Analgesics
Antiandrogens
Azvudine
Bromhexine
Budesonide
Colchicine
Conv. Plasma
Curcumin
Famotidine
Favipiravir
Fluvoxamine
Hydroxychlor..
Ivermectin
Lifestyle
Melatonin
Metformin
Minerals
Molnupiravir
Monoclonals
Naso/orophar..
Nigella Sativa
Nitazoxanide
Paxlovid
Quercetin
Remdesivir
Thermotherapy
Vitamins
More

Other
Feedback
Home
Top
Results
Abstract
All HCQ studies
Meta analysis
 
Feedback
Home
next
study
previous
study
c19hcq.org COVID-19 treatment researchHCQHCQ (more..)
Melatonin Meta
Metformin Meta
Azvudine Meta
Bromhexine Meta Molnupiravir Meta
Budesonide Meta
Colchicine Meta
Conv. Plasma Meta Nigella Sativa Meta
Curcumin Meta Nitazoxanide Meta
Famotidine Meta Paxlovid Meta
Favipiravir Meta Quercetin Meta
Fluvoxamine Meta Remdesivir Meta
Hydroxychlor.. Meta Thermotherapy Meta
Ivermectin Meta

All Studies   Meta Analysis    Recent:   
0 0.5 1 1.5 2+ Mortality 94% Improvement Relative Risk HCQ  Bernabeu-Wittel et al.  EARLY TREATMENT Is early treatment with HCQ + combined treatments beneficial for COVID-19? Retrospective 272 patients in Spain Lower mortality with HCQ + combined treatments (p=0.0011) c19hcq.org Bernabeu-Wittel et al., J. Gerontol. A.., Aug 2020 Favors HCQ Favors control

Effectiveness of a On-Site Medicalization Program for Nursing Homes with COVID-19 Outbreaks

Bernabeu-Wittel et al., J. Gerontol. A Biol. Sci. Med. Sci., doi:10.1093/gerona/glaa192
Aug 2020  
  Post
  Facebook
Share
  Source   PDF   All   Meta
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. c19hcq.org
Retrospective 272 nursing home residents showing significantly improved survival after establishing a treatment program including HCQ with or without lopinavir/ritonavir and with the addition of adjuvant and antimicrobial treatments depending on circumstances. HCQ (114 patients), HCQ+LPV/RTV (18 patients), and HCQ+AZ (7 patients). Dosage details are in the supplementary appendix.
risk of death, 93.7% lower, RR 0.06, p = 0.001, treatment 24 of 139 (17.3%), control 37 of 83 (44.6%), NNT 3.7, adjusted per study, inverted to make RR<1 favor treatment, odds ratio converted to relative risk, active standard care.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Bernabeu-Wittel et al., 1 Aug 2020, retrospective, Spain, peer-reviewed, 13 authors, dosage 400mg bid day 1, 200mg bid days 2-7, this trial uses multiple treatments in the treatment arm (combined with lopinavir/ritonavir, AZ, and/or antimicrobial treatments for some patients) - results of individual treatments may vary.
This PaperHCQAll
EFFECTIVENESS OF A ON-SITE MEDICALIZATION PROGRAM FOR NURSING HOMES WITH COVID-19 OUTBREAKS
Bernabeu-Wittel, MD, PhD Ternero-Vega Je, MD Nieto-Martín, MD, PhD Conde-Guzmán, MD, PhD J Delgado-Cuesta, MD, PhD M Rincón-Gómez, MD, PhD Díaz-Jiménez, MD Lomas-Cabezas Jm, MD, PhD), Muñoz-García Mm, MD S Calzón-Fernández, MD, PhD M Ollero-Baturone, Máximo Bernabeu-Wittel
doi:10.1093/gerona/glaa192/5879759
BACKGROUND: Nursing homes are highly vulnerable to the occurrence of COVID-19 outbreaks, which result in high lethality rates. Most of them are not prepared to SARS-CoV-2 pandemic. METHODS: A coordinated on-site medicalization program (MP) in response to a sizeable COVID-19 outbreak in four nursing homes was organized, with the objectives of improving survival, offering humanistic palliative care to residents in their natural environment, and reducing hospital referrals. Ten key processes and interventions were established (provision of informatics infrastructure, medical equipment, and human resources, universal testing, separation of 'clean' and 'contaminated' areas, epidemiological surveys, and unified protocols stratifying for active or palliative care approach, among others). Main outcomes were a composite endpoint of survival or optimal palliative care (SOPC), survival, and referral to hospital. RESULTS: 272 out of 457 (59.5%) residents and 85 out of 320 (26.5%) staff members were affected. The SOPC, survival, and referrals to hospital, occurred in 77%, 72.5%, and 29% of patients diagnosed before MP start, with respect to 97%, 83.7% and 17% of those diagnosed during the program, respectively. The SOPC was independently associated to MP (OR=15 [3-81]); and survival in patients stratified to active approach, to the use of any antiviral treatment (OR=28 ). All outbreaks were controlled in 39 [37-42] days. CONCLUSIONS: A coordinated on-site medicalization program of nursing homes with COVID-19 outbreaks achieved a higher survival or optimal palliative care rate, and a reduction in referrals to hospital, thus ensuring rigorous but also humanistic and gentle care to residents.
A c c e p t e d M a n u s c r i p t 17 deeper integration of health and social care (11, 23, 33) . Second, we learned, that health care resources re-allocation is an effective strategy to manage this pandemic, and that decisive and anticipated actions save lives and prevent unfortunate consequences; one may think, that this mobilization was exaggerated and expensive, but otherwise at least two hundred of these residents would have needed hospital care, so in this scenario the same health care resources would have been used, but in a overcrowded and saturated hospital. And at last we learned, that a true synergistic coordination between Primary and Hospital Care is possible and it works. We all have read a lot about this issue, and know, however, the daily difficulties in its implementation (37) . In these extraordinary circumstances integration worked wonderfully, because it emerged from professionalism values: willingness to serve people, altruism, generosity, and mutual respect. This study has some limitations, that should be remarked. First, the retrospective collection of the cohort's data, which could introduce some biases, as it is already known for this kind of approaches. Second, the confidence intervals for some of the findings are wide, reflecting limits in study power for some analyses. And third, the possible regression to the mean, which is present in most health care initiatives directed towards high-risk populations, could have played a role in the results;..
References
Acosta, Adrada, Bernabeu, Blanco, Brea et al., Primary Care District of Seville
Aguilar, Cisneros, Cordero, Espinosa, García et al., None
Aguilera, Rodriguez, Romero, None
Aldabó, Bellido, Carbajal, Casado, Cid et al., Intensive Care Department
Alfaro, Alonso, Pérez, Barón, Biempica et al., Internal Medicine and Vascular Surgery Departments
Amodeo, Calderón, Domínguez, García, López et al., Hospital Universitario Virgen del Rocío
Ampuero, Ferrer, Hospital Universitario Virgen del Rocío
Anonymous, Severe Outcomes Among Patients with Coronavirus Disease 2019 (COVID-19) -United States, February 12, MMWR Morb Mortal Wkly Rep, doi:10.15585/mmwr.mm6912e2
Asensio, Caballero, Espinoza, Ferrer, González et al., None
Bautista, Flores, Monzón, Santos, None
Bernabeu-Wittel, Ollero-Baturone, Moreno-Gaviño, Development of a new predictive model for polypathological patients. The PROFUND index, Eur J Intern Med, doi:10.1016/j.ejim.2010.11.012
Bonafè, Prattichizzo, Giuliani, Storci, Sabbatinelli et al., Inflamm-aging: Why older men are the most susceptible to SARS-CoV-2 complicated outcomes, Cytokine Growth Factor Rev, doi:10.1016/j.cytogfr.2020.04.005
Borasio, Gamondi, Obrist, Jox, For The Covid-Task Force Of Palliative Ch. COVID-19: decision making and palliative care, Swiss Med Wkly, doi:10.4414/smw.2020.20233
Briones, Díaz, Ruiz, Sillero, Epidemiology and Public Health Department, Primary Care District of Seville)
Cabrera, Macías, None
Cao, Wang, Wen, A Trial of Lopinavir-Ritonavir in Adults Hospitalized with Severe Covid-19, N Engl J Med, doi:10.1056/nejmoa2001282
Caraballo, Dominguez, Ferrer, Gil, Molina et al., Pharmacy Department, Primary Care Distrcit of Seville)
Davidson, Szanton, Nursing homes and COVID-19: We can and should do better, J Clin Nurs, doi:10.1111/jocn.15297
Dimer, (mg/dL) ASAT ALAT Creatinin kinase PCR Ferritin, ng/mL)
Fallon, Dukelow, Kennelly, Neill, COVID-19 in Nursing Homes, QJM, doi:10.1093/qjmed/hcaa136
Gaur, Dumyati, Nace, Jump, Unprecedented solutions for extraordinary times: Helping long-term care settings deal with the COVID-19 pandemic, Infect Control Hosp Epidemiol, doi:10.1017/ice.2020.98
Geleris, Sun, Platt, Observational Study of Hydroxychloroquine in Hospitalized Patients with Covid-19, N Engl J Med, doi:10.1056/nejmoa2012410
Grande, Suárez, None
Grasselli, Pesenti, Cecconi, Critical care utilization for the COVID-19 outbreak in Lombardy, Italy: early experience and forecast during an emergency response, JAMA, doi:10.1001/jama.2020.4031
Hui Sian Tay, Harwood, Atypical Presentation of COVID-19 in a Frail Older Person, Age Ageing, doi:10.1093/ageing/afaa068
José, León-Sotelo, Manager and Medical Director of Primary Care District of Seville)
Kalache, Mckee, Derbyshire, Geffen, Casas, WHO must prioritise the needs of older people in its response to the covid-19 pandemic, BMJ, doi:10.1136/bmj.m1164
Kunz, Minder, COVID-19 pandemic: palliative care for elderly and frail patients at home and in residential and nursing homes, Swiss Med Wkly, doi:10.4414/smw.2020.20235
Kwlatkowski, Nadonly, At least 2,300 nursing homes have coronavirus cases -and the reality is likely much worse, USA Today
Lauretani, Ravazzoni, Roberti, Assessment and Treatment of Older Individuals With COVID 19 Multi-System Disease: Clinical and Ethical Implications, Acta Biomed, doi:10.23750/abm.v91i2.9629
Mahoney, Barthel, Functional evaluation: The Barthel Index, Maryland State Medical Journal
Mannelli, Whose life to save? Scarce resources allocation in the COVID-19 outbreak, J Med Ethics, doi:10.1136/medethics-2020-106227
Martinez, Compounds with Therapeutic Potential against Novel Respiratory
Mcmichael, Currie, Clark, Epidemiology of Covid-19 in a Long-Term Care Facility in King County, Washington, New Engl J Med, doi:10.1056/nejmoa2005412
Molina, Amaya, Manager and Medical Director of Hospital Universitario Virgen del Rocío)
Pascarella, Strumia, Piliego, COVID-19 diagnosis and management: a comprehensive review, J Intern Med, doi:10.1111/joim.13091
Peterson, Largent, Karlawish, Ethics of reallocating ventilators in the covid-19 pandemic, BMJ, doi:10.1136/bmj.m1828
Pérez-Díaz, Abellán-García, Aceituno-Nieto, Fariñas, A profile of the elderly in Spain
Quigley, Dick, Agarwal, Jones, Mody et al., COVID-19
Rada, Covid-19: the precarious position of Spain's nursing homes, BMJ, doi:10.1136/bmj.m1554
Rosenbaum, Facing Covid-19 in Italy -Ethics, Logistics, and Therapeutics on the Epidemic's Front Line, N Engl J Med, doi:10.1056/nejmp2005492
Sadler, Potterton, Anderson, Service user, carer and provider perspectives on integrated care for older people with frailty, and factors perceived to facilitate and hinder implementation: A systematic review and narrative synthesis, PLoS One, doi:10.1371/journal.pone.0216488
Steinberg, Balakrishna, Habboushe, Shawl, Lee, Calculated decisions: COVID-19 calculators during extreme resource-limited situations, Emerg Med Pract
Tan, Seetharaman, COVID-19 Outbreak in Nursing Homes in Singapore, J Microbiol Immunol Infect, doi:10.1016/j.jmii.2020.04.018
Tang, Cao, Han, Hydroxychloroquine in patients with mainly mild to moderate coronavirus disease 2019: open label, randomised controlled trial, BMJ, doi:10.1136/bmj.m1849
Tseng, Wu, Ku, Tai, The Impact of the COVID-19 Pandemic on Disabled and Hospice Home Care Patients, J Gerontol A Biol Sci Med Sci, doi:10.1093/gerona/glaa081
Ward, Figiel, Mcdonald, Altered Mental Status as a Novel Initial Clinical Presentation for COVID-19 Infection in the Elderly, Am J Geriatr Psychiatry
Ye, Luo, Xia, Clinical efficacy of lopinavir/ritonavir in the treatment of Coronavirus disease 2019, Eur Rev Med Pharmacol Sci, doi:10.26355/eurrev_202003_20706
Zhou, Yu, Du, Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study, Lancet, doi:10.1016/s0140-6736(20)30566-3
Loading..
Please send us corrections, updates, or comments. c19early involves the extraction of 100,000+ datapoints from thousands of papers. Community updates help ensure high accuracy. Vaccines and treatments are complementary. All practical, effective, and safe means should be used based on risk/benefit analysis. No treatment, vaccine, or intervention is 100% available and effective for all current and future variants. We do not provide medical advice. Before taking any medication, consult a qualified physician who can provide personalized advice and details of risks and benefits based on your medical history and situation. FLCCC and WCH provide treatment protocols.
  or use drag and drop   
Submit