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0 0.5 1 1.5 2+ Mortality 63% Improvement Relative Risk HCQ for COVID-19  Aparisi et al.  LATE TREATMENT Is late treatment with HCQ beneficial for COVID-19? Prospective study of 654 patients in Spain Lower mortality with HCQ (p=0.008) Aparisi et al., medRxiv, October 2020 Favors HCQ Favors control

Low-density lipoprotein cholesterol levels are associated with poor clinical outcomes in COVID-19

Aparisi et al., medRxiv, doi:10.1101/2020.10.06.20207092
Oct 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 654 hospitalized patients focused on low-density lipoprotein cholesterol levels, also showing results for HCQ with 605 HCQ patients, unadjusted 30 day mortality relative risk RR 0.37, p = 0.008.
This study is excluded in the after exclusion results of meta analysis: unadjusted results with no group details.
risk of death, 63.0% lower, RR 0.37, p = 0.008, treatment 122 of 605 (20.2%), control 27 of 49 (55.1%), NNT 2.9.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Aparisi et al., 8 Oct 2020, prospective, Spain, preprint, 18 authors, average treatment delay 7.0 days.
This PaperHCQAll
Low-density lipoprotein cholesterol levels are associated with poor clinical outcomes in COVID-19
MD Álvaro Aparisi, MD Carolina Iglesias-Echeverría, MD Cristina Ybarra-Falcón, MD, PhD Iván Cusácovich, MD Aitor Uribarri, MD Mario García-Gómez, MD Raquel Ladrón, Raúl Fuertes, MD Jordi Candela, MD Williams Hinojosa, MD Carlos Dueñas, MD, PhD Roberto González, MD Leonor Nogales, MD Dolores Calvo, MSc Manuel Carrasco-Moraleja, J Alberto San Román, MD, PhD Ignacio J Amat-Santos, MD, PhD David Andaluz-Ojeda
Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the sole causative agent of coronavirus infectious disease-19 . Methods: We performed a retrospective single-center study of consecutively admitted patients between March 1 st and May 15 th, 2020, with a definitive diagnosis of SARS-CoV-2 infection. The primary end-point was to evaluate the association of lipid markers with 30-days all-cause mortality in COVID-19. Results: A total of 654 patients were enrolled, with an estimated 30-day mortality of 22.8% (149 patients). Non-survivors had lower total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-c) levels during the entire course of the disease with complete resolution among survivors. Both showed a significant inverse correlation with inflammatory markers and a positive correlation with lymphocyte count. In a multivariate analysis, LDL-c ≤ 69 mg/dl (hazard ratio [HR] 1.94; 95% confidence interval [CI] 1.14-3.31), C-reactive protein > 88 mg/dl (HR 2.44; 95% CI, 1.41-4.23) and lymphopenia < 1,000 (HR 2.68; 95% CI, 1.91-3.78) at admission were independently associated with 30-day mortality. This association was maintained 7 days after admission. Conclusion: Hypolipidemia in SARS-CoV-2 infection may be secondary to an immuneinflammatory response, with complete recovery in survivors. Low LDL-c serum levels are independently associated with higher 30-day mortality in COVID-19 patients.
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Na Ldl-C, None
Na, Tc, NA HDL High-density lipoprotein cholesterol: LDL-c: Low-density lipoprotein cholesterol; NA: Not applicable; TC: Total cholesterol: TG Triglycerides * Only in survivors, HDL
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Late treatment
is less effective
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