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0 0.5 1 1.5 2+ Mortality 67% Improvement Relative Risk ICU admission -6% HCQ  Ramírez-García et al.  LATE TREATMENT Is late treatment with HCQ beneficial for COVID-19? Retrospective 403 patients in Spain Lower mortality with HCQ (p=0.0000062) Ramírez-García et al., Archivos de Med.., May 2021 Favors HCQ Favors control

Hydroxychloroquine and Tocilizumab in the Treatment of COVID-19: A Longitudinal Observational Study

Ramírez-García et al., Archivos de Medicina Universitaria
May 2021  
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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.
Retrospective 403 hospitalized patients in Spain, showing lower mortality with treatment, however authors do not adjust for the differences between the groups. Confounding by indication is likely.
This study is excluded in the after exclusion results of meta analysis: excessive unadjusted differences between groups; substantial unadjusted confounding by indication likely.
risk of death, 67.0% lower, RR 0.33, p < 0.001, treatment 48 of 350 (13.7%), control 22 of 53 (41.5%), NNT 3.6.
risk of ICU admission, 6.0% higher, RR 1.06, p = 1.00, treatment 35 of 350 (10.0%), control 5 of 53 (9.4%).
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Ramírez-García et al., 31 May 2021, retrospective, Spain, peer-reviewed, 5 authors.
This PaperHCQAll
Hydroxychloroquine and Tocilizumab in the Treatment of COVID-19: A Longitudinal Observational Study
Asensi -Gómez, ; Carbajo-García, ; Cobano-Jiménez, Juan Luis, ; Lenker-Andrade, ; Vázquez- Delgado, ; Vivas-Del-Torno, ; García-Molina, ; Flor-Cremades, María Consuelo, ; Muñoz-Rojas, ; Moleón-Moya
Objectives The objective of this study is to evaluate the use of hydroxychloroquine and tocilizumab at the beginning of the COVID-19 pandemic and to describe the profile of patients who received these treatments. Method The medical records of 403 patients admitted for COVID-19 from March 1 to April 15, 2020 at the San Cecilio University Hospital (Granada, Spain) were analyzed. The data collected included sex, age, days hospitalized, previous pathologies and/or treatments, possible outcomes and drugs administered at the hospital. Student's t-test and Pearson's chi-square tests were used as statistical parameters to estimate the possible associations between the defined variables. Results Patients with a mean age of 66 years (standard deviation = 15.38), were hospitalized for an average of 15 days (standard deviation = 12.89). The ICU admission rate was 9.93 %, and the death rate added up to 17.37 % of the total number of patients. During the first wave of the pandemic, hydroxychloroquine was administered to the majority of hospitalized patients, while tocilizumab was restricted to the more severe cases. Conclusions The results showed two distinct trends in the use of the drugs studied. Tocilizumab was administered to a small number of patients, mainly those with longer length of stay or with complications. Hydroxychloroquine was administered independently of the initial characteristics of patients, especially those who presented comorbidities or took multiple medications.
Conflicts of interest The authors of this paper declare no conflicts of interest.
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Late treatment
is less effective
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