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All Studies   Meta Analysis    Recent:   
0 0.5 1 1.5 2+ Mortality -3% Improvement Relative Risk HCQ for COVID-19  Auld et al.  LATE TREATMENT Is late treatment with HCQ beneficial for COVID-19? Retrospective 217 patients in the USA No significant difference in mortality c19hcq.org Auld et al., Critical Care Medicine, Apr 2020 Favors HCQ Favors control

ICU and ventilator mortality among critically ill adults with COVID-19

Auld et al., Critical Care Medicine, doi:10.1097/ccm.0000000000004457
Apr 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 422 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.
4,100+ studies for 60+ treatments. c19hcq.org
Retrospective 217 critically ill patients, 114 receiving HCQ, showing no significant difference in mortality.
risk of death, 2.8% higher, RR 1.03, p = 1.00, treatment 33 of 114 (28.9%), control 29 of 103 (28.2%).
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Auld et al., 26 Apr 2020, retrospective, USA, peer-reviewed, 14 authors.
This PaperHCQAll
ICU and Ventilator Mortality Among Critically Ill Adults With Coronavirus Disease 2019*
MD, MSc Sara C Auld, MD Mark Caridi-Scheible, MD James M Blum, MPH Chad Robichaux, MD, MSc Colleen Kraft, MD, MSc Jesse T Jacob, MD Craig S Jabaley, PA David Carpenter, PhD, RN Roberta Kaplow, MD, MPH Alfonso C Hernandez-Romieu, MD Max W Adelman, MD, MSc Greg S Martin, MD Craig M Coopersmith, MD, PhD David J Murphy
Critical Care Medicine, doi:10.1097/ccm.0000000000004457
Patients: Adults greater than or equal to 18 years old with confirmed severe acute respiratory syndrome-CoV-2 disease who were admitted to an ICU during the study period. Interventions: None. Measurements and Main Results: Among 217 critically ill patients, mortality for those who required mechanical ventilation was 35.7% (59/165), with 4.8% of patients (8/165) still on the ventilator at the time of this report. Overall mortality to date in this critically ill cohort is 30.9% (67/217) and 60.4% (131/217) patients have survived to hospital discharge. Mortality was significantly associ-ated with older age, lower body mass index, chronic renal disease, higher Sequential Organ Failure Assessment score, lower Pao 2 / Fio 2 ratio, higher d-dimer, higher C-reactive protein, and receipt of mechanical ventilation, vasopressors, renal replacement therapy, or vasodilator therapy. Conclusions: Despite multiple reports of mortality rates exceeding 50% among critically ill adults with coronavirus disease 2019, particularly among those requiring mechanical ventilation, our early experience indicates that many patients survive their critical illness. (Crit Care Med 2020; 48:e799-e804)
For information regarding this article, E-mail: david.j.murphy@emory.edu The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
References
Adelman, Arno, Auld, Barnes, Bender et al., We would like to extend our most profound thanks and gratitude to our colleagues in the Emory Critical Care Center and Emory Healthcare who have worked so hard to provide excellent clinical care during this global pandemic. Emory COVID-19 Quality and Clinical Research Collaborative Members, REFERENCES
Arentz, Yim, Klaff, Characteristics and outcomes of 21 critically ill patients with COVID-19 in Washington State, JAMA
Begley, With Ventilators Running Out, Doctors Say the Machines Are Overused for Covid-19
Bellani, Laffey, Pham, ESICM Trials Group: Epidemiology, patterns of care, and mortality for patients with acute respiratory distress syndrome in intensive care units in 50 countries, JAMA
Bhatraju, Ghassemieh, Nichols, Covid-19 in critically ill patients in the Seattle region -case series, New Engl J Med
Domínguez-Cherit, Lapinsky, Macias, Critically ill patients with 2009 influenza A(H1N1) in Mexico, JAMA
Dondorp, Hayat, Aryal, Respiratory support in novel coronavirus disease (COVID-19) patients, with a focus on resource-limited settings, Am J Trop Med Hyg
Estenssoro, Ríos, Apezteguía, Pandemic 2009 influenza A in Argentina, Am J Respir Crit Care Med
Hamilton, Ventilators Are No Panacea for Critically Ill COVID-19 Patients
Huang, Wang, Li, Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China, Lancet
Ravani, Allday, Some Doctors Question Wisdom of Using Ventilators on Coronavirus Patients
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Yang, Yu, Xu, Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: A singlecentered, retrospective, observational study, Lancet Respir Med
Zambon, Vincent, Mortality rates for patients with acute lung injury/ARDS have decreased over time, Chest
Zhou, Yu, Du, Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: A retrospective cohort study, Lancet
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Overall mortality to date in this critically ill ' 'cohort is 30.9% (67/217) and 60.4% (131/217) patients have survived to hospital discharge. ' 'Mortality was significantly associated with older age, lower body mass index, chronic renal ' 'disease, higher Sequential Organ Failure Assessment score, lower Pa<jats:sc>o</jats:sc>\n' ' <jats:sub>2</jats:sub>/F<jats:sc>io</jats:sc>\n' ' <jats:sub>2</jats:sub> ratio, higher ' '<jats:sc>d</jats:sc>-dimer, higher C-reactive protein, and receipt of mechanical ventilation, ' 'vasopressors, renal replacement therapy, or vasodilator therapy.</jats:p>\n' ' </jats:sec>\n' ' <jats:sec>\n' ' <jats:title>Conclusions:</jats:title>\n' ' <jats:p>Despite multiple reports of mortality rates exceeding 50% among ' 'critically ill adults with coronavirus disease 2019, particularly among those requiring ' 'mechanical ventilation, our early experience indicates that many patients survive their ' 'critical illness.</jats:p>\n' ' </jats:sec>', 'author': [ {'affiliation': [], 'family': 'Auld', 'given': 'Sara C.', 'sequence': 'first'}, { 'affiliation': [ {'name': 'Emory Critical Care Center (ECCC), 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countries.', 'author': 'Bellani', 'doi-asserted-by': 'crossref', 'first-page': '788', 'journal-title': 'JAMA', 'key': 'R9-20230728', 'volume': '315', 'year': '2016'}, { 'DOI': '10.1378/chest.07-2134', 'article-title': 'Mortality rates for patients with acute lung injury/ARDS have decreased ' 'over time.', 'author': 'Zambon', 'doi-asserted-by': 'crossref', 'first-page': '1120', 'journal-title': 'Chest', 'key': 'R10-20230728', 'volume': '133', 'year': '2008'}, { 'DOI': '10.4269/ajtmh.20-0283', 'article-title': 'Respiratory support in novel coronavirus disease (COVID-19) patients, ' 'with a focus on resource-limited settings.', 'author': 'Dondorp', 'doi-asserted-by': 'crossref', 'journal-title': 'Am J Trop Med Hyg', 'key': 'R11-20230728', 'year': '2020 Apr 21. [online ahead of print]'}, { 'DOI': '10.1016/S0140-6736(20)30183-5', 'article-title': 'Clinical features of patients infected with 2019 novel coronavirus in ' 'Wuhan, China.', 'author': 'Huang', 'doi-asserted-by': 'crossref', 'first-page': '497', 'journal-title': 'Lancet', 'key': 'R15-20230728', 'volume': '395', 'year': '2020'}, { 'DOI': '10.1016/S2213-2600(20)30079-5', 'article-title': 'Clinical course and outcomes of critically ill patients with SARS-CoV-2 ' 'pneumonia in Wuhan, China: A single-centered, retrospective, ' 'observational study.', 'author': 'Yang', 'doi-asserted-by': 'crossref', 'first-page': '475', 'journal-title': 'Lancet Respir Med', 'key': 'R16-20230728', 'volume': '8', 'year': '2020'}], 'reference-count': 12, 'references-count': 12, 'relation': { 'has-preprint': [ { 'asserted-by': 'object', 'id': '10.1101/2020.04.23.20076737', 'id-type': 'doi'}]}, 'resource': {'primary': {'URL': 'https://journals.lww.com/10.1097/CCM.0000000000004457'}}, 'score': 1, 'short-title': [], 'source': 'Crossref', 'subject': ['Critical Care and Intensive Care Medicine'], 'subtitle': [], 'title': 'ICU and Ventilator Mortality Among Critically Ill Adults With Coronavirus Disease 2019*', 'type': 'journal-article', 'volume': '48'}
Late treatment
is less effective
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