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Prognostic factors for the severity of SARS-CoV-2 infection

Rubio-Sánchez et al., Advances in Laboratory Medicine / Avances en Medicina de Laboratorio, doi:10.1515/almed-2021-0017
Mar 2021  
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Severe case 40% Improvement Relative Risk HCQ for COVID-19  Rubio-Sánchez et al.  LATE TREATMENT Is late treatment with HCQ beneficial for COVID-19? Retrospective 197 patients in Spain (March - June 2020) Lower severe cases with HCQ (p=0.021) c19hcq.org Rubio-Sánchez et al., Advances in Labo.., Mar 2021 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 197 hospitalized COVID-19 patients in Spain, showing lower progression to pneumonia with HCQ in unadjusted results.
This study is excluded in the after exclusion results of meta analysis: unadjusted results with no group details.
risk of severe case, 40.0% lower, RR 0.60, p = 0.02, treatment 51 of 161 (31.7%), control 19 of 36 (52.8%), NNT 4.7.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Rubio-Sánchez et al., 3 Mar 2021, retrospective, Spain, peer-reviewed, 3 authors, study period 14 March, 2020 - 5 June, 2020. Contact: ricrubsan@gmail.com.
This PaperHCQAll
Prognostic factors for the severity of SARS-CoV-2 infection
Ricardo Rubio-Sánchez, Esperanza Lepe-Balsalobre, María Del Mar Viloria-Peñas
Advances in Laboratory Medicine / Avances en Medicina de Laboratorio, doi:10.1515/almed-2021-0017
Objectives: Severe acute respiratory syndrome coronavirus (SARS-CoV-2) is a novel coronavirus that causes COVID-19. This disease is associated with leukocytosis with lymphopenia, neutrophilia, and elevated levels of D-dimer, and C-reactive protein, ferritin, procalcitonin, and lactate dehydrogenase. The aim of this study was to describe the clinical and analytical characteristics of hospitalized patients with SARS-CoV-2 infection and to identify prognostic factors of disease progression. Methods: Patients were categorized into two groups based on COVID-19 severity. Study variables included demographic data, medical history, length of hospital stay, course of pneumonia, drug therapy, and analytical parameters. A descriptive and multivariate analysis was performed to identify prognostic factors for disease severity. Results: The study population included 197 patients, of whom 127 had mild disease and 70 had severe COVID-19. Statistically significant differences were observed in most analytical parameters. The parameters included in the multivariate analysis were advanced age and elevated levels of leukocytes, CRP, GGT, and PCT at admission as prognostic factors for disease severity. Conclusions: The prognostic factors for the severity of SARS-CoV-2 infection identified in this study (age, leukocytes, CRP, GGT, and PCT) will help predict the course of the disease at an early stage.
References
Azkur, Akdis, Azkur, Sokolowska, Van De Veen et al., Immune response to SARS-CoV-2 and mechanisms of immunopathological changes in COVID-19, Allergy
Chen, Wu, Guo, Cao, Huang et al., Clinical and immunologic features in severe and moderate coronavirus disease, J Clin Invest
Feng, Zheng, Yan, Rios, Targher et al., COVID-19 and liver dysfunction: current insights and emergent therapeutic strategies, J Clin Transl Hepatol
Galli, Plebani, Clinical laboratory and SARS-CoV-2 infection: where do we stand?, Clin Chem Lab Med
Henry, Santos, Benoit, Plebani, Lippi, Hematologic, biochemical and immune biomarker abnormalities associated with severe illness and mortality in coronavirus disease 2019 (COVID-19): a meta-analysis, Clin Chem Lab Med
Hou, Zhang, Liang, Xu, Hu, Risk factors for disease progression in hospitalized patients with COVID-19: a retrospective cohort study, Inf Dis, doi:10.1080/23744235.2020.1759817
Huang, Wang, Li, Ren, Zhao et al., Clinical features of patients infected with 2019 novel coronavirus in Wuhan, Lancet
Ji, Zhang, Xu, Chen, Yang et al., Prediction for progression risk in patients with COVID-19 pneumonia: the CALL score, Clin Infect Dis
Jin, Cai, Cheng, Cheng, Deng et al., A rapid advice guideline for the diagnosis and treatment of 2019 novel coronavirus (2019-nCoV) infected pneumonia, Mil Med Res
Kumar -Mp, Mishra, Jha, Shukla, Choudhury et al., Coronavirus disease (COVID-19) and the liver: a comprehensive systematic review and meta-analysis, Hepatol Int
Note, The original article can be found here, doi:10.1515/almed-2020-0069
Sarzi-Puttini, Sirotti, Marotto, Ardizzone, Rizzardini, COVID-19, cytokines and immunosuppression: what can we learn from severe acute respiratory syndrome?, Clin Exp Rheumatol
Shi, Yu, Zhao, Wang, Zhao et al., Host susceptibility to severe COVID-19 and establishment of a host risk score: findings of 487 cases outside Wuhan, Crit Care
Sun, Ning, Tao, Yu, Deng et al., Risk factors for mortality in 244 older adults with COVID-19 in Wuhan, China: a retrospective study, J Am Geriatr Soc
Wu, Li, Guo, Yoshida, Méndez-Sánchez et al., Incidence, risk factors, and prognosis of abnormal liver biochemical tests in COVID-19 patients: a systematic review and meta-analysis, Hepatol Int, doi:10.1007/s12072-020-10074-6
Zhang, Zhang, Wang, Zhu, Wang et al., Analysis of clinical characteristics and laboratory findings of 95 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a retrospective analysis, Respir Res
Zhou, Yu, Du, Fan, Liu et al., Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study, Lancet
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This disease is associated with leukocytosis with ' 'lymphopenia, neutrophilia, and elevated levels of <jats:sc>d</jats:sc>-dimer, and C-reactive ' 'protein, ferritin, procalcitonin, and lactate dehydrogenase. The aim of this study was to ' 'describe the clinical and analytical characteristics of hospitalized patients with SARS-CoV-2 ' 'infection and to identify prognostic factors of disease progression.</jats:p>\n' ' </jats:sec>\n' ' <jats:sec id="j_almed-2021-0017_abs_002">\n' ' <jats:title>Methods</jats:title>\n' ' <jats:p>Patients were categorized into two groups based on COVID-19 ' 'severity. Study variables included demographic data, medical history, length of hospital ' 'stay, course of pneumonia, drug therapy, and analytical parameters. 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' 'https://doi.org/10.14218/jcth.2020.00018.', 'DOI': '10.14218/JCTH.2020.00018'}, { 'key': '2023062110051876159_j_almed-2021-0017_ref_015', 'doi-asserted-by': 'crossref', 'unstructured': 'Wu, Y, Li, H, Guo, X, Yoshida, EM, Méndez-Sánchez, N, Levi, GB, et al.. ' 'Incidence, risk factors, and prognosis of abnormal liver biochemical ' 'tests in COVID-19 patients: a systematic review and meta-analysis. ' 'Hepatol Int 2020:1–17. https://doi.org/10.1007/s12072-020-10074-6.', 'DOI': '10.1007/s12072-020-10074-6'}, { 'key': '2023062110051876159_j_almed-2021-0017_ref_016', 'doi-asserted-by': 'crossref', 'unstructured': 'Kumar, -MP, Mishra, S, Jha, DK, Shukla, J, Choudhury, A, Mohindra, R, et ' 'al.. Coronavirus disease (COVID-19) and the liver: a comprehensive ' 'systematic review and meta-analysis. Hepatol Int 2020;14:711–22. 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Late treatment
is less effective
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