Conv. Plasma
Nigella Sativa

All HCQ studies
Meta analysis
study 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 35% Improvement Relative Risk Mortality (b) 36% HCQ for COVID-19  De Rosa et al.  LATE TREATMENT Is late treatment with HCQ beneficial for COVID-19? Retrospective 1,538 patients in Italy Lower mortality with HCQ (p=0.023) De Rosa et al., J. Clin. Med., May 2021 Favors HCQ Favors control

Risk Factors for Mortality in COVID-19 Hospitalized Patients in Piedmont, Italy: Results from the Multicenter, Regional, CORACLE Registry

De Rosa et al., J. Clin. Med., doi:10.3390/jcm10091951
May 2021  
  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.
Retrospective 1,538 hospitalized patients in Italy, showing only HCQ associated with reduced mortality. Authors analyze mortality amongst those that were alive at day 7 to avoid survival time bias due to drug recording requiring a minimum of 5 days treatment.
risk of death, 35.0% lower, RR 0.65, p = 0.02, treatment 118 of 731 (16.1%), control 80 of 280 (28.6%), NNT 8.0, adjusted per study, odds ratio converted to relative risk, multivariate logistic regression, patients alive at day 7.
risk of death, 36.0% lower, RR 0.64, p < 0.001, treatment 207 of 1,019 (20.3%), control 215 of 519 (41.4%), NNT 4.7, adjusted per study, odds ratio converted to relative risk, multivariate logistic regression, all patients.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
De Rosa et al., 1 May 2021, retrospective, Italy, peer-reviewed, 20 authors, average treatment delay 6.0 days.
This PaperHCQAll
Risk Factors for Mortality in COVID-19 Hospitalized Patients in Piedmont, Italy: Results from the Multicenter, Regional, CORACLE Registry
Francesco Giuseppe De Rosa, Annagloria Palazzo, Tiziana Rosso, Nour Shbaklo, Marco Mussa, Lucio Boglione, Enrica Borgogno, Antonella Rossati, Simone Mornese Pinna, Silvia Scabini, Guido Chichino, Silvio Borrè, Valerio Del Bono, Pietro Luigi Garavelli, Diego Barillà, Francesco Cattel, Giovanni Di Perri, Giovannino Ciccone, Tommaso Lupia, Silvia Corcione
Journal of Clinical Medicine, doi:10.3390/jcm10091951
Background: CORACLE is a retrospective and prospective, regional multicenter registry, developed to evaluate risk factors for mortality in a cohort of patients admitted with SARS-CoV-2 infection within non-intensive wards. Methods: The primary objective was to estimate the role of several prognostic factors on hospital mortality in terms of adjusted Odds Ratios (aOR) with multivariable logistic regression models. Results: A total of 1538 patients were enrolled; 42% were female, and 58% were >70 years old. Deceased patients were 422 (27%), with a median age of 83 years (IQR (Inter Quartile Range) 76-87). Older age at admission (aOR 1.07 per year, 95%CI 1.06-1.09), diabetes (1.41, 1.02-1.94), cardiovascular disease (1.79, 1.31-2.44), immunosuppression (1.65, 1.04-2.62), estimated glomerular filtration rate (eGFR) <30 mL/min/1.73 m 2 (3.53, 2.26-5.51), higher C-reactive protein values and a decreased PaO 2 /FiO 2 ratio at admission were associated with a higher risk of hospital mortality. Amongst patients still alive on day 7, only hydroxychloroquine (HCQ) treatment was associated with reduced mortality (0.57, 0.36-0.90). Conclusions: Several risk factors were associated with mortality in SARS-CoV-2 positive patients. Although HCQ seems to be the only factor significantly associated with reduced mortality, this result is in contrast with evidence from randomized studies. These results should be interpreted in light of the study limitations.
Institutional Review Board Statement: Data acquisition and analysis was performed in compliance with protocols approved by the Ethical Committee of all the participant centers (Città della Salute e della Scienza, Turin, Piedmont, Ethics Committee; Ethical approval number 0031285). The study was conducted according to the guidelines of the Declaration of Helsinki. Informed Consent Statement: Written informed consent was waived in light of the urgent need to collect data. Conflicts of Interest: The authors have not conflict of interest regarding the CORACLE registry.
Albitar, Ballouze, Ooi, Ghadzi, Risk Factors for Mortality among COVID-19 Patients, Diabetes Res. Clin. Pract, doi:10.1016/j.diabres.2020.108293
Alqahtani, Oyelade, Aldhahir, Alghamdi, Almehmadi et al., Severity and Mortality Associated with COPD and Smoking in Patients with COVID-19: A Rapid Systematic Review and Meta-Analysis, PLoS ONE, doi:10.1371/journal.pone.0233147
Arshad, Kilgore, Chaudhry, Jacobsen, Wang et al., Treatment with Hydroxychloroquine, Azithromycin, and Combination in Patients Hospitalized with COVID-19, Int. J. Infect. Dis, doi:10.1016/j.ijid.2020.06.099
Barton, Duval, Stroberg, Ghosh, Mukhopadhyay et al., COVID-19 Autopsies, Am. J. Clin. Pathol, doi:10.1093/ajcp/aqaa062
Bonanad, García-Blas, Tarazona-Santabalbina, Sanchis, Bertomeu-González et al., The Effect of Age on Mortality in Patients with COVID-19: A Meta-Analysis with 611,583 Subjects, J. Am. Med. Dir. Assoc, doi:10.1016/j.jamda.2020.05.045
Cai, Boss, Xiao, Kheradmand, Amos, Tobacco Smoking Increases the Lung Gene Expression of ACE2, the Receptor of SARSCoV-2, Am. J. Respir. Crit. Care Med, doi:10.1164/rccm.202003-0693LE
Casas-Rojo, Antón-Santos, Millán-Núñez-Cortés, Lumbreras-Bermejo, Ramos-Rincón et al., Características Clínicas de Los Pacientes Hospitalizados con COVID-19 en España: Resultados del Registro SEMI-COVID-19, Rev. Clín. Esp, doi:10.1016/j.rce.2020.07.003
Cavalcanti, Zampieri, Rosa, Azevedo, Veiga et al., Hydroxychloroquine with or without Azithromycin in Mild-to-Moderate Covid-19, New Engl. J. Med, doi:10.1056/NEJMoa2019014
Chu, Akl, Duda, Solo, Yaacoub et al., Physical Distancing, Face Masks, and Eye Protection to Prevent Person-to-Person Transmission of SARS-CoV-2 and COVID-19: A Systematic Review and Meta-Analysis, Lancet, doi:10.1016/S0140-6736(20)31142-9
Clay, Donart, Fomukong, Knight, Lei et al., Primary Severe Acute Respiratory Syndrome Coronavirus Infection Limits Replication but Not Lung Inflammation upon Homologous Rechallenge, J. Virol, doi:10.1128/JVI.06791-11
Copin, Parmentier, Duburcq, Poissy, Mathieu et al., 19 ICU and Anatomopathology Group. Time to Consider Histologic Pattern of Lung Injury to Treat Critically Ill Patients with COVID-19 Infection, Intensive Care Med, doi:10.1007/s00134-020-06057-8
De Rosa, Lupia, Corcione, COVID-19: Where have the Lymphocytes Gone?, Intern. Med. J, doi:10.1111/imj.14982
Esposito, Taramasso, Magnasco, Saio, Briano et al., Kidney Disease and all-Cause Mortality in Patients with COVID-19 Hospitalized in Genoa, Northern Italy, J. Nephrol, doi:10.1007/s40620-020-00875-1
Felsenstein, Herbert, Mcnamara, Hedrich, COVID-19: Immunology and Treatment Options, Clin. Immunol, doi:10.1016/j.clim.2020.108448
Force, Ranieri, Rubenfeld, Thompson, Ferguson et al., Acute Respiratory Distress Syndrome, JAMA, doi:10.1001/jama.2012.5669
Fuentes, Fuentes, Alarcón, Palomo, Immune System Dysfunction in the Elderly, Anais Acad. Bras. Ciências, doi:10.1590/0001-3765201720160487
Griffith, Morris, Tudball, Herbert, Mancano et al., Collider bias Undermines our Understanding of COVID-19 Disease Risk and Severity, Nat. Commun, doi:10.1038/s41467-020-19478-2
Hoffmann, Kleine-Weber, Schroeder, Krüger, Herrler et al., SARS-CoV-2 Cell Entry Depends on ACE2 and TMPRSS2 and is Blocked by a Clinically Proven Protease Inhibitor, Cell, doi:10.1016/j.cell.2020.02.052
Hong, Gonzalez, Nahass, Brunetti, Impact of Hydroxychloroquine on Mortality in Hospitalized Patients with COVID-19: Systematic Review and Meta-Analysis, Pharmacy, doi:10.3390/pharmacy8040208
Hussain, Jabeen, Raza, Shabbir, Baig et al., Structural Variations in Human ACE2 may Influence its Binding with SARS-CoV-2 Spike Protein, J. Med. Virol, doi:10.1002/jmv.25832
Jain, Yuan, Predictive Symptoms and Comorbidities for Severe COVID-19 and Intensive Care Unit Admission: A Systematic Review and Meta-Analysis, Int. J. Public Health, doi:10.1007/s00038-020-01390-7
Jhu, COVID-19 Dashboard by the Center for Systems Science and Engineering
Kumar, Arora, Sharma, Anikhindi, Bansal et al., Is Diabetes Mellitus Associated with Mortality and Severity of COVID-19? A Meta-Analysis, Diabetes Metab. Syndr. Clin. Res. Rev, doi:10.1016/j.dsx.2020.04.044
Lazzerini, Putoto, COVID-19 in Italy: Momentous Decisions and Many Uncertainties, Lancet Glob. Health
Leung, Niikura, Yang, Sin, COVID-19 and COPD, Eur. Respir. J, doi:10.1183/13993003.02108-2020
Li, Guan, Wu, Wang, Zhou et al., Early Transmission Dynamics in Wuhan, China, of Novel Coronavirus-Infected Pneumonia, N. Engl. J. Med, doi:10.1056/NEJMoa2001316
Li, Huang, Zou, Yang, Hui et al., Epidemiology of COVID-19: A Systematic Review and Meta-Analysis of Clinical Characteristics, Risk Factors, and Outcomes, J. Med Virol, doi:10.1002/jmv.26424
Li, Xu, Yu, Wang, Tao et al., Risk Factors for Severity and Mortality in Adult COVID-19 Inpatients in Wuhan, J. Allergy Clin. Immunol, doi:10.1016/j.jaci.2020.04.006
Lupia, Corcione, De Rosa, COVID-19: In the Uncertainty, do Not Try this at Home, Intern. Emerg. Med, doi:10.1007/s11739-020-02471-4
Lupia, Scabini, Pinna, Di Perri, De Rosa et al., Novel Coronavirus (2019-nCoV) Outbreak: A New Challenge, J. Glob. Antimicrob. Resist, doi:10.1016/j.jgar.2020.02.021
Mantovani, Byrne, Zheng, Targher, Diabetes as a Risk Factor for Greater COVID-19 Severity and in-Hospital Death: A Meta-Analysis of Observational Studies, Nutr. Metab. Cardiovasc. Dis, doi:10.1016/j.numecd.2020.05.014
Mesas, Cavero-Redondo, Álvarez-Bueno, Cabrera, De Andrade et al., Predictors of in-Hospital COVID-19 Mortality: A Comprehensive Systematic Review and Meta-Analysis Exploring Differences by Age, Sex and Health Conditions, PLoS ONE, doi:10.1371/journal.pone.0241742
Million, Lagier, Gautret, Colson, Fournier et al., Early Treatment of COVID-19 Patients with Hydroxychloroquine and Azithromycin: A Retrospective Analysis of 1061 Cases in Marseille, France, Travel Med. Infect. Dis, doi:10.1016/j.tmaid.2020.101738
Nogueira, Nobre, Costa, Ribeiro, Furtado et al., The Role of Health Preconditions on COVID-19 Deaths in Portugal: Evidence from Surveillance Data of the First 20293 Infection Cases, J. Clin. Med, doi:10.3390/jcm9082368
Opal, Girard, Ely, The Immunopathogenesis of Sepsis in Elderly Patients, Clin. Infect. Dis, doi:10.1086/432007
Palaiodimos, Kokkinidis, Li, Karamanis, Ognibene et al., Severe Obesity, Increasing Age and Male Sex are Independently Associated with Worse in-Hospital Outcomes, and Higher in-Hospital Mortality, in a Cohort of Patients with COVID-19 in the Bronx, Metabolism, doi:10.1016/j.metabol.2020.154262
Petrosillo, Viceconte, Ergonul, Ippolito, Petersen, COVID-19, SARS and MERS: Are they Closely Related?, Clin. Microbiol. Infect, doi:10.1016/j.cmi.2020.03.026
Polverino, Cigarette Smoking and COVID-19: A Complex Interaction, Am. J. Respir. Crit. Care Med, doi:10.1164/rccm.202005-1646LE
Rosenberg, Dufort, Udo, Wilberschied, Kumar et al., Association of Treatment With Hydroxychloroquine or Azithromycin With In-Hospital Mortality in Patients With COVID-19 in New York State, JAMA, doi:10.1001/jama.2020.8630
Russo, GECOVID Working Group
Sebastiani, Massa, Riboli, Covid-19 Epidemic in Italy: Evolution, Projections and Impact of Government Measures, Eur. J. Epidemiol, doi:10.1007/s10654-020-00631-6
Singh, Gillies, Singh, Singh, Chudasama et al., Prevalence of Co-Morbidities and their Association with Mortality in Patients with COVID-19: A Systematic Review and Meta-Analysis, Diabetes Obes. Metab, doi:10.1111/dom.14124
Tadic, Cuspidi, Sala, COVID-19 and Diabetes: Is there Enough Evidence?, J. Clin. Hypertens, doi:10.1111/jch.13912
The, Group, The Recovery Collaborative Group Effect of Hydroxychloroquine in Hospitalized Patients with Covid-19, N. Engl. J. Med, doi:10.1056/NEJMoa2022926
Tian, Xiong, Liu, Niu, Guo et al., Pathological Study of the 2019 Novel Coronavirus Disease (COVID-19) through Postmortem Core Biopsies, Mod. Pathol, doi:10.1038/s41379-020-0536-x
Vardavas, Nikitara, COVID-19 and Smoking: A Systematic Review of the Evidence, Tob. Induc. Dis, doi:10.18332/tid/119324
Vena, Giacobbe, Di Biagio, Mikulska, Taramasso et al., Clinical Characteristics, Management and in-Hospital Mortality of Patients with Coronavirus Disease 2019 in Genoa, Italy, Clin. Microbiol. Infect, doi:10.1016/j.cmi.2020.07.049
Wang, Xu, Gao, Lu, Han et al., Detection of SARS-CoV-2 in Different Types of Clinical Specimens, JAMA, doi:10.1001/jama.2020.3786
Who, Pneumonia of Unknown Cause-China
Wiersinga, Rhodes, Cheng, Peacock, Prescott, Pathophysiology, Transmission, Diagnosis, and Treatment of Coronavirus Disease 2019 (COVID-19): A Review, JAMA, doi:10.1001/jama.2020.12839
Yan, Shin, Pang, Meng, Lai et al., The First 75 Days of Novel Coronavirus (SARS-CoV-2) Outbreak: Recent Advances, Prevention, and Treatment, Int. J. Environ. Res. Public Health, doi:10.3390/ijerph17072323
Yang, Cao, Qin, Wang, Cheng et al., Clinical Characteristics and Imaging Manifestations of the 2019 Novel Coronavirus Disease (COVID-19):A Multi-Center Study in Wenzhou City, Zhejiang, China, J. Infect, doi:10.1016/j.jinf.2020.02.016
Zhao, Meng, Kumar, Wu, Huang et al., The Impact of COPD and Smoking History on the Severity of COVID-19: A Systemic Review and Meta-Analysis, J. Med. Virol, doi:10.1002/jmv.25889
Zheng, Peng, Xu, Zhao, Liu et al., Risk Factors of Critical & Mortal COVID-19 Cases: A Systematic Literature Review and Meta-Analysis, J. Infect, doi:10.1016/j.jinf.2020.04.021
Late treatment
is less effective
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