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Clinical characteristics of 17 patients with COVID-19 and systemic autoimmune diseases: a retrospective study

Huang et al., Annals of the Rheumatic Diseases 2020:79, 1163-1169, doi:10.1136/annrheumdis-2020-217425
Jun 2020  
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Hospitalization 80% Improvement Relative Risk HCQ for COVID-19  Huang et al.  Prophylaxis Is pre-exposure prophylaxis with HCQ beneficial for COVID-19? Retrospective 1,255 patients in China Lower hospitalization with HCQ (p=0.001) Huang et al., Annals of the Rheumatic .., Jun 2020 FavorsHCQ Favorscontrol 0 0.5 1 1.5 2+
HCQ for COVID-19
1st treatment shown to reduce risk in March 2020
*, now with p < 0.00000000001 from 411 studies, recognized in 46 countries.
No treatment is 100% effective. Protocols combine treatments. * >10% efficacy, ≥3 studies.
4,300+ studies for 75 treatments.
Analysis of 1255 COVID-19 patients in Wuhan Tongji Hospital finding 0.61% with systemic autoimmune diseases, much lower than authors expected (3%-10%). Authors hypothesise that protective factors, such as CQ/HCQ use, reduce hospitalization.
This study is excluded in the after exclusion results of meta analysis: significant unadjusted confounding possible.
risk of hospitalization, 80.0% lower, RR 0.20, p < 0.001, treatment 8, control 1,247.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Huang et al., 16 Jun 2020, retrospective, China, peer-reviewed, 15 authors.
This PaperHCQAll
Clinical characteristics of 17 patients with COVID-19 and systemic autoimmune diseases: a retrospective study
Yao Huang, Zhe Chen, Yu Wang, Liang Han, Kai Qin, Wenya Huang, Ying Huang, Hui Wang, Pan Shen, Xin Ba, Weiji Lin, Hui Dong, Mingmin Zhang, Professor Shenghao Tu
Annals of the Rheumatic Diseases, doi:10.1136/annrheumdis-2020-217425
What is already known about this subject? ► On 12 March, WHO declared COVID-19 could be characterised as a pandemic. Till 22 April, more than 2.5 million cases of COVID-19 have been reported worldwide. ► Increasing data about COVID-19 based on the general population has been reported. However, little published works were found about COVID-19 in disease-specific groups. What does this study add? ► We analysed the epidemiology of 1255 inpatients with COVID-19 who were admitted to Wuhan Tongji Hospital. Additional 17 patients with systemic autoimmune diseases (AIDs) were further screened, the demographic characteristics, epidemiological history, comorbidities, clinical symptoms or signs on admission, chest CT findings, laboratory results on admission, therapies that were prescribed for COVID-19 as well as AIDs, and clinical outcomes were reported. The detailed information of patients with systemic AIDs was investigated.
Competing interests none declared. Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting or dissemination plans of this research. Patient consent for publication not required. Ethics approval This study was approved by the ethics Commission of Tongji Hospital, Tongji Medical College, Huazhong University of science and Technology (TJ-iRB20200365). Written informed consent was waived by Tongji Hospital for emerging infectious diseases and the urgent need to collect data. Provenance and peer review not commissioned; externally peer reviewed. data availability statement Data are available upon reasonable request by email to shtu@ tjh. tjmu. edu. cn. This article is made freely available for use in accordance with BMJ's website terms and conditions for the duration of the covid-19 pandemic or until otherwise determined by BMJ. You may use, download and print the article for any lawful, on January 16, 2022 by guest. Protected by copyright.
Chen N, Zhou, Dong, epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study, Lancet, doi:10.1016/S0140-6736(20)30211-7
Clinicaltrials, Gov, Post-exposure prophylaxis / preemptive therapy for saRs-Coronavirus-2-full text view
Gautret, Parola, Hydroxychloroquine and azithromycin as a treatment of COViD-19: results of an open-label non-randomized clinical trial, Int J Antimicrob Agents, doi:10.1016/j.ijantimicag.2020.105949
Guan, Hu, Clinical characteristics of coronavirus disease 2019 in China, N Engl J Med, doi:10.1056/NEJMoa2002032
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Hemminki, Huang, autoimmune diseases and hematological malignancies: exploring the underlying mechanisms from epidemiological evidence, Semin Cancer Biol, doi:10.1016/j.semcancer.2019.06.005
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Kim Ahj, Sparks, Liew, a rush to judgment? rapid reporting and dissemination of results and its consequences regarding the use of hydroxychloroquine for COViD-19, Ann Intern Med, doi:10.7326/M20-1223
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We aim to further evaluate the clinical characteristics ' 'of COVID-19 in patients with systemic autoimmune diseases ' '(AIDs).</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>We included all ' 'confirmed inpatients with COVID-19 and systemic AIDs in Wuhan Tongji Hospital from 29 January ' 'to 8 March 2020. We retrospectively collected and analysed information on epidemiology of ' '1255 inpatients and additional clinical characteristics of patients with systemic AIDs. ' 'Outcomes were followed up until 16 April ' '2020.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>Of the 1255 ' 'patients with COVID-19, the median age was 64.0 years and 53.1% were male. More than half ' '(63.0%) had chronic comorbidities. The proportions of elderly, male and patients with ' 'comorbidities were significantly higher in intensive care unit (ICU) than in the general ward ' '(p&lt;0.001). 17 (0.61%) patients with systemic AIDs were further screened and analysed from ' '2804 inpatients. The median age was 64.0 years and 82.4% were female. All patients were ' 'living in Wuhan and two family clusters were found. 1 (5.9%) patient was admitted to ICU and ' 'one died. 10 (62.5%) of 16 patients changed or stopped their anti-AIDs treatments during ' 'hospitalisation, and 5 of them felt that the disease had worsened after the ' 'quarantine.</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>Older ' 'males with chronic comorbidities are more vulnerable to severe COVID-19. The lower proportion ' 'of COVID-19 in patients with systemic AIDs needs more high-quality human clinical trials and ' 'in-depth mechanism researches. 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