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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

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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.

Lower risk for mortality, hospitalization, recovery, cases, and viral clearance.

No treatment is 100% effective. Protocols combine complementary and synergistic treatments. ^* >10% efficacy in meta analysis with ≥3 clinical studies.

4,100+ studies for 60+ treatments. c19hcq.org

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.

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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.

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De Rosa et al., 1 May 2021, retrospective, Italy, peer-reviewed, 20 authors, average treatment delay 6.0 days.

This Paper HCQ All

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.

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