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Hydroxychloroquine shortened hospital stay and reduced intensive care unit admissions in hospitalized COVID-19 patients

Omma et al., The Journal of Infection in Developing Countries, doi:10.3855/jidc.14933
Jan 2022  
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Mortality 28% Improvement Relative Risk ICU admission 50% Hospitalization time 17% HCQ for COVID-19  Omma et al.  LATE TREATMENT Is late treatment with HCQ beneficial for COVID-19? Retrospective 393 patients in Turkey (April - December 2020) Lower ICU admission (p=0.0036) and shorter hospitalization (p=0.007) c19hcq.org Omma et al., The J. Infection in Devel.., Jan 2022 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 419 studies, recognized in 46 countries.
No treatment is 100% effective. Protocols combine treatments.
5,100+ studies for 109 treatments. c19hcq.org
Retrospective 393 hospitalized COVID-19 patients in Turkey, showing lower ICU admission and shorter hospitalization time with HCQ. There was no significant difference for mortality. Severity was higher in the HCQ group with greater baseline ventilation, high flow oxygen, fever, and dyspnea.
risk of death, 28.2% lower, RR 0.72, p = 0.30, treatment 17 of 213 (8.0%), control 20 of 180 (11.1%), NNT 32.
risk of ICU admission, 50.2% lower, RR 0.50, p = 0.004, treatment 23 of 213 (10.8%), control 39 of 180 (21.7%), NNT 9.2.
hospitalization time, 16.7% lower, relative time 0.83, p = 0.007, treatment 213, control 180.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Omma et al., 31 Jan 2022, retrospective, Turkey, peer-reviewed, 11 authors, study period 1 April, 2020 - 31 December, 2020.
This PaperHCQAll
Hydroxychloroquine shortened hospital stay and reduced intensive care unit admissions in hospitalized COVID-19 patients
Ahmet Omma, Abdulsamet Erden, MD Hakan Apaydin, Meryem Aslan, Hüseyin Çamlı, Enes Seyda Şahiner, Serdar Can Güven, Berkan Armağan, Selma Karaahmetoğlu, Ihsan Ates, Orhan Kucuksahin
The Journal of Infection in Developing Countries, doi:10.3855/jidc.14933
Introduction: Effectiveness of hydroxychloroquine against SARS-CoV-2 has been highly controversial. In our research, we aimed to investigate the effects of hydroxychloroquine on disease outcomes in hospitalized patients with COVID-19. Methodology: A total of 393 hospitalized patients with COVID-19 were retrospectively assigned to the standard of care therapy group (n = 180) or the standard of care plus hydroxychloroquine group (n = 213). The standard of care therapy comprised favipiravir, low molecular weight heparin, acetylsalicylic acid. Status of oxygenation at baseline and on the seventh day, laboratory tests at baseline and at discharge were recorded. Length of hospital stay, administration of anti-inflammatory treatment, admission to the intensive care unit and 28th day mortality were set as primary endpoints. Results: There were no statistically significant differences between groups in terms of oxygen delivery route and mortality after seven days of treatment (p = 0.592). C-reactive protein levels of the standard of care plus hydroxychloroquine group were significantly lower than that of the standard of care group at discharge (p = 0.034). Patients in the standard of care plus hydroxychloroquine group had shorter hospital stay (p = 0.007). The standard of care plus hydroxychloroquine group was favored over standard of care group in terms of rate of intensive care unit admissions (21.7% vs. 10.8%; relative risk with 95% CI = 0.49 [0.31-0.80], p = 0.003). Conclusions: Hydroxychloroquine in addition to standard of care was associated with less intensive care unit admissions, early discharge and greater C-reactive protein reduction. There was no difference in 28-day mortality.
Conflict of interests: No conflict of interests is declared.
References
Abd-Elsalam, Esmail, Khalaf, Abdo, Medhat et al., Hydroxychloroquine in the treatment of COVID-19: a multicenter randomized controlled study, Am J Trop Med Hyg
Arshad, Kilgore, Chaudhry, Jacobsen, Wang et al., COVID-19 Task Force (2020) Treatment with hydroxychloroquine, azithromycin, and combination in patients hospitalized with COVID-19, Int J Infect Dis
Borba, Val, Sampaio, Alexandre, Melo et al., ) infection: preliminary safety results of a randomized, double-blinded, phase IIb clinical trial (CloroCovid-19 Study)
Catteau, Dauby, Montourcy, Bottieau, Hautekiet et al., Belgian Collaborative Group on COVID-19 Hospital Surveillance (2020) Low-dose hydroxychloroquine therapy and mortality in hospitalised patients with COVID-19: a nationwide observational study of 8075 participants, Int J Antimicrob Agents
Chandrashekara, Jaladhar, Paramshetti, Ramachandran, Nizar et al., Post COVID inflammation syndrome: different manifestations caused by the virus, J Assoc Physicians India
Chen, Hu, Zhang, Efficacy of hydroxychloroquine in patients with COVID-19: results of a randomized clinical trial, MedRxiv preprint
Geleris, Sun, Platt, Zucker, Baldwin et al., Observational study of hydroxychloroquine in hospitalized patients with Covid-19, N Engl J Med
Guner, Hasanoglu, Kayaaslan, Aypak, Akinci et al., Comparing ICU admission rates of mild/moderate COVID-19 patients treated with hydroxychloroquine, favipiravir, and hydroxychloroquine plus favipiravir, J Infect Public Health
Jang, Choi, Byun, Jue, Chloroquine inhibits production of TNF-α, IL-1β and IL-6 from lipopolysaccharide-stimulated human monocytes/macrophages by different modes, Rheumatology
Nuri, Taraborelli, Andreoli, Tonello, Gerosa et al., Long-term use of hydroxychloroquine reduces antiphospholipid antibodies levels in patients with primary antiphospholipid syndrome, Immunol Res
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Schrezenmeier, Dörner, Mechanisms of action of hydroxychloroquine and chloroquine: implications for rheumatology, Nat Rev Rheumatol
Sheahan, Morrison, Funkhouser, Uematsu, Akira et al., MyD88 is required for protection from lethal infection with a mouse-adapted SARS-CoV, PLoS Pathog
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Yao, Ye, Zhang, Cui, Huang et al., In vitro antiviral activity and projection of optimized dosing design of hydroxychloroquine for the treatment of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), Clin Infect Dis
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Late treatment
is less effective
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