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0 0.5 1 1.5 2+ Mortality 27% Improvement Relative Risk HCQ for COVID-19  Gonzalez et al.  LATE TREATMENT Is late treatment with HCQ beneficial for COVID-19? Retrospective 9,644 patients in Spain Lower mortality with HCQ (not stat. sig., p=0.057) Gonzalez et al., medRxiv, August 2020 Favors HCQ Favors control

The Prognostic Value of Eosinophil Recovery in COVID-19: A Multicentre, Retrospective Cohort Study on Patients Hospitalised in Spanish Hospitals

Gonzalez et al., medRxiv, doi:10.1101/2020.08.18.20172874
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 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 study focused on eosinophil recovery with 9,644 hospitalized patients in Spain, showing lower mortality for HCQ (14.7% vs 29.2%, p<0.001), and AZ (15.3% vs. 18.4%, p<0.001). With a multivariate model including potential confounding factors, HCQ and AZ are associated with lower mortality, HCQ OR 0.662, p=0.057.
Although the 27% lower mortality is not statistically significant, it is consistent with the significant 24% lower mortality [20‑29%] from meta analysis of the 249 mortality results to date.
risk of death, 26.6% lower, RR 0.73, p = 0.06, treatment 1,246 of 8,476 (14.7%), control 341 of 1,168 (29.2%), NNT 6.9, adjusted per study, odds ratio converted to relative risk.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Gonzalez et al., 21 Aug 2020, retrospective, database analysis, Spain, preprint, 25 authors.
This PaperHCQAll
The Prognostic Value of Eosinophil Recovery in COVID-19: A Multicentre, Retrospective Cohort Study on Patients Hospitalised in Spanish Hospitals
María Mateos González, Elena Sierra Gonzalo, Irene Casado Lopez, Francisco Arnalich Fernández, José Luis Beato Pérez, Daniel Monge Monge, Juan Antonio Vargas Núñez, Rosa García Fenoll, Carmen Suárez Fernández, Santiago Jesús Freire Castro, Manuel Mendez Bailon, Isabel Perales Fraile, MD PhD l Manuel Madrazo, Paula Maria Pesqueira Fontan, Jeffrey Oskar Magallanes Gamboa, Andrés González García, Anxela Crestelo Vieitez, Eva María Fonseca Aizpuru, Asier Aranguren Arostegui, Ainara Coduras Erdozain, Carmen Martinez Cilleros, Jose Loureiro Amigo, MD PhD Francisco Epelde, Carlos Lumbreras Bermejo, Juan Miguel Antón Santos
Objectives: A decrease in blood cell counts, especially lymphocytes and eosinophils, has been described in patients with severe SARS-CoV-2 (COVID-19), but there is no knowledge of the potential role of their recovery in these patients' prognosis. This article aims to analyse the effect of blood cell depletion and blood cell recovery on mortality due to COVID-19. Design: This work is a multicentre, retrospective, cohort study of 9,644 hospitalised patients with confirmed COVID-19 from the Spanish Society of Internal Medicine's SEMI-COVID-19 Registry. Setting: This study examined patients hospitalised in 147 hospitals throughout Spain. Participants: This work analysed 9,644 patients (57.12% male) out of a cohort of 12,826 patients ≥18 years of age hospitalised with COVID-19 in Spain included in the SEMI-COVID-19 Registry as of 29 May 2020. Main outcome measures: The main outcome measure of this work is the effect of blood cell depletion and blood cell recovery on mortality due to COVID-19. Univariate analysis was performed to determine possible predictors of death and then multivariate analysis was carried out to control for potential confounders. Results: An increase in the eosinophil count on the seventh day of hospitalisation was associated with a better prognosis, including lower mortality rates (5.2% vs 22.6% in non-recoverers, OR 0.234 [95% CI, 0.154 to 0.354]) and lower complication rates, especially regarding to development of acute respiratory distress syndrome (8% vs 20.1%, p=0.000) and ICU admission (5.4% vs 10.8%, p=0.000). Lymphocyte recovery was found to have no effect on prognosis. Treatment with inhaled or systemic glucocorticoids was not found to be a confounding factor. Conclusion: Eosinophil recovery in patients with COVID-19 is a reliable marker of a good prognosis that is independent of prior treatment. This finding could be used to guide discharge decisions.
CONFLICTS OF INTEREST The authors declare that there are no conflicts of interest.
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Late treatment
is less effective
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