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0 0.5 1 1.5 2+ Mortality 52% Improvement Relative Risk HCQ for COVID-19  Ayerbe et al.  LATE TREATMENT Is late treatment with HCQ beneficial for COVID-19? Retrospective 2,075 patients in Spain Lower mortality with HCQ (p=0.001) Ayerbe et al., Internal and Emergency .., Sep 2020 Favors HCQ Favors control

The association of treatment with hydroxychloroquine and hospital mortality in COVID-19 patients

Ayerbe et al., Internal and Emergency Medicine, doi:0.1007/s11739-020-02505-x
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.
2075 hospital patients in Spain showing HCQ reduces mortality 52%, odds ratio OR 0.39, p<0.001, after adjustment for age, gender, temperature > 37 °C, and saturation of oxygen < 90% treatment with azithromycin, steroids, heparin, tocilizumab, a combination of lopinavir with ritonavir, and oseltamivir, and date of admission (model 4).
risk of death, 52.2% lower, RR 0.48, p < 0.001, treatment 237 of 1,857 (12.8%), control 49 of 162 (30.2%), NNT 5.7, adjusted per study, odds ratio converted to relative risk.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Ayerbe et al., 30 Sep 2020, retrospective, database analysis, Spain, peer-reviewed, 3 authors.
This PaperHCQAll
The association of treatment with hydroxychloroquine and hospital mortality in COVID-19 patients
Luis Ayerbe, Carlos Risco-Risco, Salma Ayis
Internal and Emergency Medicine, doi:10.1007/s11739-020-02505-x
This study investigates the association between the treatment with hydroxychloroquine and mortality in patients admitted with COVID-19. Routinely recorded, clinical data, up to the 24th of April 2020, from the 2075 patients with COVID-19, admitted in 17 hospitals in Spain between the 1st of March and the 20th of April 2020 were used. The following variables were extracted for this study: age, gender, temperature, and saturation of oxygen on admission, treatment with hydroxychloroquine, azithromycin, heparin, steroids, tocilizumab, a combination of lopinavir with ritonavir, and oseltamivir, together with data on mortality. Multivariable logistic regression models were used to investigate the associations. At the time of collecting the data, 301 patients had died, 1449 had been discharged home from the hospitals, 240 were still admitted, and 85 had been transferred to hospitals not included in the study. Median follow-up time was 8 (IQR 5-12) days. Hydroxychloroquine had been used in 1857 patients. Hydroxychloroquine was associated with lower mortality when the model was adjusted for age and gender, with OR (95% CI): 0.44 (0.29-0.67). This association remained significant when saturation of oxygen < 90% and temperature > 37 °C were added to de model with OR 0.45 (0.30-0.68) p < 0.001, and also when all the other drugs, and time of admission, were included as covariates. The association between hydroxychloroquine and lower mortality observed in this study can be acknowledged by clinicians in hospitals and in the community. Randomized-controlled trials to assess the causal effects of hydroxychloroquine in different therapeutic regimes are required.
Compliance with ethical standards Conflict of interests The author(s) declare that they have no conflict of interest. Ethical approval The ethics committee of HM Hospitales approved this study. Data were anonymized before the authors could access it. No results that may make patients identifiable are reported. Statements on human and animal rights The study was conducted in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki and its later amendments. Informed consent This study was conducted on already available clincal data and informed consent was not required. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creat iveco mmons .org/licen ses/by/4.0/. Publisher's Note Springer Nature..
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Late treatment
is less effective
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