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Clinical characteristics, frailty and mortality of residents with COVID-19 in nursing homes of a region of Madrid

Bielza et al., Journal of the American Medical Directors Association, doi:10.1016/j.jamda.2020.12.003
Dec 2020  
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Mortality 22% Improvement Relative Risk HCQ for COVID-19  Bielza et al.  LATE TREATMENT Is late treatment with HCQ beneficial for COVID-19? Retrospective 630 patients in Spain Lower mortality with HCQ (not stat. sig., p=0.088) c19hcq.org Bielza et al., J. the American Medical.., Dec 2020 FavorsHCQ Favorscontrol 0 0.5 1 1.5 2+
HCQ for COVID-19
1st treatment shown to reduce risk in March 2020
 
*, now with p < 0.00000000001 from 417 studies, recognized in 46 countries.
No treatment is 100% effective. Protocols combine treatments. * >10% efficacy, ≥3 studies.
4,800+ studies for 102 treatments. c19hcq.org
Retrospective 630 elderly patients in Spain showing lower mortality with HCQ treatment, unadjusted relative risk RR 0.78, p = 0.09. HCQ was used more often with patients that were hospitalized (24% versus 3% use in the nursing homes). Median age 87.
Although the 22% lower mortality is not statistically significant, it is consistent with the significant 26% lower mortality [22‑30%] from meta analysis of the 252 mortality results to date.
This study is excluded in the after exclusion results of meta analysis: unadjusted results with no group details.
risk of death, 21.5% lower, RR 0.78, p = 0.09, treatment 33 of 91 (36.3%), control 249 of 539 (46.2%), NNT 10.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Bielza et al., 11 Dec 2020, retrospective, Spain, peer-reviewed, median age 87.0, 24 authors.
This PaperHCQAll
Clinical Characteristics, Frailty, and Mortality of Residents With COVID-19 in Nursing Homes of a Region of Madrid
MD Rafael Bielza, MD Juan Sanz, MD Francisco Zambrana, MD Estefanía Arias, MD Eduardo Malmierca, MD Laura Portillo, MD Israel J Thuissard, MD Ana Lung, MD Marta Neira, María Moral, PhD a, b , María Moral MD g Cristina Andreu-Vázquez, MD h Ana Esteban, MD i Marcela Irma Ramírez, MD j Laura González, MD k Guillermo Carretero, Ricardo Vicente Moreno, MD l Pilar Martínez, MD Javier López, Mar Esteban-Ortega, MD Isabel García, María Antonia Vaquero, MD Ana Linares, MD Ana Gómez-Santana, Jorge Gómez Cerezo
Journal of the American Medical Directors Association, doi:10.1016/j.jamda.2020.12.003
Objectives: To describe the clinical characteristics, 30-day mortality, and associated factors of patients living in nursing homes (NH) with COVID-19, from March 20 to June 1, 2020. Design: This is a retrospective study. A geriatric hospital-based team acted as a consultant and coordinated the care of older people living in NHs from the hospital. Setting and Participants: A total of 630 patients aged 70 and older with Coronavirus Disease 2019 COVID-19 living in 55 NHs. Methods: A logistic regression was performed to analyze the factors associated with mortality. In addition, Kaplan-Meier curves were applied according to mortality and its associated factors using the logrank Mantel-Cox test. Results: The diagnosis of COVID-19 was mainly made by clinical compatibility (N ¼ 430). Median age was 87 years, 64.6% were women and 45.9% were transferred to be cared for at the hospital. A total of 282 patients died (44.7%) within the 30 days of first attention by the team. A severe form of COVID-19 occurred in 473 patients, and the most frequent symptoms were dyspnea (n ¼ 332) and altered level of consciousness (n ¼ 301). According to multiple logistic regression, male sex (P ¼ .019), the Clinical
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Late treatment
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