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0 0.5 1 1.5 2+ Mortality 55% Improvement Relative Risk HCQ for COVID-19  Alamdari et al.  LATE TREATMENT Is late treatment with HCQ beneficial for COVID-19? Retrospective 459 patients in Iran Lower mortality with HCQ (p=0.028) Alamdari et al., Tohoku J. Exp. Med., .., Sep 2020 Favors HCQ Favors control

Mortality Risk Factors among Hospitalized COVID-19 Patients in a Major Referral Center in Iran

Alamdari et al., Tohoku J. Exp. Med., 2020, 252, 73-84, doi:10.1620/tjem.252.73
Sep 2020  
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HCQ for COVID-19
1st treatment shown to reduce risk in March 2020
*, now known with p < 0.00000000001 from 421 studies, recognized in 42 countries.
No treatment is 100% effective. Protocols combine complementary and synergistic treatments. * >10% efficacy in meta analysis with ≥3 clinical studies.
3,800+ studies for 60+ treatments.
Retrospective 459 patients in Iran with 93% treated with HCQ, showing HCQ mortality RR 0.45, p = 0.028. HCQ was the only antiviral that showed a significant difference. There was relatively few control patients and the result is subject to confounding by indication. Average admission delay 5.72 days.
This study is excluded in the after exclusion results of meta analysis: substantial unadjusted confounding by indication likely.
Study covers aspirin and HCQ.
risk of death, 55.0% lower, RR 0.45, p = 0.03, treatment 54 of 427 (12.6%), control 9 of 32 (28.1%), NNT 6.5.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Alamdari et al., 9 Sep 2020, retrospective, Iran, peer-reviewed, 14 authors, average treatment delay 5.72 days.
This PaperHCQAll
Mortality Risk Factors among Hospitalized COVID-19 Patients in a Major Referral Center in Iran
Nasser Malekpour Alamdari, Siamak Afaghi, Fatemeh Sadat Rahimi, Farzad Esmaeili Tarki, Sasan Tavana, Alireza Zali, Mohammad Fathi, Sara Besharat, Leyla Bagheri, Fatemeh Pourmotahari, Seyed Sina Naghibi Irvani, Ali Dabbagh, Seyed Ali Mousavi
The Tohoku Journal of Experimental Medicine, doi:10.1620/tjem.252.73
The Coronavirus Disease 2019 (COVID-19) pandemic has killed many people worldwide since December 2019, and Iran has been among the most affected countries. In this retrospective study, we aimed to determine the prognostic factors associated with mortality in COVID-19 patients by analyzing 396 survived and 63 non-survived patients in Shahid Modarres Hospital, Tehran, Iran, from January 30 th until April 5 th , 2020. As the results, the BMI > 35 (p = 0.0003), lung cancer (p = 0.007), chronic kidney disease (p = 0.002), Immunocompromised condition (p = 0.003), and diabetes (p = 0.018) were more frequently observed in the expired group. The history of statins use was more common in the discharged group (p = 0.002), while there was no significant difference in the drug history of angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers, nonsteroidal anti-inflammatory drugs, aspirin, and/or steroids, and in the past-year influenza vaccination. Multivariable regression demonstrated rising odds of in-hospital death related with age (odds ratio (OR) = 1.055, p = 0.002), levels of C-reactive protein (CRP) (OR = 2.915, p < 0.001), creatinine (OR = 1.740, p = 0.023), lymphocyte count (OR = 0.999, p = 0.008), and magnesium level (OR = 0.032, p < 0.001) on admission. In conclusion, the patients with older age and higher BMI with lymphopenia, hypomagnesemia, elevated CRP and/or raised creatinine on admission are at higher risk of mortality due to the COVID-19 infection, which requires the physicians to use timely and strong therapeutic measures for such patients.
Conflict of Interest The authors declare no conflict of interest.
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Late treatment
is less effective
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