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0 0.5 1 1.5 2+ Mortality 73% Improvement Relative Risk Cangiano et al. HCQ for COVID-19 LATE TREATMENT Favors HCQ Favors control
Mortality in an Italian nursing home during COVID-19 pandemic: correlation with gender, age, ADL, vitamin D supplementation, and limitations of the diagnostic tests
Cangiano et al., Aging, doi:10.18632/aging.202307
Cangiano et al., Mortality in an Italian nursing home during COVID-19 pandemic: correlation with gender, age, ADL, vitamin D.., Aging, doi:10.18632/aging.202307
Dec 2020   Source   PDF  
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73% lower mortality with HCQ. Analysis of 98 PCR+ nursing home residents in Italy, mean age 90, showing HCQ mortality RR 0.27, p = 0.03. Subject to confounding by contraindication. The paper provides the p value for regression but not the effect size.
risk of death, 73.4% lower, RR 0.27, p = 0.03, treatment 5 of 33 (15.2%), control 37 of 65 (56.9%), NNT 2.4.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Cangiano et al., 22 Dec 2020, retrospective, Italy, peer-reviewed, 14 authors.
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Abstract: AGING 2020, Vol. 12, No. 24 Research Paper Mortality in an Italian nursing home during COVID-19 pandemic: correlation with gender, age, ADL, vitamin D supplementation, and limitations of the diagnostic tests Biagio Cangiano1,2,3,*, Letizia Maria Fatti1,*, Leila Danesi1, Giacomo Gazzano4, Marina Croci1, Giovanni Vitale1,3,5, Luisa Gilardini1, Stefania Bonadonna1, Iacopo Chiodini1,2, Chiara Francesca Caparello6, Antonio Conti1, Luca Persani1,2,3, Marco Stramba-Badiale7, Marco Bonomi1,2,3 on behalf of the “Mons G. Bicchierai” nursing home group# 1 IRCCS Istituto Auxologico Italiano, Department of Endocrine and Metabolic Diseases, Milan, Italy IRCCS Istituto Auxologico Italiano, Laboratory of Endocrine and Metabolic Diseases, Cusano Milanino, Italy 3 Department of Medical Biotechnology and Translational Medicine, University of Milan, Milan, Italy 4 IRCCS Istituto Auxologico Italiano, Anatomic Pathology Unit, Milan, Italy 5 IRCCS Istituto Auxologico Italiano, Laboratory of Geriatric and Oncologic Neuroendocrinology Research, Milan, Italy 6 IRCCS Istituto Auxologico Italiano, Gastroenterology and Digestive Endoscopy, Milan, Italy 7 IRCCS Istituto Auxologico Italiano, Department of Geriatrics and Cardiovascular Medicine, Milan, Italy *Equal contribution # “Mons. G. Bicchierai” nursing home group: Albergati S, Anselmi G, Calloni A, Bedogni S, Cammarata G, De Iulio C, Di Stefano M, Federici S, Giancola N, Giovanelli L, Goggi G, Melzi L, Moro M, Nadiani B, Rindone A, Vannucchi G 2 Correspondence to: Marco Bonomi; email:, Keywords: hydroxychloroquine, serology, nasopharyngeal swab, sensitivity and specificity, activities of daily living, COVID-19 Received: October 14, 2020 Accepted: November 16, 2020 Published: December 22, 2020 Copyright: © 2020 Cangiano et al. This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY 3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. ABSTRACT Introduction: The COVID-19 pandemic caused an increased mortality in nursing homes due to its quick spread and the age-related high lethality. Results: We observed a two-month mortality of 40%, compared to 6.4% in the previous year. This increase was seen in both COVID-19 positive (43%) and negative (24%) residents, but 8 patients among those testing negative on the swab, tested positive on serological tests. Increased mortality was associated with male gender, older age, no previous vitamin D supplementation and worse “activities of daily living (ADL)” scores, such as Barthel index, Tinetti scale and S.OS.I.A. classification. Conclusion: Our data confirms a higher geriatric mortality due to COVID-19. Negative residents also had higher mortality, which we suspect is secondary to preanalytical error and a low sensitivity of the swab test in poorly compliant subjects. Male gender, older age and low scores on ADL scales (probably due to immobility) are risk factors for COVID-19 related mortality. Finally, mortality was inversely associated with vitamin D supplementation. Design: In this observational study, we described the two-month mortality among the 157 residents (age 60100) of a nursing home after Sars-CoV-2 spreading, reporting the factors associated with the outcome. We also compared the diagnostic tests for..
Late treatment
is less effective
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