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0 0.5 1 1.5 2+ Mortality 20% Improvement Relative Risk Outpatient use 88% HCQ for COVID-19  Guisado-Vasco et al.  LATE TREATMENT Is late treatment with HCQ beneficial for COVID-19? Retrospective 607 patients in Spain Lower mortality with HCQ (not stat. sig., p=0.36) Guisado-Vasco, October 2020 Favors HCQ Favors control

Clinical characteristics and outcomes among hospitalized adults with severe COVID-19 admitted to a tertiary medical center and receiving antiviral, antimalarials, glucocorticoids, or immunomodulation with tocilizumab or cyclosporine: A retrospective observational study (COQUIMA cohort)

Oct 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 607 patients reporting results for early outpatient HCQ use with mortality odds ratio OR 0.092 [0.022-0.381], p = 0.001 (65 patients), and for hospital use, mortality odds ratio OR 0.737 [0.38-1.41], p = 0.36 (558 patients). Median age 69.
risk of death, 20.3% lower, RR 0.80, p = 0.36, treatment 127 of 558 (22.8%), control 14 of 49 (28.6%), NNT 17, adjusted per study, odds ratio converted to relative risk.
outpatient use, 88.0% lower, RR 0.12, p = 0.001, treatment 2 of 65 (3.1%), control 139 of 542 (25.6%), NNT 4.4, adjusted per study, odds ratio converted to relative risk.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Guisado-Vasco et al., 15 Oct 2020, retrospective, Spain, peer-reviewed, median age 69.0, 25 authors.
This PaperHCQAll
Clinical characteristics and outcomes among hospitalized adults with severe COVID-19 admitted to a tertiary medical center and receiving antiviral, antimalarials, glucocorticoids, or immunomodulation with tocilizumab or cyclosporine: A retrospective observational study (COQUIMA cohort)
Pablo Guisado-Vasco, Sofia Valderas-Ortega, Maria Maravillas Carralón-González, Ana Roda-Santacruz, Lucia González-Cortijo, Gabriel Sotres-Fernández, Eva María Martí-Ballesteros, José Manuel Luque-Pinilla, Elena Almagro-Casado, Félix J La Coma-Lanuza, Ruth Barrena-Puertas, Esteban Javier Malo-Benages, María José Monforte-Gómez, Rocío Diez-Munar, Esther Merino-Lanza, Lorena Comeche-Casanova, Margarita Remirez-De-Esparza-Otero, María Correyero-Plaza, Manuel Recio-Rodríguez, Margarita Rodríguez-López, María Dolores Sánchez-Manzano, Cristina Andreu-Vázquez, Israel John Thuissard-Vasallo, José María Echave-Sustaeta María-Tomé, Daniel Carnevali-Ruiz
EClinicalMedicine, doi:10.1016/j.eclinm.2020.100591
Background: The COVID-19 outbreak challenges the Spanish health system since March 2020. Some available therapies (antimalarials, antivirals, biological agents) were grounded on clinical case observations or basic science data. The aim of this study is to describe the characteristics and impact of different therapies on clinical outcomes in a cohort of severe COVID-19 patients. Methods: In this retrospective, single-center, observational study, we collected sequential data on adult patients admitted to Hospital Universitario Quironsalud Madrid. Eligible patients should have a microbiological (positive test on RT-PCR assay from a nasal swab) or an epidemiological diagnosis of severe COVID-19. Demographic, baseline comorbidities, laboratory data, clinical outcomes, and treatments were compared between survivors and non-survivors. We carried out univariate and multivariate logistic regression models to assess potential risk factors for in-hospital mortality. Findings: From March 10th to April 15th, 2020, 607 patients were included. Median age was 69 years [interquartile range, {IQR} 22; 65% male). The most common comorbidities were hypertension (276 [46¢94%]),
JMES helped in the design of the study. ARS and SVO collected the data and coordinate the analysis. CAV and IJTV run the statistical analysis and designed the table and figures. JMLP, GSF, LGC, EAC, MDSM, MCG, RBP, EMMB, EJMB, MJMG, RDM, EMB, LCC, MREO, MCP, MRR, MRL, FLL collected data. PGV, DCR, CAV, IJTV, ARS, GSF, LGC drafted the paper. All authors critically revised the manuscript for important intellectual content and gave final approval for the version to be published. All authors agree to be accountable for all aspects of the work. They also in ensuring in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. Data sharing statement The dataset used for the present analyses, although partially anonymized, contains detailed and thus possibly identifiable patient data so that a publication of the database is not possible. However, upon reasonable and personal requests to the Authors, and as a further notification to the Ethics Committee and amendment of the study protocol, anonymous data would be shared with individual researchers or working groups. List of contributors Supplementary materials Supplementary material associated with this article can be found in the online version at doi:10.1016/j.eclinm.2020.100591.
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Late treatment
is less effective
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