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All Studies   Meta Analysis    Recent:   
0 0.5 1 1.5 2+ Mortality 17% Improvement Relative Risk HCQ for COVID-19  Bernaola et al.  LATE TREATMENT Is late treatment with HCQ beneficial for COVID-19? Retrospective 1,645 patients in Spain Lower mortality with HCQ (p<0.000001) c19hcq.org Bernaola et al., medRxiv, July 2020 Favors HCQ Favors control

Observational Study of the Efficiency of Treatments in Patients Hospitalized with Covid-19 in Madrid

Bernaola et al., medRxiv, doi:10.1101/2020.07.17.20155960
Jul 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. c19hcq.org
HCQ HR 0.83 [0.77-0.89] based on propensity score matched retrospective analysis of 1,645 hospitalized patients. Prednisone HR 0.85 [0.82-0.88], 14 other medications showed either no signicant benefit or a negative effect.
risk of death, 17.0% lower, HR 0.83, p < 0.001, treatment 236 of 1,498 (15.8%), control 28 of 147 (19.0%), NNT 30.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Bernaola et al., 21 Jul 2020, retrospective, Spain, preprint, 7 authors.
This PaperHCQAll
Observational Study of the Efficiency of Treatments in Patients Hospitalized with Covid-19 in Madrid
Nikolas Bernaola, Raquel Mena, Ander Bernaola, Cesar Carballo, Antonio Lara, Concha Bielza, Pedro Larrañaga
doi:10.1101/2020.07.17.20155960
Background Many different treatments were heavily administered to patients with COVID-19 during the peak of the pandemic in Madrid without robust evidence supporting them. Methods We examined the association between sixteen treatments in four groups (steroids, antivirals, antibiotics and immunomodulators) and intubation or death. Data were obtained from patients that were admitted to an HM hospital with suspicion of COVID-19 until 24/04/2020, excluding unconfirmed diagnosis, those who were admitted before the epidemic started in Madrid, had an outcome that was not discharge or death or died within 24 hours of presentation. We compared outcomes between treated and untreated patients using propensity-score caliper matching. Results Of 2,307 patients in the dataset, 679 were excluded. Of the remaining 1,645 patients, 263 (16%) died and 311 (18.9%) died or were intubated. Except for hydroxychloroquine and prednisone, patients that were treated with any of the medications were more likely to go through an outcome of death or intubation at baseline. After propensity matching we found an association between treatment with hydroxychloroquine and prednisone and better outcomes (hazard ratios with 95% CI of 0.83 ± 0.06 and 0.85 ± 0.03). Results were similar in multiple sensitivity analyses. Conclusions In this multicenter study of patients admitted with COVID-19 hydroxychloroquine and prednisone administration was found to be associated with improved outcomes. Other treatments were associated with no effect or worse outcomes. Randomized, controlled trials of these medications in patients with COVID-19 are needed to avoid heavy administration of treatments with no strong evidence to support them. .
Appendix 1: HM dataset description The following text has been copied from a document released by the HM hospital network along with its database explaining its project and the structure of the dataset. The information is organized in tables according to their content, all of them linked by a unique admission identifier. This identifier is the de-anonymization key, explicitly created for this purpose, and has nothing to do with the actual identifier of each admission.
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Late treatment
is less effective
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