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All Studies   Meta Analysis    Recent:   

Predictors of Mortality and Effect of Drug Therapies in Mechanically Ventilated Patients With Coronavirus Disease 2019: A Multicenter Cohort Study

Lambermont et al., Critical Care Explorations, doi:10.1097/CCE.0000000000000305
Nov 2020  
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Mortality 32% Improvement Relative Risk HCQ for COVID-19  Lambermont et al.  LATE TREATMENT Is late treatment with HCQ beneficial for COVID-19? Retrospective 247 patients in Belgium Lower mortality with HCQ (not stat. sig., p=0.46) c19hcq.org Lambermont et al., Critical Care Explo.., Nov 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. c19hcq.org
Retrospective 247 mechanically ventilated patients showing lower mortality with HCQ, but not statistically significant on multiple Cox regression.
The paper gives the p value for multiple Cox (0.46) and simple Cox (0.02), but does not specify the adjusted risk values.
Although the 32% lower mortality is not statistically significant, it is consistent with the significant 26% lower mortality [22‑30%] from meta analysis of the 249 mortality results to date.
risk of death, 32.3% lower, RR 0.68, p = 0.46, treatment 97 of 225 (43.1%), control 14 of 22 (63.6%), NNT 4.9, adjusted per study.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Lambermont et al., 28 Nov 2020, retrospective, Belgium, peer-reviewed, 15 authors.
This PaperHCQAll
Letter to the Editor
We conducted a multicenter cohort study to determine the effect of drug therapies on survival in mechanically ventilated patients with coronavirus disease 2019. All consecutive adult patients admitted to ICU for coronavirus disease 2019 from March 1, 2020, to April 25, 2020, and under invasive mechanical ventilation for more than 24 hours were included. Out of 2,003 patients hospitalized for coronavirus disease 2019, 361 were admitted to ICU, 257 were ventilated for more than 24 hours, and 247 were included in the study. Simple and multiple time-dependent Cox regression models were used to assess the effects of factors on survival. Methylprednisolone administration during the first week of mechanical ventilation was associated with a decrease in mortality rate from 48% to 34% (p = 0.01). Mortality was significantly associated with older age, higher creatinine, lower lymphocyte count, and mean arterial pressure lower than 70 mm Hg on the day of admission.
References
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Argenziano, Bruce, Slater, Characterization and clinical course of 1000 patients with coronavirus disease 2019 in New York: Retrospective case series, BMJ
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Boccar, Md, Department of Intensive Care
Cavalcanti, Zampieri, Rosa, Hydroxychloroquine with or without azithromycin in mild-to-moderate Covid-19, N Engl J Med
Christophe, Dubois, Md, Department of Intensive Care
Cummings, Baldwin, Abrams, Epidemiology, clinical course, and outcomes of critically ill adults with COVID-19 in New York City: A prospective cohort study, Lancet
Delanaye, Md, None
Fadel, Morrison, Vahia, Early short course corticosteroids in hospitalized patients with COVID-19, Clin Infect Dis
Grasselli, Zangrillo, Zanella, COVID-19 Lombardy ICU Network: Baseline characteristics and outcomes of 1591 patients infected with SARS-CoV-2 admitted to ICUs of the Lombardy Region, Italy, JAMA
Gurdebeke, Md, Department of Intensive Care
Higny, Md, Department of Intensive Care
Horby, Lim, Emberson, Dexamethasone in hospitalized patients with Covid-19 -preliminary report, N Engl J Med
Lemineur, Md, Department of Intensive Care
Misset, Md, Department of Intensive Care
Quinonez, Md, Department of Intensive Care
Sterne, Murthy, Diaz, Association between administration of systemic corticosteroids and mortality among critically ill patients with COVID-19: A meta-analysis, JAMA
Villar, Ferrando, Martínez, Dexamethasone in ARDS Network: Dexamethasone treatment for the acute respiratory distress syndrome: A multicentre, randomised controlled trial, Lancet Respir Med
Wertz, Md, Department of Intensive Care
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Late treatment
is less effective
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