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0 0.5 1 1.5 2+ Mortality 54% Improvement Relative Risk Ventilation 65% HCQ for COVID-19  Heberto et al.  LATE TREATMENT Is late treatment with HCQ + AZ beneficial for COVID-19? Prospective study of 254 patients in Mexico Lower mortality (p=0.04) and ventilation (p=0.008) with HCQ + AZ Heberto et al., IJC Heart & Vasculature, Sep 2020 Favors HCQ Favors control

Implications of myocardial injury in Mexican hospitalized patients with coronavirus disease 2019 (COVID-19)

Heberto et al., IJC Heart & Vasculature, doi:10.1016/j.ijcha.2020.100638
Sep 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.
Observational prospective 254 hospitalized patients, HCQ+AZ mortality odds ratio OR 0.36, p = 0.04. Ventilation OR 0.20, p = 0.008.
risk of death, 53.9% lower, RR 0.46, p = 0.04, treatment 139, control 115, odds ratio converted to relative risk.
risk of mechanical ventilation, 65.1% lower, RR 0.35, p = 0.008, treatment 139, control 115, odds ratio converted to relative risk.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Heberto et al., 12 Sep 2020, prospective, Mexico, peer-reviewed, 8 authors, this trial uses multiple treatments in the treatment arm (combined with AZ) - results of individual treatments may vary. Contact:,
This PaperHCQAll
Implications of myocardial injury in Mexican hospitalized patients with coronavirus disease 2019 (COVID-19)
Aquino Bruno Heberto, Plata Corona Juan Carlos, Castro Rubio José Antonio, Pulido Pérez Patricia, Torres Rasgado Enrique, Morales Portano Julieta Danira, Gómez Álvarez Enrique Benito, Merino Rajme José Alfredo
IJC Heart & Vasculature, doi:10.1016/j.ijcha.2020.100638
Background: Respiratory illnesses is the most common manifestation of Coronavirus disease 2019 (COVID-19); however, myocardial injury has recently emerged as a frequent complication. Methods: An observational, longitudinal, prospective, and multicenter study of hospitalized Mexican patients was made. We assessed the prevalence of myocardial injury and its relationship with complications and mortality. Results: 254 COVID-19 patients were included. Their average age was 53.8 years old, 167 (65.7%) were male and 87 (34.3%) female. According to troponin levels, two populations were generated, those with and without myocardial injury. There was no difference in gender or age between both groups. However, there was a greater proportion of obesity and hypertension in myocardial injury group. Multivariate logistic regression analysis revealed that obesity (OR 2.029, 95% CI 1.039-3.961; p = 0.038), arterial oxygen saturation <90% (OR 2.250, 95% CI 1.216-3.560; p = 0.025), and systolic blood pressure <90 mmHg (OR 2.636, 95% CI 1.530-4.343; p = 0.042), were directly related to higher levels of troponins. Multivariate cox proportional hazards analysis showed that primary endpoint (mortality) was determined by overweight/obesity (OR 1.290, 95% CI 0.115-0.730; p = 0.009), ferritin levels (OR 1.001, 95% CI 1.000-1.001; p < 0.001), myocardial injury (OR 3.764, 95% CI 1.307-10.838; p = 0.014), septic shock (OR 4.104,; p = 0.024), acute respiratory distress syndrome (OR 3.001, 95% CI 1.008-10.165; p = 0.040), and treatment with Hydroxychloroquine/Azithromycin (OR 0.357, 95% IC 0.133-0.955; p = 0.040). Secondary endpoint (Mechanical ventilation risk) was associated to the same factors. Conclusions: Myocardial injury represents an increased risk of complications and death in Mexican hospitalized patients with COVID-19.
CRediT authorship contribution statement Aquino Bruno Heberto: Conceptualization, Methodology, Validation, Investigation, Formal analysis, Writing -original draft, Writing -review & editing, Visualization, Supervision, Project Declaration of Competing Interest The authors report no relationships that could be construed as a conflict of interest. Author's contributions and consent for publication As the corresponding author, I declare that all authors in this paper contribute substantially in the work design, analysis, data interpretation, drafting, and intellectual content. Finally all authors approved this version to be published. Author's agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. Manuscript We declare this manuscript has not been published before; that it is not under consideration for publication anywhere else; that its publication has been approved by all co-authors, if any, as well as by the responsible authorities -tacitly or explicitly -at the institute where the work has been carried out. The publisher will not be held legally responsible should there be any claims for compensation. Ethics approval This research was approved by bioethics committee of hospitals involved. We certify that the study was performed in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki and its later..
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Late treatment
is less effective
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