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0 0.5 1 1.5 2+ Mortality 32% Improvement Relative Risk Lambermont et al. HCQ for COVID-19 LATE TREATMENT Favors HCQ Favors control
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
Lambermont et al., Predictors of Mortality and Effect of Drug Therapies in Mechanically Ventilated Patients With Coronavirus.., Critical Care Explorations, doi:10.1097/CCE.0000000000000305
Nov 2020   Source   PDF  
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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 22% lower mortality [18‑27%] from meta analysis of the 229 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.
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Abstract: Letter to the Editor Predictors of Mortality and Effect of Drug Therapies in Mechanically Ventilated Patients With Coronavirus Disease 2019: A Multicenter Cohort Study 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. To the Editor: S ince the start of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic, the World Health Organization (WHO) has advocated for trials to assess the benefit of antiviral treatment, anticytokine drugs, anti-inflammatory drugs, convalescent plasma, and hydroxychloroquine. However, evidence of the efficacy of such strategies is still lacking, except for corticosteroid therapy. In particular, a before-after study suggested a beneficial effect of methylprednisolone use in patients with moderate-to-severe coronavirus disease 2019 (COVID-19) (1). The randomized evaluation of COVID-19 therapy (RECOVERY) trial recently showed dexamethasone resulted in lower 28-day mortality among COVID-19 patients receiving either invasive mechanical ventilation or oxygen (2). Following Key Words: coronavirus; corticosteroids; critical care; mortality; outcome; ventilation Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal’s website ( For information regarding this article, E-mail: Copyright © 2020 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of the Society of Critical Care Medicine. This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. Critical Care Explorations Critical Care Explorations these results, further studies comparing hydrocortisone or dexamethasone and placebo in COVID-19 patients were underpowered to find statistically significant reductions in mortality and stopped early. These studies were then included in the WHO Rapid Evidence Appraisal for COVID-19 Therapies (REACT) meta-analysis pooling data from seven randomized clinical trials and including 1,703 patients (3). This meta-analysis observed administration of systemic..
Late treatment
is less effective
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