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0 0.5 1 1.5 2+ Mortality 3% Improvement Relative Risk HCQ for COVID-19  Çiyiltepe et al.  ICU PATIENTS Is very late treatment with HCQ beneficial for COVID-19? Retrospective 147 patients in Turkey No significant difference in mortality Çiyiltepe et al., South. Clin. Ist. Eu.., Apr 2021 Favors HCQ Favors control

The Effect of Pre-admission Hydroxychloroquine Treatment on COVID-19-Related Intensive Care Follow-up in Geriatric Patients

Çiyiltepe et al., South. Clin. Ist. Euras., doi:10.14744/scie.2021.89847
Apr 2021  
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HCQ for COVID-19
1st treatment shown to reduce risk in March 2020
*, now known with p < 0.00000000001 from 422 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.
4,000+ studies for 60+ treatments.
Retrospective 147 ICU patients in Turkey, showing no significant difference in outcomes based on HCQ treatment before ICU admission. This is not very informative, for example we do not know if HCQ treated patients were much less likely to be admitted to the ICU.
This study is excluded in the after exclusion results of meta analysis: treatment group only includes patients where treatment failed resulting in ICU admission.
risk of death, 3.2% lower, RR 0.97, p = 0.85, treatment 69 of 95 (72.6%), control 39 of 52 (75.0%), NNT 42.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Çiyiltepe et al., 30 Apr 2021, retrospective, Turkey, peer-reviewed, 5 authors.
This PaperHCQAll
Effect of Pre-admission Hydroxychloroquine Treatment on COVID-19-related Intensive Care Follow-up in Geriatric Patients
SBÜ Fulya Çiyiltepe, Ayten Saracoglu, Yeliz Bilir, Elif Bombacı, Kemal Saracoglu, Dr İstanbul Kartal, Lütfi Kırdar, Şehir Hastanesi, Anesteziyoloji Ve
Southern Clinics of Istanbul Eurasia, doi:10.14744/scie.2021.89847
Objective: The admission rates to intensive care units and mortalities in geriatric patients are higher than the rest of the population with COVID-19 infection. Although the efficacy of hydroxychloroquine sulfate has been recognized, especially when started early during infection, its effectiveness at these early time points in geriatric patients has not been investigated. In this study, our primary aim was to investigate the effects of early treatment of hydroxychloroquine sulfate on COVID-19 positive geriatric patients, according to their clinical symptoms, situation before the intensive care, and patient survival. Methods: A total of 147 geriatric patients diagnosed with COVID-19 in the intensive care unit were divided into three groups: Patients who were admitted to the intensive care unit from the emergency department but did not receive treatment (Group 1); from the service for whose a 5-day treatment was initiated but not completed (Group 2); and those who completed 5-days of drug therapy (Group 3). Results: Although demographic data were similar between the three groups, the age parameters were significantly differed between them. Furthermore, there was no difference between the groups regarding mortality rate, discharge time, or extubation. The time to mortality and the duration of mechanical ventilation were found to be significantly shorter in Group 1 (p=0.001). Conclusion: No significant effect was observed on patient survival and outcome due to early administration of hydroxychloroquine sulfate.According to our main findings, this study cannot recommend pre-admission hydroxychloroquine treatment for critically ill geriatric patients with COVID-19.
Conflict of Interest None declared.
Amaç, Gereç ve Yöntem: Yoğun bakım ünitesinde COVID-19 tanısı alan toplam 147 geriatrik hasta üç gruba ayrıldı: Acil servisten yoğun bakım ünitesine kabul edilen ancak tedavi almayan hastalar (Grup 1); beş günlük tedavi başlatılan ancak tamamlanmayan klinikten kabul edilen hastalar (Grup 2); ve beş günlük ilaç tedavisini tamamlamış olanlar
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Bulgular, Üç grup arasında demografik veriler benzer olmasına rağmen, yaş parametreleri aralarında önemli ölçüde farklıydı. Ayrıca ölüm oranı, taburculuk veya ekstübasyon zamanı açısından gruplar arasında fark yoktu
Celotto, Veronese, Barbagallo, Ometto, Smith et al., An umbrella review of systematic reviews with meta-analyses evaluating positive and negative outcomes of Hydroxychloroquine and chloroquine therapy, Int J Infect Dis, doi:10.1016/j.ijid.2020.12.018
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Fda, against use of hydroxychloroquine or chloroquine for COVID-19 outside of the hospital setting or a clinical trial due to risk of heart rhythm problems
Grasselli, Zangrillo, Zanella, Antonelli, Cabrini et al., Baseline characteristics and outcomes of 1591 patients infected with SARS-CoV-2 admitted to ICUs of the Lombardy Region, Italy, JAMA, doi:10.1001/jama.2020.5394
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Sonuç, Ana bulgularımıza göre, bu çalışma COVID-19'u olan geriatrik kritik hastalarda başvuru öncesi hidroksiklorokin tedavisi önermemektedir
Van Den Brand, Smits, Haagmans, Pathogenesis of Middle East respiratory syndrome coronavirus, J Pathol, doi:10.1002/path.4458
Who, Definition of an older or elderly person
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Late treatment
is less effective
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