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All Studies   Meta Analysis    Recent:   

Predictors of COVID-19 severity and outcomes in Indian patients with rheumatic diseases: a prospective cohort study

Mathew et al., Rheumatology Advances in Practice, doi:10.1093/rap/rkad025
Feb 2023  
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Mortality 20% Improvement Relative Risk Hospitalization 0% Severe case 40% HCQ for COVID-19  Mathew et al.  Prophylaxis Is pre-exposure prophylaxis with HCQ beneficial for COVID-19? Prospective study of 64 patients in India (April 2020 - October 2021) Lower severe cases with HCQ (not stat. sig., p=0.37) c19hcq.org Mathew et al., Rheumatology Advances i.., Feb 2023 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 417 studies, recognized in 46 countries.
No treatment is 100% effective. Protocols combine treatments. * >10% efficacy, ≥3 studies.
4,800+ studies for 102 treatments. c19hcq.org
Prospective study of 64 rheumatic disease patients with COVID-19, showing no significant difference in outcomes with HCQ use.
Although the 20% lower mortality is not statistically significant, it is consistent with the significant 26% lower mortality [22‑30%] from meta analysis of the 252 mortality results to date.
risk of death, 20.0% lower, OR 0.80, p = 0.80, treatment 23, control 41, RR approximated with OR.
risk of hospitalization, no change, OR 1.00, p = 0.94, treatment 23, control 41, RR approximated with OR.
risk of severe case, 40.0% lower, OR 0.60, p = 0.37, treatment 23, control 41, RR approximated with OR.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Mathew et al., 28 Feb 2023, prospective, India, peer-reviewed, 8 authors, study period April 2020 - October 2021.
This PaperHCQAll
Predictors of COVID-19 severity and outcomes in Indian patients with rheumatic diseases: a prospective cohort study
Dr Jithin Mathew, Siddharth Jain, Terence Susngi, Gsrsnk Naidu, Varun Dhir, Aman Sharma, Sanjay Jain, Shefali Khanna, Dr Siddharth Jain, Dr Shefali K Sharma
doi:10.1093/rap/rkad025/7059537
Objectives: There is dearth of data regarding COVID-19 outcomes amongst rheumatic and musculoskeletal diseases (RMD) patients from South-East-Asia. We report the clinico-demographic profile and identify predictors of COVID-19 outcomes in a large cohort of Indian RMD patients. Methods : This prospective cohort study done at PGIMER, Chandigarh (tertiary care centre in India) included RMD patients affected with COVID-19 between April 2020-October 2021. Demographic and clinico-laboratory details of COVID-19 and underlying RMD were noted. Predictors of mortality, hospitalization, and severe COVID-19 were identified using stepwise multivariable logistic regression. Results: A total of 64 SARS-CoV-2 infected RMD patients [age 41.5 (19-85 years); 46 (72%) females] were included. 18(28%) patients had severe COVID-19. 23 (36%) required respiratory support [11 (17%) required mechanical ventilation]. 36 (56%) patients required hospitalization [median duration of stay 10(1-42) days]; 17 (27%) required intensive care unit (ICU) admission. Presence of comorbidities [OR=4.5(1.4-14.7)] was found to independently predict COVID-19 severity. Comorbidities [OR=10.7(2.5-45.4)] and underlying lupus [OR=7.0(1.2-40.8)] were independently associated with COVID-19-hospitalization. Ongoing rheumatic disease activity [OR=6.8(1.3-35.4)] and underlying diagnosis of lupus [OR=7.1(1.2-42.4)] and systemic sclerosis (SSc) [OR=9.5(1.5-61.8)] were found to be strong independent predictors of mortality. Age, gender, underlying RMD-interstitial lung disease (ILD) and choice of immunosuppressive therapy were not associated with COVID-19 severity or adverse outcomes. Conclusion: Presence of comorbidities was independently associated with COVID-19 severity and hospitalization. Ongoing rheumatic disease activity and presence of lupus or SSc independently predicted mortality. Age, gender, type of immunosuppressive therapy and presence of RMD-ILD did not affect COVID-19 severity or outcomes in Indian RMD patients.
Conflict of Interest: The authors have declared no conflicts of interest
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We report the ' 'clinicodemographic profile and identify predictors of COVID-19 outcomes in a large cohort of ' 'Indian RMD ' 'patients.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>This ' 'prospective cohort study, carried out at the Postgraduate Institute of Medical Education and ' 'Research, Chandigarh (a tertiary care centre in India), included RMD patients affected with ' 'COVID-19 between April 2020 and October 2021. Demographic and clinical and laboratory details ' 'of COVID-19 and underlying RMD were noted. Predictors of mortality, hospitalization and ' 'severe COVID-19 were identified using stepwise multivariable logistic ' 'regression.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>A total of ' '64 severe acute respiratory syndrome coronavirus-2-infected RMD patients [age 41.5 ' '(19–85)\u2009years; 46 (72%) females] were included. Eighteen (28%) patients had severe ' 'COVID-19. Twenty-three (36%) required respiratory support [11 (17%) required mechanical ' 'ventilation]. Thirty-six (56%) patients required hospitalization [median duration of stay 10 ' '(1–42) days]; 17 (27%) required intensive care unit admission. Presence of co-morbidities ' '[odds ratio (OR)\u2009=\u20094.5 (95% CI: 1.4, 14.7)] was found to be an independent ' 'predictor of COVID-19 severity. Co-morbidities [OR\u2009=\u200910.7 (95% CI: 2.5, 45.4)] and ' 'underlying lupus [OR\u2009=\u20097.0 (95% CI: 1.2, 40.8)] were independently associated with ' 'COVID-19 hospitalization. Ongoing rheumatic disease activity [OR\u2009=\u20096.8 (95% CI: ' '1.3, 35.4)] and underlying diagnosis of lupus [OR\u2009=\u20097.1 (95% CI: 1.2, 42.4)] and ' 'SSc [OR\u2009=\u20099.5 (95% CI: 1.5, 61.8)] were found to be strong independent predictors ' 'of mortality. Age, sex, underlying RMD-associated interstitial lung disease and choice of ' 'immunosuppressive therapy were not associated with COVID-19 severity or adverse ' 'outcomes.</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>The ' 'presence of co-morbidities was independently associated with COVID-19 severity and ' 'hospitalization. Ongoing rheumatic disease activity and the presence of lupus or SSc ' 'independently predicted mortality. Age, sex, type of immunosuppressive therapy and presence ' 'of RMD-associated interstitial lung disease did not affect COVID-19 severity or outcomes in ' 'Indian RMD patients.</jats:p></jats:sec>', 'DOI': '10.1093/rap/rkad025', 'type': 'journal-article', 'created': {'date-parts': [[2023, 2, 28]], 'date-time': '2023-02-28T12:14:00Z', 'timestamp': 1677586440000}, 'source': 'Crossref', 'is-referenced-by-count': 0, 'title': 'Predictors of COVID-19 severity and outcomes in Indian patients with rheumatic diseases: a ' 'prospective cohort study', 'prefix': '10.1093', 'volume': '7', 'author': [ { 'ORCID': 'http://orcid.org/0000-0001-7043-4654', 'authenticated-orcid': False, 'given': 'Jithin', 'family': 'Mathew', 'sequence': 'first', 'affiliation': [ { 'name': 'Division of Clinical Immunology and Rheumatology, Department of ' 'Internal Medicine, Postgraduate Institute of Medical Education ' 'and Research , Chandigarh, India'}]}, { 'ORCID': 'http://orcid.org/0000-0003-4065-5880', 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'key': '2023030819251207700_', 'doi-asserted-by': 'crossref', 'first-page': '442', 'DOI': '10.1038/s41577-020-0348-8', 'article-title': 'Considering how biological sex impacts immune responses and COVID-19 ' 'outcomes', 'volume': '20', 'author': 'Scully', 'year': '2020', 'journal-title': 'Nat Rev Immunol'}, { 'key': '2023030819251207700_', 'first-page': '748', 'article-title': 'COVID-19 in rheumatic diseases in Italy: first results from the Italian ' 'registry of the Italian Society for Rheumatology (CONTROL-19)', 'volume': '38', 'author': 'Scirè', 'year': '2020', 'journal-title': 'Clin Exp Rheumatol'}, { 'key': '2023030819251207700_', 'doi-asserted-by': 'crossref', 'first-page': '2213', 'DOI': '10.1007/s10067-022-06087-1', 'article-title': 'Prevalence and risk of COVID-19 in patients with rheumatic diseases: a ' 'systematic review and meta-analysis', 'volume': '41', 'author': 'Wang', 'year': '2022', 'journal-title': 'Clin Rheumatol'}, { 'key': '2023030819251207700_', 'first-page': '2038', 'article-title': 'Increased COVID-19 mortality in patients with rheumatic diseases: ' 'results from the CONTROL-19 study by the Italian Society for ' 'Rheumatology', 'volume': '40', 'author': 'Zanetti', 'year': '2022', 'journal-title': 'Clin Exp Rheumatol'}, { 'key': '2023030819251207700_', 'doi-asserted-by': 'crossref', 'first-page': '914', 'DOI': '10.1002/art.41619', 'article-title': 'COVID-19 outcomes in patients with systemic autoimmune rheumatic ' 'diseases compared to the general population: a US multicenter, ' 'comparative cohort study', 'volume': '73', 'author': 'D’Silva', 'year': '2021', 'journal-title': 'Arthritis Rheumatol'}, { 'key': '2023030819251207700_', 'doi-asserted-by': 'crossref', 'first-page': 'e0233147', 'DOI': '10.1371/journal.pone.0233147', 'article-title': 'Prevalence, severity and mortality associated with COPD and smoking in ' 'patients with COVID-19: a rapid systematic review and meta-analysis', 'volume': '15', 'author': 'Alqahtani', 'year': '2020', 'journal-title': 'PLoS ONE'}, { 'key': '2023030819251207700_', 'doi-asserted-by': 'crossref', 'first-page': '335', 'DOI': '10.1016/S1470-2045(20)30096-6', 'article-title': 'Cancer patients in SARS-CoV-2 infection: a nationwide analysis in China', 'volume': '21', 'author': 'Liang', 'year': '2020', 'journal-title': 'Lancet Oncol'}, { 'key': '2023030819251207700_', 'doi-asserted-by': 'crossref', 'first-page': '790', 'DOI': '10.1016/j.jaci.2020.08.008', 'article-title': 'Allergic disorders and susceptibility to and severity of COVID-19: a ' 'nationwide cohort study', 'volume': '146', 'author': 'Yang', 'year': '2020', 'journal-title': 'J Allergy Clin Immunol'}, { 'key': '2023030819251207700_', 'doi-asserted-by': 'crossref', 'first-page': '2004125', 'DOI': '10.1183/13993003.04125-2020', 'article-title': 'Interstitial lung disease increases susceptibility to and severity of ' 'COVID-19', 'volume': '58', 'author': 'Lee', 'year': '2021', 'journal-title': 'Eur Respir J'}, { 'key': '2023030819251207700_', 'doi-asserted-by': 'crossref', 'first-page': '1656', 'DOI': '10.1164/rccm.202007-2794OC', 'article-title': 'Outcome of hospitalization for COVID-19 in patients with interstitial ' 'lung disease. An international multicenter study', 'volume': '202', 'author': 'Drake', 'year': '2020', 'journal-title': 'Am J Respir Crit Care Med'}, { 'key': '2023030819251207700_', 'doi-asserted-by': 'crossref', 'first-page': 'e33', 'DOI': '10.1016/S2665-9913(21)00325-8', 'article-title': 'Long-term use of immunosuppressive medicines and in-hospital COVID-19 ' 'outcomes: a retrospective cohort study using data from the National ' 'COVID Cohort Collaborative', 'volume': '4', 'author': 'Andersen', 'year': '2022', 'journal-title': 'Lancet Rheumatol'}], 'container-title': 'Rheumatology Advances in Practice', 'original-title': [], 'language': 'en', 'link': [ { 'URL': 'https://academic.oup.com/rheumap/advance-article-pdf/doi/10.1093/rap/rkad025/49350397/rkad025.pdf', 'content-type': 'application/pdf', 'content-version': 'am', 'intended-application': 'syndication'}, { 'URL': 'https://academic.oup.com/rheumap/article-pdf/7/1/rkad025/49457343/rkad025.pdf', 'content-type': 'application/pdf', 'content-version': 'vor', 'intended-application': 'syndication'}, { 'URL': 'https://academic.oup.com/rheumap/article-pdf/7/1/rkad025/49457343/rkad025.pdf', 'content-type': 'unspecified', 'content-version': 'vor', 'intended-application': 'similarity-checking'}], 'deposited': { 'date-parts': [[2023, 3, 26]], 'date-time': '2023-03-26T20:42:03Z', 'timestamp': 1679863323000}, 'score': 1, 'resource': { 'primary': { 'URL': 'https://academic.oup.com/rheumap/article/doi/10.1093/rap/rkad025/7059537'}}, 'subtitle': [], 'short-title': [], 'issued': {'date-parts': [[2022, 12, 30]]}, 'references-count': 36, 'journal-issue': {'issue': '1', 'published-print': {'date-parts': [[2022, 12, 30]]}}, 'URL': 'http://dx.doi.org/10.1093/rap/rkad025', 'relation': {}, 'ISSN': ['2514-1775'], 'subject': ['Rheumatology'], 'published-other': {'date-parts': [[2023, 1, 1]]}, 'published': {'date-parts': [[2022, 12, 30]]}}
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Please send us corrections, updates, or comments. c19early involves the extraction of 100,000+ datapoints from thousands of papers. Community updates help ensure high accuracy. Treatments and other interventions are complementary. All practical, effective, and safe means should be used based on risk/benefit analysis. No treatment or intervention is 100% available and effective for all current and future variants. We do not provide medical advice. Before taking any medication, consult a qualified physician who can provide personalized advice and details of risks and benefits based on your medical history and situation. FLCCC and WCH provide treatment protocols.
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