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0 0.5 1 1.5 2+ Mortality 43% Improvement Relative Risk c19hcq.org Alberici et al. HCQ for COVID-19 LATE TREATMENT Is late treatment with HCQ beneficial for COVID-19? Retrospective 94 patients in Italy Lower mortality with HCQ (not stat. sig., p=0.12) Alberici et al., Kidney Int., 98:1, 20-26, July .., doi:10.1016/j.kint.2020.04.030 Favors HCQ Favors control
A report from the Brescia Renal COVID Task Force on the clinical characteristics and short-term outcome of hemodialysis patients with SARS-CoV-2 infection
Alberici et al., Kidney Int., 98:1, 20-26, July 1, 2020, doi:10.1016/j.kint.2020.04.030 (date from earlier preprint)
Alberici et al., A report from the Brescia Renal COVID Task Force on the clinical characteristics and short-term outcome of.., Kidney Int., 98:1, 20-26, July 1, 2020, doi:10.1016/j.kint.2020.04.030 (date from earlier preprint)
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Analysis of 94 hemodialysis COVID-19 positive patients, showing lower mortality with HCQ treatment, not reaching statistical significance.
risk of death, 42.9% lower, RR 0.57, p = 0.12, treatment 17 of 72 (23.6%), control 9 of 22 (40.9%), NNT 5.8, odds ratio converted to relative risk.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Alberici et al., 10 May 2020, retrospective, Italy, peer-reviewed, 31 authors, average treatment delay 4.0 days.
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Abstract: editorial: special report www.kidney-international.org A report from the Brescia Renal COVID Task Force on the clinical characteristics and short-term outcome of hemodialysis patients with SARS-CoV-2 infection Federico Alberici1,26, Elisa Delbarba2,6, Chiara Manenti2, Laura Econimo2, Francesca Valerio2, Alessandra Pola2, Camilla Maffei2, Stefano Possenti2, Bernardo Lucca2, Roberta Cortinovis2, Vincenzo Terlizzi2, Mattia Zappa2, Chiara Saccà2, Elena Pezzini2, Eleonora Calcaterra2, Paola Piarulli2, Alice Guerini2, Francesca Boni2, Agnese Gallico2, Alberto Mucchetti2, Stefania Affatato2, Sergio Bove3, Martina Bracchi4, Ester Maria Costantino5, Roberto Zubani1,2, Corrado Camerini2, Paola Gaggia2, Ezio Movilli2, Nicola Bossini2, Mario Gaggiotti2 and Francesco Scolari1,2 1 Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy; 2 Nephrology Unit, Spedali Civili Hospital, ASST Spedali Civili di Brescia, Brescia, Italy; 3 Nephrology Unit, Montichiari Hospital, ASST Spedali Civili di Brescia, Montichiari, Italy; 4 Nephrology Unit, ASST Franciacorta, Chiari, Italy; and 5 Nephrology Unit, ASST del Garda, Manerbio, Italy Correspondence: Federico Alberici, University of Brescia— ASST Spedali Civili, Piazzale Spedali Civili 1, 25125 Brescia, Italy. E-mail: federico.alberici@ unibs.it 6 FA and ED are co-first authors. Received 15 April 2020; revised 24 April 2020; accepted 29 April 2020; published online 8 May 2020 20 The SARS-CoV-2 epidemic is pressuring healthcare systems worldwide. Disease outcomes in certain subgroups of patients are still scarce, and data are needed. Therefore, we describe here the experience of four dialysis centers of the Brescia Renal COVID Task Force. During March 2020, within an overall population of 643 hemodialysis patients, SARS-CoV-2 RNA positivity was detected in 94 (15%). At disease diagnosis, 37 of the 94 (39%) patients (group 1) were managed on an outpatient basis, whereas the remaining 57 (61%) (group 2) required hospitalization. Choices regarding management strategy were made based on disease severity. In group 1, 41% received antivirals and 76% hydroxychloroquine. Eight percent died and 5% developed acute respiratory distress syndrome (ARDS). In group 2, 79% received antivirals and 77% hydroxychloroquine. Forty two percent died and 79% developed ARDS. Overall mortality rate for the entire cohort was 29%. History of ischemic cardiac disease, fever, older age (over age 70), and dyspnea at presentation were associated with the risk of developing ARDS, whereas fever, cough and a C-reactive protein higher than 50 mg/l at disease presentation were associated with the risk of death. Thus, in our population of hemodialysis patients with SARS-CoV-2 infection, we documented a wide range of disease severity. The risk of ARDS and death is significant for patients requiring hospital admission at disease diagnosis. Kidney International (2020) 98, 20–26; https://doi.org/10.1016/j.kint.2020.04.030 KEYWORDS: COVID-19; hemodialysis; SARS-CoV-2 Copyright ª 2020, International Society of Nephrology. Published by Elsevier Inc. All rights reserved. he impact of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) epidemic in subgroups of patients has yet to be determined. In Brescia, Italy, we have developed a standardized protocol when approaching patients on maintenance hemodialysis (MHD) and kidney transplant recipients, respectively.1 Reports..
Late treatment
is less effective
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