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All Studies   Meta Analysis    Recent:   
0 0.5 1 1.5 2+ Hospitalization -2% Improvement Relative Risk Case -3% Case, before adjustments 23% HCQ for COVID-19  Guillaume et al.  Prophylaxis Is pre-exposure prophylaxis with HCQ beneficial for COVID-19? Retrospective 459 patients in France (April - April 2020) Study underpowered to detect differences c19hcq.org Guillaume et al., Rheumatology and The.., Sep 2021 Favors HCQ Favors control

Antirheumatic Drug Intake Influence on Occurrence of COVID-19 Infection in Ambulatory Patients with Immune-Mediated Inflammatory Diseases: A Cohort Study

Guillaume et al., Rheumatology and Therapy, doi:10.1007/s40744-021-00373-1, NCT04345159
Sep 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.
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 459 SLE, RA, SjS, or PsA patients in France, showing no significant difference with HCQ treatment. However, the statistical analysis shows significant mismatches with prior research, which may be due to overfitting with the limited data and very small number of events. For example, the analysis estimates lower risk OR 0.72 for age, and shows very different relative risks of SLE, RA, SjS, or PsA compared to other research. We note the very different distribution of diseases in the groups, for example there is a much higher prevalence of PsA in the no HCQ group. The inaccurate estimations of risk for the different diseases and for age likely makes the adjusted analysis very inaccurate.
This study is excluded in the after exclusion results of meta analysis: statistical analysis shows significant mismatch with prior research, potential overfitting.
risk of hospitalization, 2.4% higher, RR 1.02, p = 1.00, treatment 2 of 181 (1.1%), control 3 of 278 (1.1%).
risk of case, 2.9% higher, RR 1.03, p = 0.96, treatment 6 of 181 (3.3%), control 12 of 278 (4.3%), adjusted per study, odds ratio converted to relative risk.
risk of case, 23.2% lower, RR 0.77, p = 0.63, treatment 6 of 181 (3.3%), control 12 of 278 (4.3%), NNT 100.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Guillaume et al., 16 Sep 2021, retrospective, France, peer-reviewed, survey, 25 authors, study period 17 April, 2020 - 30 April, 2020, trial NCT04345159 (history). Contact: gatinel@gmail.com.
This PaperHCQAll
Antirheumatic Drug Intake Influence on Occurrence of COVID-19 Infection in Ambulatory Patients with Immune-Mediated Inflammatory Diseases: A Cohort Study
Debellemanière Guillaume, Bouvet Magalie, Elahi Sina, Salah-Mabed Imène, Vayr Frédéric, Dubois Mathieu, Muselier Aurore, Gozlan Yoni, Elbaz Emma, Badatcheff Charlotte, Fabre Laura, Saad Alain, Nahaisi Steven, Zeboulon Pierre, Febbraro Jean-Luc, Courtin Romain, Grise-Dulac Alice, Mazharian Adrien, Ghazal Wassim, Remongin Pierre-Emmanuel, Panthier Christophe, Chirouze Catherine, Bertrand Kevin, Sené Thomas, Gatinel Damien
Rheumatology and Therapy, doi:10.1007/s40744-021-00373-1
Introduction: We aimed to study the prevalence of a history of COVID-19 infection among patients suffering from systemic lupus erythematosus (SLE), rheumatoid arthritis (RA), Sjo ¨gren's syndrome (SjS) or psoriatic arthritis (PsA), and the potential influence of long-term hydroxychloroquine (HCQ) intake. Methods: We performed an observational monocentric cohort study at the Adolphe de Rothschild Foundation Hospital ophthalmology division (Paris, France). Electronic medical records (EMR) data were searched for keywords associated with SLE, RA, SjS, or PsA. Patients were contacted by phone and were interviewed using a standardized questionnaire. The primary outcome was the occurrence of a positive COVID-19 test result during the study period. We determined the adjusted association between various antirheumatic drugs intake, COVID-19 risk factors, and occurrence of COVID-19 using a logistic regression model. This study is registered on ClinicalTrials.gov (Identifier: NCT04345159). Results: Patients were recruited between Apr 17, 2020, and Apr 30, 2020 and were recontacted between Oct 6, 2020, and Nov 2, 2020. A total of 569 patients were included, of whom 459 patients were eligible for data analysis. One hundred and eighty-one patients were treated with long-term HCQ and 18 patients had tested positive for COVID-19. No antirheumatic drug intake, including HCQ intake, was significantly associated with an increased or decreased risk of developing COVID-19 infection. Conclusions: No antirheumatic drug intake was associated with an increased or decreased risk of developing COVID-19 infection in our cohort of patients suffering from immune-mediated inflammatory diseases.
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' '2021. https://doi.org/10.1093/aje/kwab183.', 'year': '2021'}, { 'DOI': '10.1056/NEJMoa2019014', 'author': 'AB Cavalcanti', 'doi-asserted-by': 'publisher', 'first-page': '2041', 'issue': '21', 'journal-title': 'N Engl J Med', 'key': '373_CR16', 'unstructured': 'Cavalcanti AB, Zampieri FG, Rosa RG, Azevedo LCP, Veiga VC, Avezum A, et ' 'al. Hydroxychloroquine with or without azithromycin in mild-to-moderate ' 'Covid-19. N Engl J Med. 2020;383(21):2041–52.', 'volume': '383', 'year': '2020'}, { 'DOI': '10.9778/cmajo.20210069', 'author': 'I Schwartz', 'doi-asserted-by': 'publisher', 'first-page': 'E693', 'issue': '2', 'journal-title': 'CMAJ Open', 'key': '373_CR17', 'unstructured': 'Schwartz I, Boesen ME, Cerchiaro G, Doram C, Edwards BD, Ganesh A, et ' 'al. Assessing the efficacy and safety of hydroxychloroquine as ' 'outpatient treatment of COVID-19: a randomized controlled trial. CMAJ ' 'Open. 2021;9(2):E693-702.', 'volume': '9', 'year': '2021'}, { 'DOI': '10.1183/13993003.00752-2021', 'author': 'P Sivapalan', 'doi-asserted-by': 'publisher', 'journal-title': 'Eur Respir J', 'key': '373_CR18', 'unstructured': 'Sivapalan P, Suppli Ulrik C, Sophie Lapperre T, Dahlin Bojesen R, Eklöf ' 'J, Browatzki A, et al. Azithromycin and hydroxychloroquine in ' 'hospitalised patients with confirmed COVID-19-a randomised ' 'double-blinded placebo-controlled trial. Eur Respir J. 2021. ' 'https://doi.org/10.1183/13993003.00752-2021.', 'year': '2021'}, { 'DOI': '10.1016/j.cmi.2021.05.020', 'author': 'F Ader', 'doi-asserted-by': 'publisher', 'journal-title': 'Clin Microbiol Infect', 'key': '373_CR19', 'unstructured': 'Ader F, Peiffer-Smadja N, Poissy J, Bouscambert-Duchamp M, Belhadi D, ' 'Diallo A, et al. An open-label randomized controlled trial of the effect ' 'of lopinavir/ritonavir, lopinavir/ritonavir plus IFN-β-1a and ' 'hydroxychloroquine in hospitalized patients with COVID-19. Clin ' 'Microbiol Infect. 2021. https://doi.org/10.1016/j.cmi.2021.05.020.', 'year': '2021'}, { 'DOI': '10.1038/s41598-021-88509-9', 'author': 'Á Réa-Neto', 'doi-asserted-by': 'publisher', 'first-page': '9023', 'issue': '1', 'journal-title': 'Sci Rep', 'key': '373_CR20', 'unstructured': 'Réa-Neto Á, Bernardelli RS, Câmara BMD, Reese FB, Queiroga MVO, Oliveira ' 'MC. An open-label randomized controlled trial evaluating the efficacy of ' 'chloroquine/hydroxychloroquine in severe COVID-19 patients. Sci Rep. ' '2021;11(1):9023.', 'volume': '11', 'year': '2021'}, { 'DOI': '10.1001/jamanetworkopen.2021.6468', 'author': 'G Reis', 'doi-asserted-by': 'publisher', 'first-page': 'e216468', 'issue': '4', 'journal-title': 'JAMA Netw Open', 'key': '373_CR21', 'unstructured': 'Reis G, Moreira Silva EADS, Medeiros Silva DC, Thabane L, Singh G, Park ' 'JJH, et al. Effect of early treatment with hydroxychloroquine or ' 'lopinavir and ritonavir on risk of hospitalization among patients with ' 'COVID-19: the TOGETHER randomized clinical trial. JAMA Netw Open. ' '2021;4(4):e216468.', 'volume': '4', 'year': '2021'}, { 'DOI': '10.1016/j.cmi.2021.03.005', 'author': 'V Dubée', 'doi-asserted-by': 'publisher', 'journal-title': 'Clin Microbiol Infect', 'key': '373_CR22', 'unstructured': 'Dubée V, Roy P-M, Vielle B, Parot-Schinkel E, Blanchet O, Darsonval A, ' 'et al. Hydroxychloroquine in mild-to-moderate coronavirus disease 2019: ' 'a placebo-controlled double blind trial. Clin Microbiol Infect. 2019. ' 'https://doi.org/10.1016/j.cmi.2021.03.005.', 'year': '2019'}, { 'DOI': '10.1080/20477724.2021.1890887', 'author': 'LEB Galan', 'doi-asserted-by': 'publisher', 'first-page': '235', 'issue': '4', 'journal-title': 'Pathog Glob Health', 'key': '373_CR23', 'unstructured': 'Galan LEB, Santos NMD, Asato MS, Araújo JV, de Lima MA, Araújo AMM, et ' 'al. Phase 2 randomized study on chloroquine, hydroxychloroquine or ' 'ivermectin in hospitalized patients with severe manifestations of ' 'SARS-CoV-2 infection. Pathog Glob Health. 2021;115(4):235–42.', 'volume': '115', 'year': '2021'}, { 'DOI': '10.1016/j.eclinm.2021.100773', 'author': 'C Johnston', 'doi-asserted-by': 'publisher', 'first-page': '100773', 'journal-title': 'EClinicalMedicine', 'key': '373_CR24', 'unstructured': 'Johnston C, Brown ER, Stewart J, Karita HCS, Kissinger PJ, Dwyer J, et ' 'al. Hydroxychloroquine with or without azithromycin for treatment of ' 'early SARS-CoV-2 infection among high-risk outpatient adults: a ' 'randomized clinical trial. EClinicalMedicine. 2021;33:100773.', 'volume': '33', 'year': '2021'}, { 'DOI': '10.3390/jcm10122609', 'author': 'AV Hernandez', 'doi-asserted-by': 'publisher', 'journal-title': 'J Clin Med Res', 'key': '373_CR25', 'unstructured': 'Hernandez AV, Ingemi J 3rd, Sherman M, Pasupuleti V, Barboza JJ, Piscoya ' 'A, et al. Impact of prophylactic hydroxychloroquine on people at high ' 'risk of COVID-19: a systematic review and meta-analysis. J Clin Med Res. ' '2021. https://doi.org/10.3390/jcm10122609.', 'year': '2021'}, { 'DOI': '10.3390/jcm10112503', 'author': 'AV Hernandez', 'doi-asserted-by': 'publisher', 'journal-title': 'J Clin Med Res', 'key': '373_CR26', 'unstructured': 'Hernandez AV, Phan MT, Rocco J, Pasupuleti V, Barboza JJ, Piscoya A, et ' 'al. Efficacy and safety of hydroxychloroquine for hospitalized COVID-19 ' 'patients: a systematic review and meta-analysis. J Clin Med Res. 2021. ' 'https://doi.org/10.3390/jcm10112503.', 'year': '2021'}, { 'DOI': '10.1080/20477724.2021.1936818', 'author': 'A Di Castelnuovo', 'doi-asserted-by': 'publisher', 'first-page': '1', 'journal-title': 'Pathog Glob Health', 'key': '373_CR27', 'unstructured': 'Di Castelnuovo A, Costanzo S, Cassone A, Cauda R, De Gaetano G, ' 'Iacoviello L. Hydroxychloroquine and mortality in COVID-19 patients: a ' 'systematic review and a meta-analysis of observational studies and ' 'randomized controlled trials. Pathog Glob Health. 2021;15:1–11.', 'volume': '15', 'year': '2021'}, { 'DOI': '10.1038/s41598-021-91089-3', 'author': 'B Amani', 'doi-asserted-by': 'publisher', 'first-page': '11974', 'issue': '1', 'journal-title': 'Sci Rep', 'key': '373_CR28', 'unstructured': 'Amani B, Khanijahani A, Amani B. Hydroxychloroquine plus standard of ' 'care compared with standard of care alone in COVID-19: a meta-analysis ' 'of randomized controlled trials. Sci Rep. 2021;11(1):11974.', 'volume': '11', 'year': '2021'}, { 'DOI': '10.1038/s41467-021-22446-z', 'author': 'C Axfors', 'doi-asserted-by': 'publisher', 'first-page': '2349', 'issue': '1', 'journal-title': 'Nat Commun', 'key': '373_CR29', 'unstructured': 'Axfors C, Schmitt AM, Janiaud P, Van’t Hooft J, Abd-Elsalam S, Abdo EF, ' 'et al. Mortality outcomes with hydroxychloroquine and chloroquine in ' 'COVID-19 from an international collaborative meta-analysis of randomized ' 'trials. Nat Commun. 2021;12(1):2349.', 'volume': '12', 'year': '2021'}, { 'author': 'P Eze', 'first-page': '93', 'issue': '1', 'journal-title': 'Am J Cardiovasc Dis', 'key': '373_CR30', 'unstructured': 'Eze P, Mezue KN, Nduka CU, Obianyo I, Egbuche O. Efficacy and safety of ' 'chloroquine and hydroxychloroquine for treatment of COVID-19 patients-a ' 'systematic review and meta-analysis of randomized controlled trials. Am ' 'J Cardiovasc Dis. 2021;11(1):93–107.', 'volume': '11', 'year': '2021'}, { 'DOI': '10.1007/s10067-021-05779-4', 'author': 'B Yousefghahari', 'doi-asserted-by': 'publisher', 'journal-title': 'Clin Rheumatol', 'key': '373_CR31', 'unstructured': 'Yousefghahari B, Navari S, Sadeghi M, Soleimaniamiri S, Soleimaniamiri ' 'M, Heidari B, et al. Risk of COVID-19 infection in patients with ' 'rheumatic disease taking disease-modifying anti-rheumatic drugs. Clin ' 'Rheumatol. 2021. https://doi.org/10.1007/s10067-021-05779-4.', 'year': '2021'}, { 'DOI': '10.1093/rap/rkab014', 'author': 'K Pham', 'doi-asserted-by': 'publisher', 'first-page': 'rkab014', 'issue': '1', 'journal-title': 'Rheumatol Adv Pract.', 'key': '373_CR32', 'unstructured': 'Pham K, Torres H, Satlin MJ, Goyal P, Gulick RM. Failure of chronic ' 'hydroxychloroquine in preventing severe complications of COVID-19 in ' 'patients with rheumatic diseases. Rheumatol Adv Pract. ' '2021;5(1):rkab014.', 'volume': '5', 'year': '2021'}, { 'DOI': '10.1093/rheumatology/keaa897', 'author': 'R Cordtz', 'doi-asserted-by': 'publisher', 'journal-title': 'Rheumatology', 'key': '373_CR33', 'unstructured': 'Cordtz R, Lindhardsen J, Soussi BG, Vela J, Uhrenholt L, Westermann R, ' 'et al. Incidence and severeness of COVID-19 hospitalisation in patients ' 'with inflammatory rheumatic disease: a nationwide cohort study from ' 'Denmark. Rheumatology. 2020. ' 'https://doi.org/10.1093/rheumatology/keaa897.', 'year': '2020'}, { 'DOI': '10.1371/journal.pone.0255343', 'author': 'JE Dalton', 'doi-asserted-by': 'publisher', 'first-page': 'e0255343', 'issue': '8', 'journal-title': 'PLoS ONE', 'key': '373_CR34', 'unstructured': 'Dalton JE, Gunzler DD, Jain V, Perzynski AT, Dawson NV, Einstadter D, ' 'Tarabichi Y, Imrey PB, Lewis M, Kattan MW, Yao J, Taksler G, Berg KA, ' 'Krieger NI, Kaelber D, Jehi L, Kalra A. Mechanisms of socioeconomic ' 'differences in COVID-19 screening and hospitalizations. PLoS ONE. ' '2021;16(8):e0255343.', 'volume': '16', 'year': '2021'}, { 'DOI': '10.1111/irv.12901', 'doi-asserted-by': 'crossref', 'key': '373_CR35', 'unstructured': 'Zerbo O, Lewis N, Fireman B, Goddard K, Skarbinski J, Sejvar JJ, ' 'Azziz-Baumgartner E, Klein NP. Population-based assessment of risks for ' 'severe COVID-19 disease outcomes. Influenza Other Respir Viruses. 2021.'}, { 'DOI': '10.1371/journal.pone.0255544', 'author': 'M Sandoval', 'doi-asserted-by': 'publisher', 'first-page': 'e0255544', 'issue': '7', 'journal-title': 'PLoS ONE', 'key': '373_CR36', 'unstructured': 'Sandoval M, Nguyen DT, Vahidy FS, Graviss EA. Risk factors for severity ' 'of COVID-19 in hospital patients aged 18–29 years. PLoS ONE. ' '2021;16(7):e0255544.', 'volume': '16', 'year': '2021'}, { 'DOI': '10.1371/journal.pone.0255171', 'author': 'Y Zhang', 'doi-asserted-by': 'publisher', 'first-page': 'e0255171', 'issue': '7', 'journal-title': 'PLoS ONE', 'key': '373_CR37', 'unstructured': 'Zhang Y, Khullar D, Wang F, Steel P, Wu Y, Orlander D, Weiner M, Kaushal ' 'R. Socioeconomic variation in characteristics, outcomes, and healthcare ' 'utilization of COVID-19 patients in New York City. PLoS ONE. ' '2021;16(7):e0255171.', 'volume': '16', 'year': '2021'}, { 'DOI': '10.1016/j.eclinm.2021.101029', 'author': 'CH Lo', 'doi-asserted-by': 'publisher', 'first-page': '101029', 'journal-title': 'EClinical Medicine.', 'key': '373_CR38', 'unstructured': 'Lo CH, Nguyen LH, Drew DA, Warner ET, Joshi AD, Graham MS, Anyane-Yeboa ' 'A, Shebl FM, Astley CM, Figueiredo JC, Guo CG, Ma W, Mehta RS, Kwon S, ' 'Song M, Davies R, Capdevila J, Sudre CH, Wolf J, Cozier YC, Rosenberg L, ' 'Wilkens LR, Haiman CA, Marchand LL, Palmer JR, Spector TD, Ourselin S, ' 'Steves CJ, Chan AT, COPE Consortium. Race, ethnicity, community-level ' 'socioeconomic factors, and risk of COVID-19 in the United States and the ' 'United Kingdom. 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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. Treatments and other interventions are complementary. All practical, effective, and safe means should be used based on risk/benefit analysis. No treatment 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.
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