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All Studies   Meta Analysis    Recent:   
0 0.5 1 1.5 2+ Mortality 29% Improvement Relative Risk HCQ for COVID-19  Osawa et al.  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) c19hcq.org Osawa et al., The J. Critical Care Med.., Jul 2022 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
Jul 2022  
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HCQ for COVID-19
1st treatment shown to reduce risk in March 2020
 
*, now known with p < 0.00000000001 from 422 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.
4,000+ studies for 60+ treatments. c19hcq.org
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 25% lower mortality [20‑29%] from meta analysis of the 250 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. Contact: eduardo.osawa@imedgroup.com.br.
This PaperHCQAll
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
The Journal of Critical Care Medicine, doi:10.2478/jccm-2022-0015
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.
Conflict of interest None to declare.
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Late treatment
is less effective
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