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0 0.5 1 1.5 2+ Mortality 42% Improvement Relative Risk Treatment escalation 6% Viral+ at day 7 15% c19hcq.org Lecronier et al. HCQ for COVID-19 ICU PATIENTS Favors HCQ Favors control
Comparison of hydroxychloroquine, lopinavir/ritonavir, and standard of care in critically ill patients with SARS-CoV-2 pneumonia: an opportunistic retrospective analysis
Lecronier et al., Critical Care, 24:418, 2020, doi:10.1186/s13054-020-03117-9
Lecronier et al., Comparison of hydroxychloroquine, lopinavir/ritonavir, and standard of care in critically ill patients with.., Critical Care, 24:418, 2020, doi:10.1186/s13054-020-03117-9
Jul 2020   Source   PDF  
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Retrospective 80 ICU patients, 22 SOC, 20 lopinavir/ritonavir, 38 HCQ. 28 day mortality 24% (HCQ) versus 41% (SOC), a 41% decrease, but not statistically significant due to very small sample sizes. No statistically significant differences found for treatment escalation, ventilator-free days, viral load, or mortality. Authors consider treatment escalation more important than mortality, for unknown reasons. This study is excluded in the after exclusion results of meta analysis: very late stage, >50% on oxygen/ventilation at baseline.
risk of death, 42.0% lower, RR 0.58, p = 0.24, treatment 9 of 38 (23.7%), control 9 of 22 (40.9%), NNT 5.8.
risk of treatment escalation, 6.0% lower, RR 0.94, p = 0.73, treatment 15 of 38 (39.5%), control 9 of 22 (40.9%), NNT 70.
risk of viral+ at day 7, 15.0% lower, RR 0.85, p = 0.61, treatment 19 of 26 (73.1%), control 12 of 14 (85.7%), NNT 7.9.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Lecronier et al., 11 Jul 2020, retrospective, France, peer-reviewed, baseline oxygen required 100.0%, 25 authors, HCQ vs. control.
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Abstract: Lecronier et al. Critical Care (2020) 24:418 https://doi.org/10.1186/s13054-020-03117-9 RESEARCH Open Access Comparison of hydroxychloroquine, lopinavir/ritonavir, and standard of care in critically ill patients with SARS-CoV-2 pneumonia: an opportunistic retrospective analysis Marie Lecronier1* , Alexandra Beurton1,2, Sonia Burrel3,4, Luc Haudebourg1, Robin Deleris1, Julien Le Marec1, Sara Virolle1, Safaa Nemlaghi1, Côme Bureau1,2, Pierre Mora1, Martin De Sarcus5, Olivier Clovet5, Baptiste Duceau5, Paul Henri Grisot5, Marie Hélène Pari5, Jérémy Arzoine5, Ulrich Clarac5, David Boutolleau3,4, Mathieu Raux2,5, Julie Delemazure1, Morgane Faure1, Maxens Decavele1,2, Elise Morawiec1, Julien Mayaux1, Alexandre Demoule1,2 and Martin Dres1,2* Abstract Background: The severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) outbreak is spreading worldwide. To date, no specific treatment has convincingly demonstrated its efficacy. Hydroxychloroquine and lopinavir/ ritonavir have potential interest, but virological and clinical data are scarce, especially in critically ill patients. Methods: The present report took the opportunity of compassionate use and successive drug shortages to compare the effects of two therapeutic options, lopinavir/ritonavir and hydroxychloroquine, as compared to standard of care only. The primary outcomes were treatment escalation (intubation, extra-corporeal membrane oxygenation support, or renal replacement therapy) after day 1 until day 28. Secondary outcomes included ventilator-free days at day 28, mortality at day 14 and day 28, treatment safety issues and changes in respiratory tracts, and plasma viral load (as estimated by cycle threshold value) between admission and day 7. (Continued on next page) * Correspondence: marie.lecronier@aphp.fr; martin.dres@aphp.fr 1 AP-HP. Sorbonne Université, Hôpital Pitié-Salpêtrière, Service de Pneumologie, Médecine intensive – Réanimation (Département “R3S”), Paris, France Full list of author information is available at the end of the article © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. Lecronier et al. Critical Care (2020) 24:418 Page 2 of 9 (Continued from previous page) Results: Eighty patients were treated during a 4-week period and included in the analysis: 22 (28%) received standard of care only, 20 (25%) patients received lopinavir/ritonavir associated to standard of care, and 38 (47%) patients received hydroxychloroquine and standard of..
Late treatment
is less effective
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