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0 0.5 1 1.5 2+ Mortality 29% Improvement Relative Risk Osawa et al. HCQ for COVID-19 VENTILATED PATIENTS Is late treatment with HCQ beneficial for COVID-19? Retrospective 215 patients in Brazil (March - October 2020) Lower mortality with HCQ (not stat. sig., p=0.07) Osawa et al., The J. Critical Care Medicine, doi:10.2478/jccm-2022-0015 Favors HCQ Favors control
Characteristics and risk factors for mortality in critically ill patients with COVID-19 receiving invasive mechanical ventilation: the experience of a private network in Sao Paulo, Brazil
Osawa et al., The Journal of Critical Care Medicine, doi:10.2478/jccm-2022-0015
Osawa et al., Characteristics and risk factors for mortality in critically ill patients with COVID-19 receiving invasive.., The Journal of Critical Care Medicine, doi:10.2478/jccm-2022-0015
Jul 2022   Source   PDF  
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Retrospective 215 mechanically ventilated COVID-19 patients in Brazil, 71 treated with HCQ, showing lower mortality with treatment in unadjusted results, without statistical significance. Authors note HCQ was used more toward the start of the pandemic, which may introduce confounding due to overall protocols improving over time, suggesting that the actual benefit may be greater.
Although the 29% lower mortality is not statistically significant, it is consistent with the significant 22% lower mortality [18‑27%] from meta analysis of the 232 mortality results to date.
risk of death, 28.6% lower, RR 0.71, p = 0.07, treatment 25 of 71 (35.2%), control 71 of 144 (49.3%), NNT 7.1.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Osawa et al., 1 Jul 2022, retrospective, Brazil, peer-reviewed, mean age 62.7, 2 authors, study period 18 March, 2020 - 26 October, 2020.
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Abstract: The Journal of Critical Care Medicine 2022;8(3):165-175 RESEARCH ARTICLE DOI: 10.2478/jccm-2022-0015 Characteristics and risk factors for mortality in critically ill patients with COVID-19 receiving invasive mechanical ventilation: the experience of a private network in Sao Paulo, Brazil Eduardo Atsushi Osawa*, Alexandre Toledo Maciel Imed Group, Research Department, Sao Paulo, Brazil; Adult Intensive Care Unit, São Camilo Hospital, Brazil Abstract Introduction: The use of invasive mechanical ventilation (IMV) in COVID-19 represents in an incremental burden to healthcare systems. Aim of the study: We aimed to characterize patients hospitalized for COVID-19 who received IMV and identify risk factors for mortality in this population. Material and Methods: A retrospective cohort study including consecutive adult patients admitted to a private network in Brazil who received IMV from March to October, 2020. A bidirectional stepwise logistic regression analysis was used to determine the risk factors for mortality. Results: We included 215 patients, of which 96 died and 119 were discharged from ICU. The mean age was 62.7 ± 15.4 years and the most important comorbidities were hypertension (62.8%), obesity (50.7%) and diabetes (40%). Non-survivors had lower body mass index (BMI) (28.3 [25.5; 31.6] vs. 31.2 [28.3; 35], p<0.001, and a shorter duration from symptom onset to intubation (8.5 [6.0; 12] days vs. 10 [8.0; 12.5] days, p = 0.005). Multivariable regression analysis showed that the risk factors for mortality were age (OR: 1.07, 95% CI: 1.03 to 1.1, p < 0.001), creatinine level at the intubation date (OR: 3.28, 95% CI: 1.47 to 7.33, p = 0.004), BMI (OR: 0.91, 95% CI: 0.84 to 0.99, p = 0.033), lowest PF ratio within 48 hours post-intubation (OR: 0.988, 95% CI: 0.979 to 0.997, p = 0.011), barotrauma (OR: 5.18, 95% CI: 1.14 to 23.65, p = 0.034) and duration from symptom onset to intubation (OR: 0.76, 95% CI: 0.76 to 0.95, p = 0.006). Conclusion: In our retrospective cohort we identified the main risk factors for mortality in COVID-19 patients receiving IMV: age, creatinine at the day of intubation, BMI, lowest PF ratio 48-hours post-intubation, barotrauma and duration from symptom onset to intubation. Keywords: coronavirus, COVID-19, mortality, mechanical ventilation, body mass index, barotrauma Received: 12 December 2021 / Accepted: 12 June 2022 „Introduction „ The coronavirus disease [COVID-19] was first reported in Wuhan, China and spread rapidly across the globe causing millions of deaths worldwide. Patients hospitalized for COVID-19 are at high risk of developing acute respiratory failure and receiving invasive mechanical ventilation [IMV]. In an effort to understand a novel disease and gain knowledge from other centres, multiple epidemiological cohorts have been carried out in different settings. Nevertheless, a striking variability in the mortality rates were reported among those requiring mechanical ventilation [1, 2]. The understanding of which factors are associated with greater mortality in COVID-19 patients receiv* ing mechanical ventilation would enable clinicians to perform better treatment decisions to mitigate the progression of a severe illness. Previously, studies assessing COVID-19 mortality did not incorporate variables specific to intensive care or were restricted to a nongeneralizable population [3, 4]. Moreover, the majority of studies aiming to evaluate mortality in COVID-19 patients addressed this issue in a larger..
Late treatment
is less effective
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