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0 0.5 1 1.5 2+ 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) Mathew et al., Rheumatology Advances i.., Feb 2023 Favors HCQ Favors control

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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HCQ for COVID-19
1st treatment shown to reduce risk in March 2020
*, now known with p < 0.00000000001 from 421 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.
3,800+ studies for 60+ treatments.
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 24% lower mortality [20‑29%] from meta analysis of the 249 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
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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