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Clinical characteristics and outcome of COVID-19 in patients with rheumatic diseases

Alzahrani et al., Rheumatology International , doi:10.1007/s00296-021-04857-9
Apr 2021  
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Mortality 59% Improvement Relative Risk Ventilation 81% Severe case 33% HCQ for COVID-19  Alzahrani et al.  Prophylaxis Is pre-exposure prophylaxis with HCQ beneficial for COVID-19? Retrospective 47 patients in Saudi Arabia Lower ventilation with HCQ (not stat. sig., p=0.54) c19hcq.org Alzahrani et al., Rheumatology Int. , Apr 2021 FavorsHCQ Favorscontrol 0 0.5 1 1.5 2+
HCQ for COVID-19
1st treatment shown to reduce risk in March 2020, now with p < 0.00000000001 from 419 studies, recognized in 46 countries.
No treatment is 100% effective. Protocols combine treatments.
5,100+ studies for 112 treatments. c19hcq.org
Retrospective 47 rheumatic disease patients not finding significant differences with HCQ.
risk of death, 58.7% lower, RR 0.41, p = 1.00, treatment 0 of 14 (0.0%), control 1 of 33 (3.0%), NNT 33, relative risk is not 0 because of continuity correction due to zero events (with reciprocal of the contrasting arm).
risk of mechanical ventilation, 81.0% lower, RR 0.19, p = 0.54, treatment 0 of 14 (0.0%), control 3 of 33 (9.1%), NNT 11, relative risk is not 0 because of continuity correction due to zero events (with reciprocal of the contrasting arm).
risk of severe case, 32.7% lower, RR 0.67, p = 0.70, treatment 2 of 14 (14.3%), control 7 of 33 (21.2%), NNT 14.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Alzahrani et al., 15 Apr 2021, retrospective, Saudi Arabia, peer-reviewed, 3 authors.
This PaperHCQAll
Clinical characteristics and outcome of COVID-19 in patients with rheumatic diseases
Zeyad A Alzahrani, Khalid Abdullah Alghamdi, Ahmed Saeed Almaqati
Rheumatology International, doi:10.1007/s00296-021-04857-9
This study aimed to assess the baseline characteristics and clinical outcomes of coronavirus disease 2019 in patients with rheumatic diseases and identify the risk factors associated with severe COVID-19 pneumonia. This was a retrospective study in a tertiary care center conducted through the period between March 2020 and November 2020 and included all adult patients with rheumatic diseases who tested positive on the COVID-19 polymerase chain reaction (PCR) test. We assessed the patients' demographic data, history of rheumatic disease, COVID-19 symptoms and experimental treatment, if any, their disease course, and outcome. In all, 47 patients were included, and most were females. The commonest rheumatic diseases were rheumatoid arthritis (53.2%), followed by systemic lupus erythematosus (21.3%), and psoriatic arthritis (10.6%). Methotrexate and hydroxychloroquine were the most commonly used disease-modifying anti-rheumatic drugs in 36.1% and 25.5%, respectively. Out of 47 patients, 48.9% required hospitalization with a median hospital stay of 7 days. Severe COVID-19 pneumonia, defined as clinical signs of pneumonia plus one of the following: respiratory rate > 30 bpm, severe respiratory distress, or oxygen saturation < 90% in room air was observed in 19.1% of the patients, and one patient died. We found that elderly patients with a mean age of 65.3 years were more likely to develop severe COVID-19 pneumonia and that was statistically significant. Our study showed that elderly patients with a mean age of 65 years and having rheumatic diseases had an increased risk of hospital admission and development of severe COVID-19 pneumonia.
References
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Rheumatol Int ' '40(12):2015–2021', 'journal-title': 'Rheumatol Int'}], 'container-title': 'Rheumatology International', 'original-title': [], 'language': 'en', 'link': [ { 'URL': 'https://link.springer.com/content/pdf/10.1007/s00296-021-04857-9.pdf', 'content-type': 'application/pdf', 'content-version': 'vor', 'intended-application': 'text-mining'}, { 'URL': 'https://link.springer.com/article/10.1007/s00296-021-04857-9/fulltext.html', 'content-type': 'text/html', 'content-version': 'vor', 'intended-application': 'text-mining'}, { 'URL': 'https://link.springer.com/content/pdf/10.1007/s00296-021-04857-9.pdf', 'content-type': 'application/pdf', 'content-version': 'vor', 'intended-application': 'similarity-checking'}], 'deposited': { 'date-parts': [[2022, 12, 24]], 'date-time': '2022-12-24T10:29:22Z', 'timestamp': 1671877762000}, 'score': 1, 'resource': {'primary': {'URL': 'https://link.springer.com/10.1007/s00296-021-04857-9'}}, 'subtitle': [], 'short-title': [], 'issued': {'date-parts': [[2021, 4, 15]]}, 'references-count': 28, 'journal-issue': {'issue': '6', 'published-print': {'date-parts': [[2021, 6]]}}, 'alternative-id': ['4857'], 'URL': 'http://dx.doi.org/10.1007/s00296-021-04857-9', 'relation': {}, 'ISSN': ['0172-8172', '1437-160X'], 'subject': ['Immunology', 'Immunology and Allergy', 'Rheumatology'], 'container-title-short': 'Rheumatol Int', 'published': {'date-parts': [[2021, 4, 15]]}, 'assertion': [ { 'value': '8 February 2021', 'order': 1, 'name': 'received', 'label': 'Received', 'group': {'name': 'ArticleHistory', 'label': 'Article History'}}, { 'value': '1 April 2021', 'order': 2, 'name': 'accepted', 'label': 'Accepted', 'group': {'name': 'ArticleHistory', 'label': 'Article History'}}, { 'value': '15 April 2021', 'order': 3, 'name': 'first_online', 'label': 'First Online', 'group': {'name': 'ArticleHistory', 'label': 'Article History'}}, { 'value': 'This content has been made available to all.', 'name': 'free', 'label': 'Free to read'}]}
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