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0 0.5 1 1.5 2+ COVID-19 case 63% Improvement Relative Risk HCQ for COVID-19  Ferri et al.  Prophylaxis Is pre-exposure prophylaxis with HCQ beneficial for COVID-19? Retrospective 1,641 patients in Italy Fewer cases with HCQ (p=0.015) Ferri et al., Clinical Rheumatology, Aug 2020 Favors HCQ Favors control

COVID-19 and rheumatic autoimmune systemic diseases: report of a large Italian patients series

Ferri et al., Clinical Rheumatology, doi:0.1007/s10067-020-05334-7
Aug 2020  
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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.
Analysis of 1641 systemic autoimmune disease patients showing csDMARD (HCQ etc.) RR 0.37, p=0.015.
csDMARDs include HCQ, CQ, and several other drugs, so the effect of HCQ/CQ alone could be higher.
This study also confirms that the risk of COVID-19 for systemic autoimmune disease patients is much higher overall, OR 4.42, p<0.001 (this is the observed real-world risk which takes into account factors such as these patients potentially being more careful to avoid exposure).
(results are for "definite + highly suspected" cases and the main result is presented in the paper as the OR for not taking csDMARDs, we have converted this to RR for taking csDMARDs).
risk of COVID-19 case, 63.0% lower, RR 0.37, p = 0.01, treatment 9 of 994 (0.9%), control 16 of 647 (2.5%), NNT 64.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Ferri et al., 27 Aug 2020, retrospective, Italy, peer-reviewed, survey, 29 authors.
This PaperHCQAll
COVID-19 and rheumatic autoimmune systemic diseases: report of a large Italian patients series
Clodoveo Ferri, Dilia Giuggioli, Vincenzo Raimondo, Massimo L’andolina, Antonio Tavoni, Riccardo Cecchetti, Serena Guiducci, Francesco Ursini, Maurizio Caminiti, Giuseppe Varcasia, Pietro Gigliotti, Roberta Pellegrini, Domenico Olivo, Michele Colaci, Giuseppe Murdaca, Raffaele Brittelli, Giuseppa Pagano Mariano, Amelia Spinella, Silvia Bellando-Randone, Vincenzo Aiello, Silvia Bilia, Daiana Giannini, Tommaso Ferrari, Rodolfo Caminiti, Veronica Brusi, Riccardo Meliconi, Poupak Fallahi, Alessandro Antonelli
Clinical Rheumatology, doi:10.1007/s10067-020-05334-7
Introduction Covid-19 infection poses a serious challenge for immune-compromised patients with inflammatory autoimmune systemic diseases. We investigated the clinical-epidemiological findings of 1641 autoimmune systemic disease Italian patients during the Covid-19 pandemic. Method This observational multicenter study included 1641 unselected patients with autoimmune systemic diseases from three Italian geographical areas with different prevalence of Covid-19 [high in north (Emilia Romagna), medium in central (Tuscany), and low in south (Calabria)] by means of telephone 6-week survey. Covid-19 was classified as (1) definite diagnosis of Covid-19 disease: presence of symptomatic Covid-19 infection, confirmed by positive oral/nasopharyngeal swabs; (2) highly suspected Covid-19 disease: presence of highly suggestive symptoms, in absence of a swab test. Results A significantly higher prevalence of patients with definite diagnosis of Covid-19 disease, or with highly suspected Covid-19 disease, or both the conditions together, was observed in the whole autoimmune systemic disease series, compared to "Italian general population" (p = .030, p = .001, p = .000, respectively); and for definite + highly suspected diagnosis of Covid-19 disease, in patients with autoimmune systemic diseases of the three regions (p = .000, for all comparisons with the respective regional general population). Moreover, significantly higher prevalence of definite + highly suspected diagnosis of Covid-19 disease was found either in patients with various "connective tissue diseases" compared to "inflammatory arthritis group" (p < .000), or in
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