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0 0.5 1 1.5 2+ Mortality 36% Improvement Relative Risk HCQ  Lavilla Olleros et al.  LATE TREATMENT Is late treatment with HCQ beneficial for COVID-19? Retrospective 14,921 patients in Spain Lower mortality with HCQ (p<0.000001) Lavilla Olleros et al., PLOS ONE, January 2022 Favors HCQ Favors control

Use of glucocorticoids megadoses in SARS-CoV-2 infection in a spanish registry: SEMI-COVID-19

Lavilla Olleros et al., PLOS ONE, doi:10.1371/journal.pone.0261711
Jan 2022  
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HCQ for COVID-19
1st treatment shown to reduce risk in March 2020
*, now known with p < 0.00000000001 from 422 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.
4,000+ studies for 60+ treatments.
Retrospective 14,921 hospitalized patients in Spain, showing lower mortality with HCQ treatment.
risk of death, 36.2% lower, RR 0.64, p < 0.001, treatment 2,285 of 12,772 (17.9%), control 774 of 2,149 (36.0%), NNT 5.5, adjusted per study, odds ratio converted to relative risk, multivariable.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Lavilla Olleros et al., 21 Jan 2022, retrospective, Spain, peer-reviewed, 22 authors.
This PaperHCQAll
Use of glucocorticoids megadoses in SARS-CoV-2 infection in a spanish registry: SEMI-COVID-19
Cristina Lavilla Olleros, Cristina Ausín García, Alejandro David Bendala Estrada, Ana Muñoz, Philip Erick Wikman Jogersen, Ana Fernández Cruz, Vicente Giner Galvañ, Juan Antonio Vargas, José Miguel Seguí Ripoll, Manuel Rubio-Rivas, Rodrigo Miranda Godoy, Luis Mérida Rodrigo, Eva Fonseca Aizpuru, Francisco Arnalich Fernández, Arturo Artero, Jose Loureiro Amigo, Gema María García García, Luis Corral Gudino, Jose Jiménez Torres, José-Manuel Casas-Rojo, Jesús Millán Núñez-Cortés
PLOS ONE, doi:10.1371/journal.pone.0261711
Objective To describe the impact of different doses of corticosteroids on the evolution of patients with COVID-19 pneumonia, based on the potential benefit of the non-genomic mechanism of these drugs at higher doses. Methods Observational study using data collected from the SEMI-COVID-19 Registry. We evaluated the epidemiological, radiological and analytical scenario between patients treated with megadoses therapy of corticosteroids vs low-dose of corticosteroids and the development of complications. The primary endpoint was all-cause in-hospital mortality according to use of corticosteroids megadoses.
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Buttgereit, Straub, Wehling, Burmester, Glucocorticoids in the treatment of rheumatic diseases: an update on the mechanisms of action, Arthritis Rheum, doi:10.1002/art.20583
Cao, Wang, Wen, A Trial of Lopinavir-Ritonavir in Adults Hospitalized with Severe Covid-19, N Engl J Med, doi:10.1056/NEJMoa2001282
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Horby, Lim, Dexamethasone in Hospitalized Patients with Covid-19, N Engl J Med, doi:10.1056/NEJMoa2021436
Jeronimo, Farias, Val, Methylprednisolone as Adjunctive Therapy for Patients Hospitalized With COVID-19 (Metcovid): A Randomised, Double-Blind, Phase IIb, Placebo-Controlled Trial
Jorgensen, Tse, Burry, Dresser, Baricitinib: A Review of Pharmacology, Safety, and Emerging Clinical Experience in COVID-19, Pharmacotherapy, doi:10.1002/phar.2438
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Panettieri, Schaafsma, Amrani, Koziol-White, Ostrom et al., Non-genomic Effects of Glucocorticoids: An Updated View, Trends Pharmacol Sci, doi:10.1016/
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Ruiz-Irastorza, Pijoan, Bereciartua, Second week methyl-prednisolone pulses improve prognosis in patients with severe coronavirus disease 2019 pneumonia: An observational comparative study using routine care data, PLoS One, doi:10.1371/journal.pone.0239401
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Titanji, Farley, Mehta, Use of Baricitinib in Patients with Moderate and Severe COVID-19
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Late treatment
is less effective
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