical outcomes of hydroxychloroquine in COVID‐19 patients

Zakariya Kashour / Tarek Kashour / Danielle Gerberi / Imad M. Tleyjeh

Clinical and Translational Science, Vol 14, Iss 3, Pp 1101-

A systematic review and meta‐analysis of randomized controlled trials

2021 Volume 1112

Abstract: Abstract Many meta‐analyses have been published about the efficacy of hydroxychloroquine (HCQ) in coronavirus disease 2019 (COVID‐19). Most of them included observational studies, and few have assessed HCQ as a prophylaxis or evaluated its safety profile. ...

Abstract	Abstract Many meta‐analyses have been published about the efficacy of hydroxychloroquine (HCQ) in coronavirus disease 2019 (COVID‐19). Most of them included observational studies, and few have assessed HCQ as a prophylaxis or evaluated its safety profile. We searched multiple databases and preprint servers for randomized controlled trials (RCTs) that assessed HCQ for the treatment or prevention of COVID‐19. We summarized the effect of HCQ on mortality, viral clearance, and other clinical outcomes. Out of 768 papers screened, 21 RCTs with a total of 14,138 patients were included. A total of 9 inpatient and 3 outpatient RCTs assessed mortality in 8596 patients with a pooled risk difference of 0.01 (95% confidence interval [CI] 0.00–0.03, I2 = 1%, p = 0.07). Six studies assessed viral clearance at 7 days with a pooled risk ratio (RR) of 1.11 (95% CI 0.86–1.42, I2 = 61%, p = 0.44) and 5 studies at 14 days with a pooled RR of 0.96 (95% CI 0.89–1.04, I2 = 0%, p = 0.34). Several trials showed no significant effect of HCQ on other clinical outcomes and. Five prevention RCTs with 5012 patients found no effect of HCQ on the risk of acquiring COVID‐19. Thirteen trials showed that HCQ was associated with increased risk of adverse events. We observed, with high level of certainty of evidence, that HCQ is not effective in reducing mortality in patients with COVID‐19. Lower certainty evidence also suggests that HCQ neither improves viral clearance and other clinical outcomes, nor prevents COVID‐19 infection in patients with high‐risk exposure. HCQ is associated with an increased rate of adverse events.
Keywords	Therapeutics. Pharmacology ; RM1-950 ; Public aspects of medicine ; RA1-1270
Subject code	610
Language	English
Publishing date	2021-05-01T00:00:00Z
Publisher	Wiley
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Efficacy and safety of tocilizumab in COVID-19 patients: a living systematic review and meta-analysis, first update.

Tleyjeh, Imad M / Kashour, Zakariya / Riaz, Muhammad / Hassett, Leslie / Veiga, Viviane C / Kashour, Tarek

Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases

2021 Volume 27, Issue 8, Page(s) 1076–1082

Abstract: Objectives: Cytokine release syndrome with elevated interleukin-6 (IL-6) levels is associated with multiorgan damage and death in severe coronavirus disease 2019 (COVID-19). Our objective was to update the data in a living systematic review of the ... ...

Abstract	Objectives: Cytokine release syndrome with elevated interleukin-6 (IL-6) levels is associated with multiorgan damage and death in severe coronavirus disease 2019 (COVID-19). Our objective was to update the data in a living systematic review of the literature concerning the efficacy and toxicity of the IL-6 receptor antagonist tocilizumab in COVID-19 patients. Methods: Data sources were Ovid MEDLINE(R) and Epub Ahead of Print, In-Process & Other Non-Indexed Citations and Daily, Ovid Embase, Ovid Cochrane Central Register of Controlled Trials, Ovid Cochrane Database of Systematic Reviews, Web of Science, Scopus up, preprint servers and Google from 8th October 2020 till 24th February 2021. Eligible studies were randomized controlled trials (RCTs) and observational studies at low or moderate risk of bias. The participants were hospitalized COVID-19 patients, and intervention was tocilizumab versus placebo or standard of care. We pooled crude risk ratios (RRs) of RCTs with a random effects model and evaluated inconsistency between studies with I Results: Of 1600 citations, eight RCTs and 28 cohorts were eligible. The eight RCTs had low risk of bias, and with 6311 patients they examined the effect of tocilizumab on short-term mortality; pooled RR was 0.91 (95%CI 0.78-1.07, I Conclusions: Cumulative high-certainty evidence shows that tocilizumab reduces the risk of mechanical ventilation in hospitalized patients with severe COVID-19. Moderate-certainty evidence shows that tocilizumab reduces the risk of poor outcome and the risk of secondary infections in hospitalized COVID-19 patients. This review will continuously evaluate the role of tocilizumab in COVID-19 treatment.
MeSH term(s)	Antibodies, Monoclonal, Humanized/therapeutic use ; COVID-19/drug therapy ; COVID-19/epidemiology ; COVID-19/virology ; Humans ; Immunosuppressive Agents/therapeutic use ; Interleukin-6/antagonists & inhibitors ; Interleukin-6/blood ; Odds Ratio ; Placebos ; Respiration, Artificial ; SARS-CoV-2/drug effects ; Standard of Care ; Treatment Outcome
Chemical Substances	Antibodies, Monoclonal, Humanized ; Immunosuppressive Agents ; Interleukin-6 ; Placebos ; tocilizumab (I031V2H011)
Language	English
Publishing date	2021-04-27
Publishing country	England
Document type	Journal Article ; Meta-Analysis ; Systematic Review
ZDB-ID	1328418-6
ISSN	1469-0691 ; 1470-9465 ; 1198-743X
ISSN (online)	1469-0691
ISSN	1470-9465 ; 1198-743X
DOI	10.1016/j.cmi.2021.04.019
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Zs.A 4541: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (2.OG) ab Jg. 2022: Lesesaal (EG)
Zs.MO 284: Show issues

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Article ; Online: Gemtuzumab ozogamicin plus standard induction hemotherapy improves outcomes of newly diagnosed intermediate cytogenetic risk acute myeloid leukemia.

Awada, Hassan / Abdelmalek, Mina / Cronin, Tara / Baron, Jeffrey / Kashour, Zakariya / Azad, Farhan / Faisal, Muhammad Salman / Faber, Mark / Gravina, Matthew / Sung, Pamela J / Green, Steven D / Przespolewski, Amanda / Thompson, James E / Griffiths, Elizabeth A / Wang, Eunice S

Blood cancer journal

2023 Volume 13, Issue 1, Page(s) 131

MeSH term(s)	Humans ; Gemtuzumab ; Leukemia, Myeloid, Acute/diagnosis ; Leukemia, Myeloid, Acute/genetics ; Leukemia, Myeloid, Acute/therapy ; Cytogenetic Analysis
Chemical Substances	Gemtuzumab (93NS566KF7)
Language	English
Publishing date	2023-09-04
Publishing country	United States
Document type	Letter ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	2600560-8
ISSN	2044-5385 ; 2044-5385
ISSN (online)	2044-5385
ISSN	2044-5385
DOI	10.1038/s41408-023-00910-x
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Article ; Online: Efficacy and safety of tocilizumab in COVID-19 patients: a living systematic review and meta-analysis.

Tleyjeh, Imad M / Kashour, Zakariya / Damlaj, Moussab / Riaz, Muhammad / Tlayjeh, Haytham / Altannir, Mustafa / Altannir, Youssef / Al-Tannir, Mohamad / Tleyjeh, Rana / Hassett, Leslie / Kashour, Tarek

Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases

2020 Volume 27, Issue 2, Page(s) 215–227

Abstract: Objectives: Cytokine release syndrome with elevated interleukin-6 (IL-6) levels is associated with multiorgan damage and death in severe coronavirus disease 2019 (COVID-19). Our objective was to perform a living systematic review of the literature ... ...

Abstract	Objectives: Cytokine release syndrome with elevated interleukin-6 (IL-6) levels is associated with multiorgan damage and death in severe coronavirus disease 2019 (COVID-19). Our objective was to perform a living systematic review of the literature concerning the efficacy and toxicity of the IL-6 receptor antagonist tocilizumab in COVID-19 patients. Methods: Data sources were Ovid MEDLINE(R) and Epub Ahead of Print, In-Process & Other Non-Indexed Citations and Daily, Ovid Embase, Ovid Cochrane Central Register of Controlled Trials, Ovid Cochrane Database of Systematic Reviews, Web of Science, Scopus up, preprint servers and Google up to October 8, 2020. Study eligibility criteria were randomized controlled trials (RCTs) and observational studies at low or moderate risk of bias. Participants were hospitalized COVID-19 patients. Interventions included tocilizumab versus placebo or standard of care. We pooled crude risk ratios (RRs) of RCTs and adjusted RRs from cohorts, separately. We evaluated inconsistency between studies with I Results: Of 1156 citations, 24 studies were eligible (five RCTs and 19 cohorts). Five RCTs at low risk of bias, with 1325 patients, examined the effect of tocilizumab on short-term mortality; pooled RR was 1.09 (95%CI 0.80-1.49, I Conclusions: Cumulative moderate-certainty evidence shows that tocilizumab reduces the risk of mechanical ventilation in hospitalized COVID-19 patients. While RCTs showed that tocilizumab did not reduce short-term mortality, low-certainty evidence from cohort studies suggests an association between tocilizumab and lower mortality. We did not observe a higher risk of infections or adverse events with tocilizumab use. This review will continuously evaluate the role of tocilizumab in COVID-19 treatment.
MeSH term(s)	Antibodies, Monoclonal, Humanized/therapeutic use ; COVID-19/mortality ; COVID-19/therapy ; Cytokine Release Syndrome/drug therapy ; Cytokine Release Syndrome/mortality ; Cytokine Release Syndrome/therapy ; Humans ; Observational Studies as Topic ; Odds Ratio ; Randomized Controlled Trials as Topic ; Receptors, Interleukin-6/antagonists & inhibitors ; Respiration, Artificial/statistics & numerical data ; SARS-CoV-2 ; Safety ; COVID-19 Drug Treatment
Chemical Substances	Antibodies, Monoclonal, Humanized ; Receptors, Interleukin-6 ; tocilizumab (I031V2H011)
Keywords	covid19
Language	English
Publishing date	2020-11-05
Publishing country	England
Document type	Journal Article ; Meta-Analysis ; Systematic Review
ZDB-ID	1328418-6
ISSN	1469-0691 ; 1470-9465 ; 1198-743X
ISSN (online)	1469-0691
ISSN	1470-9465 ; 1198-743X
DOI	10.1016/j.cmi.2020.10.036
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Zs.A 4541: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (2.OG) ab Jg. 2022: Lesesaal (EG)
Zs.MO 284: Show issues

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Article ; Online: Efficacy of chloroquine or hydroxychloroquine in COVID-19 patients: a systematic review and meta-analysis.

Kashour, Zakariya / Riaz, Muhammad / Garbati, Musa A / AlDosary, Oweida / Tlayjeh, Haytham / Gerberi, Dana / Murad, M Hassan / Sohail, M Rizwan / Kashour, Tarek / Tleyjeh, Imad M

The Journal of antimicrobial chemotherapy

2020 Volume 76, Issue 1, Page(s) 30–42

Abstract: Objectives: Clinical studies of chloroquine (CQ) and hydroxychloroquine (HCQ) in COVID-19 disease reported conflicting results. We sought to systematically evaluate the effect of CQ and HCQ with or without azithromycin on outcomes of COVID-19 patients.!# ...

Abstract	Objectives: Clinical studies of chloroquine (CQ) and hydroxychloroquine (HCQ) in COVID-19 disease reported conflicting results. We sought to systematically evaluate the effect of CQ and HCQ with or without azithromycin on outcomes of COVID-19 patients. Methods: We searched multiple databases, preprints and grey literature up to 17 July 2020. We pooled only adjusted-effect estimates of mortality using a random-effect model. We summarized the effect of CQ or HCQ on viral clearance, ICU admission/mechanical ventilation and hospitalization. Results: Seven randomized clinical trials (RCTs) and 14 cohort studies were included (20 979 patients). Thirteen studies (1 RCT and 12 cohort studies) with 15 938 hospitalized patients examined the effect of HCQ on short-term mortality. The pooled adjusted OR was 1.05 (95% CI 0.96-1.15, I2 = 0%). Six cohort studies examined the effect of the HCQ+azithromycin combination with a pooled adjusted OR of 1.32 (95% CI 1.00-1.75, I2 = 68.1%). Two cohort studies and four RCTs found no effect of HCQ on viral clearance. One small RCT demonstrated improved viral clearance with CQ and HCQ. Three cohort studies found that HCQ had no significant effect on mechanical ventilation/ICU admission. Two RCTs found no effect for HCQ on hospitalization risk in outpatients with COVID-19. Conclusions: Moderate certainty evidence suggests that HCQ, with or without azithromycin, lacks efficacy in reducing short-term mortality in patients hospitalized with COVID-19 or risk of hospitalization in outpatients with COVID-19.
MeSH term(s)	Antiviral Agents/therapeutic use ; Azithromycin/therapeutic use ; COVID-19/mortality ; Chloroquine/adverse effects ; Chloroquine/therapeutic use ; Hospitalization/statistics & numerical data ; Humans ; Hydroxychloroquine/adverse effects ; Hydroxychloroquine/therapeutic use ; Randomized Controlled Trials as Topic ; Treatment Outcome ; COVID-19 Drug Treatment
Chemical Substances	Antiviral Agents ; Hydroxychloroquine (4QWG6N8QKH) ; Azithromycin (83905-01-5) ; Chloroquine (886U3H6UFF)
Keywords	covid19
Language	English
Publishing date	2020-10-08
Publishing country	England
Document type	Journal Article ; Meta-Analysis ; Systematic Review
ZDB-ID	191709-2
ISSN	1460-2091 ; 0305-7453
ISSN (online)	1460-2091
ISSN	0305-7453
DOI	10.1093/jac/dkaa403
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Zs.A 1197: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)
Zs.MO 124: Show issues

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Article ; Online: Efficacy and safety of tocilizumab in COVID-19 patients

Tleyjeh, Imad M. / Kashour, Zakariya / Damlaj, Moussab / Riaz, Muhammad / Tlayjeh, Haytham / Altannir, Mustafa / Altannir, Youssef / Al-Tannir, Mohamad / Tleyjeh, Rana / Hassett, Leslie / Kashour, Tarek

Clinical Microbiology and Infection ; ISSN 1198-743X

A living systematic review and meta-analysis

2020

Keywords	Microbiology (medical) ; Infectious Diseases ; General Medicine ; covid19
Language	English
Publisher	Elsevier BV
Publishing country	us
Document type	Article ; Online
DOI	10.1016/j.cmi.2020.10.036
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Cardiac Toxicity of Chloroquine or Hydroxychloroquine in Patients With COVID-19: A Systematic Review and Meta-regression Analysis.

Tleyjeh, Imad M / Kashour, Zakariya / AlDosary, Oweida / Riaz, Muhammad / Tlayjeh, Haytham / Garbati, Musa A / Tleyjeh, Rana / Al-Mallah, Mouaz H / Sohail, M Rizwan / Gerberi, Dana / Bin Abdulhak, Aref A / Giudicessi, John R / Ackerman, Michael J / Kashour, Tarek

Mayo Clinic proceedings. Innovations, quality & outcomes

2020 Volume 5, Issue 1, Page(s) 137–150

Abstract: Objective: To systematically review the literature and to estimate the risk of chloroquine (CQ) and hydroxychloroquine (HCQ) cardiac toxicity in patients with coronavirus disease 2019 (COVID-19).: Methods: We searched multiple data sources including ... ...

Abstract	Objective: To systematically review the literature and to estimate the risk of chloroquine (CQ) and hydroxychloroquine (HCQ) cardiac toxicity in patients with coronavirus disease 2019 (COVID-19). Methods: We searched multiple data sources including PubMed/MEDLINE, Ovid Embase, Ovid EBM Reviews, Scopus, and Web of Science and medrxiv.org from November 2019 through May 27, 2020. We included studies that enrolled patients with COVID-19 treated with CQ or HCQ, with or without azithromycin, and reported on cardiac toxic effects. We performed a meta-analysis using the arcsine transformation of the different incidences. Results: A total of 19 studies with a total of 5652 patients were included. The pooled incidence of torsades de pointes arrhythmia, ventricular tachycardia, or cardiac arrest was 3 per 1000 (95% CI, 0-21; Conclusion: Treatment of patients with COVID-19 with CQ or HCQ is associated with an important risk of drug-induced QT prolongation and relatively higher incidence of torsades de pointes, ventricular tachycardia, or cardiac arrest. Therefore, these agents should not be used routinely in the management of COVID-19 disease. Patients with COVID-19 who are treated with antimalarials for other indications should be adequately monitored.
Keywords	covid19
Language	English
Publishing date	2020-11-02
Publishing country	Netherlands
Document type	Journal Article
ISSN	2542-4548
ISSN (online)	2542-4548
DOI	10.1016/j.mayocpiqo.2020.10.005
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: The Cardiac Toxicity of Chloroquine or Hydroxychloroquine in COVID-19 Patients

Tleyjeh, Imad M. / Kashour, Zakariya / AlDosary, Oweida / Riaz, Muhammad / Tlayjeh, Haytham / Garbati, Musa A. / Tleyjeh, Rana / Al-Mallah, Mouaz H. / Sohail, M. Rizwan / Gerberi, Dana / Bin Abdulhak, Aref A. / Giudicessi, John R. / Ackerman, Michael J. / Kashour, Tarek

Mayo Clinic Proceedings: Innovations, Quality & Outcomes ; ISSN 2542-4548

A Systematic Review and Meta-regression Analysis

2020

Keywords	covid19
Language	English
Publisher	Elsevier BV
Publishing country	us
Document type	Article ; Online
DOI	10.1016/j.mayocpiqo.2020.10.005
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Efficacy of chloroquine or hydroxychloroquine in COVID-19 patients

Kashour, Zakariya / Riaz, Muhammad / Garbati, Musa A / AlDosary, Oweida / Tlayjeh, Haytham / Gerberi, Dana / Murad, M Hassan / Sohail, M Rizwan / Kashour, Tarek / Tleyjeh, Imad M

Journal of Antimicrobial Chemotherapy ; ISSN 0305-7453 1460-2091

a systematic review and meta-analysis

2020

Abstract: Abstract Objectives Clinical studies of chloroquine (CQ) and hydroxychloroquine (HCQ) in COVID-19 disease reported conflicting results. We sought to systematically evaluate the effect of CQ and HCQ with or without azithromycin on outcomes of COVID-19 ... ...

Abstract	Abstract Objectives Clinical studies of chloroquine (CQ) and hydroxychloroquine (HCQ) in COVID-19 disease reported conflicting results. We sought to systematically evaluate the effect of CQ and HCQ with or without azithromycin on outcomes of COVID-19 patients. Methods We searched multiple databases, preprints and grey literature up to 17 July 2020. We pooled only adjusted-effect estimates of mortality using a random-effect model. We summarized the effect of CQ or HCQ on viral clearance, ICU admission/mechanical ventilation and hospitalization. Results Seven randomized clinical trials (RCTs) and 14 cohort studies were included (20 979 patients). Thirteen studies (1 RCT and 12 cohort studies) with 15 938 hospitalized patients examined the effect of HCQ on short-term mortality. The pooled adjusted OR was 1.05 (95% CI 0.96–1.15, I2 = 0%). Six cohort studies examined the effect of the HCQ+azithromycin combination with a pooled adjusted OR of 1.32 (95% CI 1.00–1.75, I2 = 68.1%). Two cohort studies and four RCTs found no effect of HCQ on viral clearance. One small RCT demonstrated improved viral clearance with CQ and HCQ. Three cohort studies found that HCQ had no significant effect on mechanical ventilation/ICU admission. Two RCTs found no effect for HCQ on hospitalization risk in outpatients with COVID-19. Conclusions Moderate certainty evidence suggests that HCQ, with or without azithromycin, lacks efficacy in reducing short-term mortality in patients hospitalized with COVID-19 or risk of hospitalization in outpatients with COVID-19.
Keywords	Pharmacology (medical) ; Pharmacology ; Infectious Diseases ; covid19
Language	English
Publisher	Oxford University Press (OUP)
Publishing country	uk
Document type	Article ; Online
DOI	10.1093/jac/dkaa403
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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