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The Need for Early Management in Patients With COVID-19

Giraud-Gatineau et al., Research Square,
Feb 2021  
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Review of early treatment of COVID-19 at IHU Méditerranée Infection in France, including HCQ+AZ treatment, comparing outcomes to those for all of France. Age-standardized mortality was lower with early treatment for all periods of the epidemic. Authors recommend early treatment for all age groups.
Giraud-Gatineau et al., 26 Feb 2021, preprint, 9 authors.
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The Need for Early Management in Patients With&nbsp;COVID-19
Audrey Giraud-Gatineau, Sébastien Cortaredona, Jean-Christophe Lagier, Matthieu Million, Philippe Brouqui, Yolande Obadia, Patrick Peretti-Watel, Didier Raoult, Stéphanie Gentile
In March 2020, the IHU Méditerranée Infection set up a screening and treatment center for patients with COVID-19, a system that has been ultimately recommended by French public health authorities. The recent publication of the pro les of patients hospitalized in France published by the Directorate for Research, Studies, Evaluation and Statistics gives us the opportunity to measure the impact of this multidisciplinary early management system coupled with screening on mortality at 90 days. Analysis of the data shows that the system established at IHU-MI was associated with lower mortality, taking age and sex into account. Regarding the age-standardized mortality rate, mortality rates were lower than national data regardless of the period of the epidemic. Early management seems to have signi cantly decreased the mortality rate in the under-60 age group, suggesting the importance of early management, regardless of age. In addition, these patients had pejorative clinical criteria (high NEWS-2 score, ICU visits, oxygen saturation below 95%) requiring hospitalization, and co-morbidities that are now known to be aggravating factors [7] . This reinforces the need to care for all individuals, regardless of age. Early medical care, as part of a system integrating a screening center and a day hospital, may explain the lower mortality rates.
N°: 2020-021) approved this non-interventional retrospective study. According to European General Data Protection Regulation No 2016/679, patients were informed of the potential use of their medical data and that they could refuse the use of their data. The analysis of collected data followed the reference methodology MR-004 registered on N° MR 5010010520 in the AP-HM register. Consent for publication Not applicable. Competing interests The authors have no competing interests. Authors' contributions Conceived and designed the study: DR, YO and SG. Designed and/or performed experiments: AGG, SC, JCL, MM and PB. Analysed and interpreted data: AGG, YO, DR and SG. Wrote the manuscript: AGG, SC, PPW and SG. All authors read and approved the nal manuscript. Figure 1 Death rate at 90 days with 95% CI* according to age and gender (%) in France [17] and in our Institute. Figure 2 Death rate at 90 days with 95% CI* according to the month of admission in France [17] and in our Institute.
Bergeron, Borraz, Patrick, François DEDIEU Crise organisationnelle Sciences Les presses2020 Presses de la Fondation Nationale des sciences politiques ; Quand le sénat juge sévèrement la gestion du Covid-19, Rev Francoph Lab, doi:10.1016/S1773-035X(20)30221-5
Brouqui, Amrane, Million, Asymptomatic hypoxia in COVID-19 is associated with poor outcome
Camoin-Jo, Gautret, Colson, High prevalence of Lupus Anticoagulant in Ambulatory COVID-19 patients: interest of Hydroxychloroquine? -IHU
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Michot A,, Launois A, Bertranda, Bringer A, Degos A et al., enseignement, recherche -parcours de formation) et XVI (parcours de soins et organisation de soins)1 Rapport 19-02. L'hôpital public en crise : origines et propositions
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