Analgesics
Antiandrogens
Antihistamines
Azvudine
Bromhexine
Budesonide
Colchicine
Conv. Plasma
Curcumin
Famotidine
Favipiravir
Fluvoxamine
Hydroxychlor..
Ivermectin
Lifestyle
Melatonin
Metformin
Minerals
Molnupiravir
Monoclonals
Naso/orophar..
Nigella Sativa
Nitazoxanide
PPIs
Paxlovid
Quercetin
Remdesivir
Thermotherapy
Vitamins
More

Other
Feedback
Home
Top
Results
Abstract
All HCQ studies
Meta analysis
 
Feedback
Home
next
study
previous
study
c19hcq.org COVID-19 treatment researchHCQHCQ (more..)
Melatonin Meta
Metformin Meta
Antihistamines Meta
Azvudine Meta Molnupiravir Meta
Bromhexine Meta
Budesonide Meta
Colchicine Meta Nigella Sativa Meta
Conv. Plasma Meta Nitazoxanide Meta
Curcumin Meta PPIs Meta
Famotidine Meta Paxlovid Meta
Favipiravir Meta Quercetin Meta
Fluvoxamine Meta Remdesivir Meta
Hydroxychlor.. Meta Thermotherapy Meta
Ivermectin Meta

All Studies   Meta Analysis       

Clinical Characteristics, Prognostic Factors, and Outcomes of COVID-19 in Autoimmune Rheumatic Disease Patients: A Retrospective Case–Control Study from Astana, Kazakhstan

Rutskaya-Moroshan et al., Medicina, doi:10.3390/medicina60091377
Aug 2024  
  Post
  Facebook
Share
  Source   PDF   All Studies   Meta AnalysisMeta
Severe case 38% Improvement Relative Risk Hospitalization 24% HCQ  Rutskaya-Moroshan et al.  Prophylaxis Is pre-exposure prophylaxis with HCQ beneficial for COVID-19? Retrospective 140 patients in Kazakhstan (January 2022 - July 2023) Study underpowered to detect differences c19hcq.org Rutskaya-Moroshan et al., Medicina, Aug 2024 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 418 studies, recognized in 46 countries.
No treatment is 100% effective. Protocols combine treatments.
5,000+ studies for 104 treatments. c19hcq.org
Retrospective case-control study of 140 COVID-19 patients with autoimmune rheumatic diseases (AIRDs) and 140 matched controls showing higher rates of hospitalization, oxygen therapy, and mechanical ventilation with AIRDs. For the AIRD patients, there was no significant difference in outcomes based on HCQ use (only 10 patients).
This study is excluded in the after exclusion results of meta analysis: unadjusted results with no group details.
risk of severe case, 38.1% lower, RR 0.62, p = 1.00, treatment 1 of 10 (10.0%), control 21 of 130 (16.2%), NNT 16.
risk of hospitalization, 23.5% lower, RR 0.76, p = 1.00, treatment 2 of 10 (20.0%), control 34 of 130 (26.2%), NNT 16.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Rutskaya-Moroshan et al., 23 Aug 2024, retrospective, Kazakhstan, peer-reviewed, mean age 56.1, 6 authors, study period January 2022 - July 2023. Contact: saule_tabisheva@mail.ru (corresponding author), rutskayakristina@gmail.com, aanelim@bk.ru, zhadra_82@mail.ru, tatyanavinnik15@gmail.com, tansholpan.batyrkhan@gmail.com.
This PaperHCQAll
Clinical Characteristics, Prognostic Factors, and Outcomes of COVID-19 in Autoimmune Rheumatic Disease Patients: A Retrospective Case–Control Study from Astana, Kazakhstan
Kristina Rutskaya-Moroshan, Saule Abisheva, Anilim Abisheva, Zhadra Amangeldiyeva, Tatyana Vinnik, Tansholpan Batyrkhan
Medicina, doi:10.3390/medicina60091377
Background: Viral infections, including coronavirus disease 2019 (COVID-19), in patients with autoimmune rheumatic diseases (AIRDs) tend to present more severe disease. This study aims to investigate the clinical characteristics and risk factors for severe infection in rheumatologic patients. Methods: We included patients with a diagnosis of AIRD and COVID-19 infection between January 2022 and July 2023. Patients with AIRDs infected with SARS-CoV-2 were matched with control patients of the general population according to age (±5 years) and sex in a 1:1 ratio. Confirmed infection was defined if a patient had a positive polymerase chain reaction (PCR) test. The severity was divided into mild, moderate, severe, and critical according to the guidelines of the United States National Institutes of Health (NIH). Results: A total of 140 individuals (37 males, 103 females; mean age 56.1 ± 11.3 years) with rheumatic disease diagnosed with COVID-19 infection were enrolled in the study. AIRDs included rheumatoid arthritis (RA) (n = 63, 45%), ankylosing spondylitis (AS) (n = 35, 25%), systemic lupus erythematosus (SLE) (n = 26, 8.6%), and systemic sclerosis (SSc) (n = 16, 11.4%). The AIRDs group had more SARS-CoV-2-related dyspnea (38.6%), arthralgia (45.7%), and depression (27.1%) than the control group (p = 0.004). The rate of lung infiltration on radiographic examination was higher in 58 (41.4%, p = 0.005) patients with rheumatic diseases than in those without them. Severe SARS-CoV-2 infection was more common in the AIRDs group than in the control group (22% vs. 12%; p = 0.043). Conclusions: Patients with AIRDs experienced more symptoms of arthralgia, depression, and dyspnea. There was a trend towards an increased severity of the disease in patients with AIRDs. Patients with arterial hypertension, diabetes, chronic lung, and kidney disease, treated with corticosteroids, had a longer duration, and high activity of autoimmune disease had an increased risk of severe COVID-19.
Conflicts of Interest: The authors declare no conflicts of interest.
References
Amigues, Pearlman, Patel, Reid, Robinson et al., Coronavirus Disease 2019: Investigational Therapies in the Prevention and Treatment of Hyperinflammation, Expert. Rev. Clin. Immunol, doi:10.1080/1744666X.2021.1847084
Balakrishnan, COVID-19 response in central Asia, Lancet Microbe, doi:10.1016/S2666-5247(20)30177-4
Battakova, Imasheva, Slazhneva, Imashev, Beloussov et al., Public Health Response Measures for COVID-19 in Kazakhstan, Disaster Med. Public Health Prep, doi:10.1017/dmp.2023.181
Briquez, Rouhani, Yu, Pyzer, Trujillo et al., Severe COVID-19 induces autoantibodies against angiotensin II that correlate with blood pressure dysregulation and disease severity, Sci. Adv, doi:10.1126/sciadv.abn3777
Bruce, Fries, Murtagh, Health status disparities in ethnic minority patients with rheumatoid arthritis: A cross-sectional study, J. Rheumatol
Conway, Grimshaw, Konig, Putman, Duarte-García et al., SARS-CoV-2 Infection and COVID-19 Outcomes in Rheumatic Diseases: A Systematic Literature Review and Meta-Analysis, Arthritis Rheumatol, doi:10.1002/art.42030
Cordtz, Lindhardsen, Soussi, Vela, Uhrenholt et al., Incidence and Severeness of COVID-19 Hospitalisation in Patients with Inflammatory Rheumatic Disease: A Nationwide Cohort Study from Denmark, Rheumatology, doi:10.1093/rheumatology/keaa897
Dadras, Afsahi, Pashaei, Mojdeganlou, Karimi et al., The relationship between COVID-19 viral load and disease severity: A systematic review, Immun. Inflamm. Dis, doi:10.1002/iid3.580
Fleiss, Statistical Methods for Rates and Proportions, Formulas
Flook, Jackson, Vasileiou, Simpson, Muckian et al., Informing the public health response to COVID-19: A systematic review of risk factors for disease, severity, and mortality, BMC Infect. Dis, doi:10.1186/s12879-021-05992-1
Fonseca, Filgueiras, Marques, Vojdani, Halpert et al., Severe COVID-19 patients exhibit elevated levels of autoantibodies targeting cardiolipin and platelet glycoprotein with age: A systems biology approach, NPJ Aging, doi:10.1038/s41514-023-00118-0
Gao, Ding, Dong, Zhang, Kursat Azkur et al., Risk Factors for Severe and Critically Ill COVID-19 Patients: A Review, Allergy, doi:10.1111/all.14657
Gastelum-Strozzi, Pascual, Hernández-Garduño, Moctezuma-Rios, Guaracha-Basañez et al., Perception of risk and impact of the COVID-19 pandemic on patients with rheumatic diseases: A case-control study, Clin. Rheumatol, doi:10.1007/s10067-022-06257-1
Gianfrancesco, Hyrich, Al-Adely, Carmona, Danila et al., Characteristics Associated with Hospitalisation for COVID-19 in People with Rheumatic Disease: Data from the COVID-19 Global Rheumatology Alliance Physician-Reported Registry, Ann. Rheum. Dis, doi:10.1136/annrheumdis-2020-217871
Gianfrancesco, Leykina, Izadi, Taylor, Sparks et al., Association of Race and Ethnicity With COVID-19 Outcomes in Rheumatic Disease: Data From the COVID-19 Global Rheumatology Alliance Physician Registry, Arthritis Rheumatol, doi:10.1002/art.41567
Greenberg, Spruill, Shan, Reed, Kremer et al., Racial and ethnic disparities in disease activity in patients with rheumatoid arthritis, Am. J. Med, doi:10.1016/j.amjmed.2013.09.002
Group; Horby, Lim, Emberson, Mafham, Bell et al., Dexamethasone in Hospitalized Patients with COVID-19, N. Engl. J. Med
Haberman, Castillo, Chen, Yan, Ramirez et al., COVID-19 in Patients With Inflammatory Arthritis: A Prospective Study on the Effects of Comorbidities and Disease-Modifying Antirheumatic Drugs on Clinical Outcomes, Arthritis Rheumatol, doi:10.1002/art.41456
Hamming, Timens, Bulthuis, Lely, Navis et al., Tissue distribution of ACE2 protein, the functional receptor for SARS coronavirus. A first step in understanding SARS pathogenesis, J. Pathol, doi:10.1002/path.1570
Horwitz, Fahmy, Piccirillo, La Cava, Rebalancing Immune Homeostasis to Treat Autoimmune Diseases, Trends Immunol, doi:10.1016/j.it.2019.08.003
Jones, Faruqi, Sullivan, Calabrese, Calabrese, COVID-19 Outcomes in Patients Undergoing B Cell Depletion Therapy and Those with Humoral Immunodeficiency States: A Scoping Review, Pathog. Immun, doi:10.20411/pai.v6i1.435
Kastritis, Kitas, Vassilopoulos, Giannopoulos, Dimopoulos et al., Systemic Autoimmune Diseases, Anti-Rheumatic Therapies, COVID-19 Infection Risk and Patient Outcomes, Rheumatol. Int, doi:10.1007/s00296-020-04629-x
Kelsey, Evans, Alice, Methods in Observational Epidemiology
Kokkotis, Kitsou, Xynogalas, Spoulou, Magiorkinis et al., Systematic Review with Meta-Analysis: COVID-19 Outcomes in Patients Receiving Anti-TNF Treatments, Aliment. Pharmacol. Ther, doi:10.1111/apt.16717
Lassale, Gaye, Hamer, Gale, Batty, Ethnic disparities in hospitalisation for COVID-19 in England: The role of socioeconomic factors, mental health, and inflammatory and pro-inflammatory factors in a community-based cohort study, Brain Behav. Immun, doi:10.1016/j.bbi.2020.05.074
Leipe, Wilke, Ebert, Teufel, Reindl et al., Relapsing, and Atypical Symptomatic Course of COVID-19 in a B-Cell-Depleted Patient after Rituximab, Semin. Arthritis Rheum, doi:10.1016/j.semarthrit.2020.06.013
Li, Huang, Zou, Yang, Hui et al., Epidemiology of COVID-19: A systematic review and meta-analysis of clinical characteristics, risk factors, and outcomes, J. Med. Virol, doi:10.1002/jmv.26424
Liu, Gao, Zhang, Shi, Chen et al., The association between severe or dead COVID-19 and autoimmune diseases: A systematic review and meta analysis, J. Infect, doi:10.1016/j.jinf.2020.05.065
Loarce-Martos, García-Fernández, López-Gutiérrez, García-García, Calvo-Sanz et al., High Rates of Severe Disease and Death Due to SARS-CoV-2 Infection in Rheumatic Disease Patients Treated with Rituximab: A Descriptive Study, Rheumatol. Int, doi:10.1007/s00296-020-04699-x
Lu, Chen, Ho, Wang, Autoimmune inflammatory rheumatic diseases and COVID-19 outcomes in South Korea: A nationwide cohort study, Lancet Rheumatol, doi:10.1016/S2665-9913(21)00151-X
Maddur, Vani, Lacroix-Desmazes, Kaveri, Bayry, Autoimmunity as a Predisposition for Infectious Diseases, PLoS Pathog, doi:10.1371/journal.ppat.1001077
Mahendra, Nuchin, Kumar, Shreedhar, Mahesh, Predictors of mortality in patients with severe COVID-19 pneumonia-A retrospective study, Adv. Respir. Med, doi:10.5603/arm.a2021.0036
Mckeigue, Porter, Hollick, Ralston, Mcallister et al., Risk of Severe COVID-19 in Patients with Inflammatory Rheumatic Diseases Treated with Immunosuppressive Therapy in Scotland, Scand. J. Rheumatol, doi:10.1080/03009742.2022.2063376
Mikuls, Johnson, Fraenkel, Arasaratnam, Baden et al., American College of Rheumatology Guidance for the Management of Rheumatic Disease in Adult Patients During the COVID-19 Pandemic: Version 2, Arthritis Rheumatol, doi:10.1002/art.41437
Mukusheva, Assylbekova, Poddighe, Management of pediatric rheumatic patients in Kazakhstan during the coronavirus disease 2019 (COVID-19) pandemic, Rheumatol. Int, doi:10.1007/s00296-020-04613-5
Nas, Güçlü, Keskin, Dilek, Kalçık Unan et al., Clinical Course and Prognostic Factors of COVID-19 Infection in Patients with Chronic Inflammatory-Rheumatic Disease: A Retrospective, Case-Control Study, Arch. Rheumatol, doi:10.46497/ArchRheumatol.2023.9289
Pablos, Galindo, Carmona, Lledó, Retuerto et al., Clinical Outcomes of Hospitalised Patients with COVID-19 and Chronic Inflammatory and Autoimmune Rheumatic Diseases: A Multicentric Matched Cohort Study, Ann. Rheum. Dis, doi:10.1136/annrheumdis-2020-218296
Pijls, Jolani, Atherley, Derckx, Dijkstra et al., Demographic risk factors for COVID-19 infection, severity, ICU admission and death: A meta-analysis of 59 studies, BMJ Open, doi:10.1136/bmjopen-2020-044640
Robinson, Morand, Divergent Effects of Acute versus Chronic Glucocorticoids in COVID-19, Lancet Rheumatol, doi:10.1016/S2665-9913(21)00005-9
Robinson, Yazdany, The COVID-19 Global Rheumatology Alliance: Collecting data in a pandemic, Nat. Rev. Rheumatol, doi:10.1038/s41584-020-0418-0
Rodriguez-Perez, Labandeira, Pedrosa, Valenzuela, Suarez-Quintanilla et al., Autoantibodies against ACE2 and angiotensin type-1 receptors increase severity of COVID-19, J. Autoimmun, doi:10.1016/j.jaut.2021.102683
Rorat, Zarębska-Michaluk, Kowalska, Kujawa, Rogalska et al., The Course of COVID-19 in Patients with Systemic Autoimmune Rheumatic Diseases, J. Clin. Med, doi:10.3390/jcm11247342
Rutskaya-Moroshan, Abisheva, Sarsenova, Ogay, Vinnik et al., Autoimmune Rheumatic Diseases and COVID-19 Vaccination: A Retrospective Cross-Sectional Study from Astana, Reumatologia, doi:10.5114/reum/184335
Sinha, Rosin, Arora, Labit, Jaffer et al., Dexamethasone Modulates Immature Neutrophils and Interferon Programming in Severe COVID-19, Nat. Med, doi:10.1038/s41591-021-01576-3
Strangfeld, Schäfer, Gianfrancesco, Lawson-Tovey, Liew et al., Factors associated with COVID-19-related death in people with rheumatic diseases: Results from the COVID-19 Global Rheumatology Alliance physician-reported registry, Ann. Rheum. Dis, doi:10.1136/annrheumdis-2020-219498
Tepasse, Hafezi, Lutz, Kühn, Wilms et al., Persisting SARS-CoV-2 Viraemia after Rituximab Therapy: Two Cases with Fatal Outcome and a Review of the Literature, Br. J. Haematol, doi:10.1111/bjh.16896
Wang, Liu, Shao, Han, Su et al., Risk and clinical outcomes of COVID-19 in patients with rheumatic diseases compared with the general population: A systematic review and meta-analysis, Rheumatol. Int, doi:10.1007/s00296-021-04803-9
Wang, Ma, Xu, Liu, Chen et al., Prevalence and risk of COVID-19 in patients with rheumatic diseases: A systematic review and meta-analysis, Clin. Rheumatol, doi:10.1007/s10067-022-06087-1
Watson, Wilkinson, Respiratory viral infections in the elderly, Ther. Adv. Respir. Dis, doi:10.1177/1753466621995050
Wei, Lin, Wei, Chen, He et al., Tocilizumab Treatment for COVID-19 Patients: A Systematic Review and Meta-Analysis, Infect. Dis. Poverty, doi:10.1186/s40249-021-00857-w
Williamson, Walker, Bhaskaran, Bacon, Bates et al., Factors Associated with COVID-19-Related Death Using OpenSAFELY, Nature, doi:10.1038/s41586-020-2521-4
Wu, Mcgoogan, Characteristics of and Important Lessons From the Coronavirus Disease 2019 (COVID-19) Outbreak in China: Summary of a Report of 72 314 Cases From the Chinese Center for Disease Control and Prevention, JAMA, doi:10.1001/jama.2020.2648
Xu, Yi, Cai, Chen, Thong et al., Clinical outcomes of COVID-19 in patients with rheumatic diseases: A systematic review and meta-analysis of global data, Autoimmun. Rev, doi:10.1016/j.autrev.2021.102778
Yan, Ng, Nguyen, High Mortality from COVID-19 among Asian Americans in San Francisco
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, doi:10.1093/cid/ciaa237
Zhong, Shen, Yang, Huang, Chen et al., COVID-19 in patients with rheumatic disease in Hubei province, China: A multicentre retrospective observational study, Lancet Rheumatol, doi:10.1016/S2665-9913(20)30227-7
{ 'indexed': {'date-parts': [[2024, 8, 24]], 'date-time': '2024-08-24T00:23:20Z', 'timestamp': 1724459000862}, 'reference-count': 60, 'publisher': 'MDPI AG', 'issue': '9', 'license': [ { 'start': { 'date-parts': [[2024, 8, 23]], 'date-time': '2024-08-23T00:00:00Z', 'timestamp': 1724371200000}, 'content-version': 'vor', 'delay-in-days': 0, 'URL': 'https://creativecommons.org/licenses/by/4.0/'}], 'content-domain': {'domain': [], 'crossmark-restriction': False}, 'abstract': '<jats:p>Background: Viral infections, including coronavirus disease 2019 (COVID-19), in ' 'patients with autoimmune rheumatic diseases (AIRDs) tend to present more severe disease. This ' 'study aims to investigate the clinical characteristics and risk factors for severe infection ' 'in rheumatologic patients. Methods: We included patients with a diagnosis of AIRD and ' 'COVID-19 infection between January 2022 and July 2023. Patients with AIRDs infected with ' 'SARS-CoV-2 were matched with control patients of the general population according to age (±5 ' 'years) and sex in a 1:1 ratio. Confirmed infection was defined if a patient had a positive ' 'polymerase chain reaction (PCR) test. The severity was divided into mild, moderate, severe, ' 'and critical according to the guidelines of the United States National Institutes of Health ' '(NIH). Results: A total of 140 individuals (37 males, 103 females; mean age 56.1 ± 11.3 ' 'years) with rheumatic disease diagnosed with COVID-19 infection were enrolled in the study. ' 'AIRDs included rheumatoid arthritis (RA) (n = 63, 45%), ankylosing spondylitis (AS) (n = 35, ' '25%), systemic lupus erythematosus (SLE) (n = 26, 8.6%), and systemic sclerosis (SSc) (n = ' '16, 11.4%). The AIRDs group had more SARS-CoV-2-related dyspnea (38.6%), arthralgia (45.7%), ' 'and depression (27.1%) than the control group (p = 0.004). The rate of lung infiltration on ' 'radiographic examination was higher in 58 (41.4%, p = 0.005) patients with rheumatic diseases ' 'than in those without them. Severe SARS-CoV-2 infection was more common in the AIRDs group ' 'than in the control group (22% vs. 12%; p = 0.043). Conclusions: Patients with AIRDs ' 'experienced more symptoms of arthralgia, depression, and dyspnea. There was a trend towards ' 'an increased severity of the disease in patients with AIRDs. Patients with arterial ' 'hypertension, diabetes, chronic lung, and kidney disease, treated with corticosteroids, had a ' 'longer duration, and high activity of autoimmune disease had an increased risk of severe ' 'COVID-19.</jats:p>', 'DOI': '10.3390/medicina60091377', 'type': 'journal-article', 'created': {'date-parts': [[2024, 8, 23]], 'date-time': '2024-08-23T16:38:43Z', 'timestamp': 1724431123000}, 'page': '1377', 'source': 'Crossref', 'is-referenced-by-count': 0, 'title': 'Clinical Characteristics, Prognostic Factors, and Outcomes of COVID-19 in Autoimmune Rheumatic ' 'Disease Patients: A Retrospective Case–Control Study from Astana, Kazakhstan', 'prefix': '10.3390', 'volume': '60', 'author': [ { 'ORCID': 'http://orcid.org/0000-0002-9324-8720', 'authenticated-orcid': False, 'given': 'Kristina', 'family': 'Rutskaya-Moroshan', 'sequence': 'first', 'affiliation': [ { 'name': 'Department of Family Medicine №1, NJSC «Astana Medical ' 'University», Astana 010000, Kazakhstan'}]}, { 'ORCID': 'http://orcid.org/0000-0001-6260-8220', 'authenticated-orcid': False, 'given': 'Saule', 'family': 'Abisheva', 'sequence': 'additional', 'affiliation': [ { 'name': 'Department of Family Medicine №1, NJSC «Astana Medical ' 'University», Astana 010000, Kazakhstan'}]}, { 'given': 'Anilim', 'family': 'Abisheva', 'sequence': 'additional', 'affiliation': [ { 'name': 'Department of Family Medicine №1, NJSC «Astana Medical ' 'University», Astana 010000, Kazakhstan'}]}, { 'given': 'Zhadra', 'family': 'Amangeldiyeva', 'sequence': 'additional', 'affiliation': [ { 'name': 'Department of Family Medicine №1, NJSC «Astana Medical ' 'University», Astana 010000, Kazakhstan'}]}, { 'given': 'Tatyana', 'family': 'Vinnik', 'sequence': 'additional', 'affiliation': [ { 'name': 'Department of Family Medicine №1, NJSC «Astana Medical ' 'University», Astana 010000, Kazakhstan'}, { 'name': 'Department of Molecular Biology, Ariel University, Ariel 40700, ' 'Israel'}]}, { 'given': 'Tansholpan', 'family': 'Batyrkhan', 'sequence': 'additional', 'affiliation': [ { 'name': 'Department of Family Medicine №1, NJSC «Astana Medical ' 'University», Astana 010000, Kazakhstan'}]}], 'member': '1968', 'published-online': {'date-parts': [[2024, 8, 23]]}, 'reference': [ { 'key': 'ref_1', 'unstructured': '(2024, June 29). COVID-19 Cases|WHO COVID-19 Dashboard. Available ' 'online: https://data.who.int/dashboards/covid19/cases.'}, { 'key': 'ref_2', 'doi-asserted-by': 'crossref', 'unstructured': 'Maddur, M.S., Vani, J., Lacroix-Desmazes, S., Kaveri, S., and Bayry, J. ' '(2010). Autoimmunity as a Predisposition for Infectious Diseases. PLoS ' 'Pathog., 6.', 'DOI': '10.1371/journal.ppat.1001077'}, { 'key': 'ref_3', 'doi-asserted-by': 'crossref', 'first-page': 'SI59', 'DOI': '10.1093/rheumatology/keaa897', 'article-title': 'Incidence and Severeness of COVID-19 Hospitalisation in Patients with ' 'Inflammatory Rheumatic Disease: A Nationwide Cohort Study from Denmark', 'volume': '60', 'author': 'Cordtz', 'year': '2020', 'journal-title': 'Rheumatology'}, { 'key': 'ref_4', 'doi-asserted-by': 'crossref', 'first-page': '1185', 'DOI': '10.1080/1744666X.2021.1847084', 'article-title': 'Coronavirus Disease 2019: Investigational Therapies in the Prevention ' 'and Treatment of Hyperinflammation', 'volume': '16', 'author': 'Amigues', 'year': '2020', 'journal-title': 'Expert. Rev. Clin. Immunol.'}, { 'key': 'ref_5', 'doi-asserted-by': 'crossref', 'first-page': '430', 'DOI': '10.1038/s41586-020-2521-4', 'article-title': 'Factors Associated with COVID-19-Related Death Using OpenSAFELY', 'volume': '584', 'author': 'Williamson', 'year': '2020', 'journal-title': 'Nature'}, { 'key': 'ref_6', 'doi-asserted-by': 'crossref', 'first-page': '859', 'DOI': '10.1136/annrheumdis-2020-217871', 'article-title': 'Characteristics Associated with Hospitalisation for COVID-19 in People ' 'with Rheumatic Disease: Data from the COVID-19 Global Rheumatology ' 'Alliance Physician-Reported Registry', 'volume': '79', 'author': 'Gianfrancesco', 'year': '2020', 'journal-title': 'Ann. Rheum. Dis.'}, { 'key': 'ref_7', 'doi-asserted-by': 'crossref', 'first-page': '732', 'DOI': '10.1093/cid/ciaa237', 'article-title': '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)', 'volume': '71', 'author': 'Yao', 'year': '2020', 'journal-title': 'Clin. Infect. Dis.'}, { 'key': 'ref_8', 'doi-asserted-by': 'crossref', 'first-page': '201', 'DOI': '10.1038/s41591-021-01576-3', 'article-title': 'Dexamethasone Modulates Immature Neutrophils and Interferon Programming ' 'in Severe COVID-19', 'volume': '28', 'author': 'Sinha', 'year': '2022', 'journal-title': 'Nat. Med.'}, { 'key': 'ref_9', 'doi-asserted-by': 'crossref', 'first-page': '71', 'DOI': '10.1186/s40249-021-00857-w', 'article-title': 'Tocilizumab Treatment for COVID-19 Patients: A Systematic Review and ' 'Meta-Analysis', 'volume': '10', 'author': 'Wei', 'year': '2021', 'journal-title': 'Infect. Dis. Poverty'}, { 'key': 'ref_10', 'doi-asserted-by': 'crossref', 'first-page': '154', 'DOI': '10.1111/apt.16717', 'article-title': 'Systematic Review with Meta-Analysis: COVID-19 Outcomes in Patients ' 'Receiving Anti-TNF Treatments', 'volume': '55', 'author': 'Kokkotis', 'year': '2022', 'journal-title': 'Aliment. Pharmacol. Ther.'}, { 'key': 'ref_11', 'doi-asserted-by': 'crossref', 'first-page': '1351', 'DOI': '10.1007/s00296-020-04613-5', 'article-title': 'Management of pediatric rheumatic patients in Kazakhstan during the ' 'coronavirus disease 2019 (COVID-19) pandemic', 'volume': '40', 'author': 'Mukusheva', 'year': '2020', 'journal-title': 'Rheumatol. Int.'}, { 'key': 'ref_12', 'doi-asserted-by': 'crossref', 'first-page': 'e524', 'DOI': '10.1017/dmp.2023.181', 'article-title': 'Public Health Response Measures for COVID-19 in Kazakhstan', 'volume': '17', 'author': 'Battakova', 'year': '2023', 'journal-title': 'Disaster Med. Public Health Prep.'}, { 'key': 'ref_13', 'unstructured': '(2024, June 29). Agency for Strategic Planning and Reforms of the ' 'Republic of Kazakhstan Bureau of National Statistics—Main, Available ' 'online: https://stat.gov.kz/en/.'}, { 'key': 'ref_14', 'doi-asserted-by': 'crossref', 'first-page': 'e281', 'DOI': '10.1016/S2666-5247(20)30177-4', 'article-title': 'COVID-19 response in central Asia', 'volume': '1', 'author': 'Balakrishnan', 'year': '2020', 'journal-title': 'Lancet Microbe'}, { 'key': 'ref_15', 'doi-asserted-by': 'crossref', 'first-page': '26', 'DOI': '10.5114/reum/184335', 'article-title': 'Autoimmune Rheumatic Diseases and COVID-19 Vaccination: A Retrospective ' 'Cross-Sectional Study from Astana', 'volume': '62', 'author': 'Abisheva', 'year': '2024', 'journal-title': 'Reumatologia'}, { 'key': 'ref_16', 'doi-asserted-by': 'crossref', 'first-page': '851', 'DOI': '10.1007/s00296-021-04803-9', 'article-title': 'Risk and clinical outcomes of COVID-19 in patients with rheumatic ' 'diseases compared with the general population: A systematic review and ' 'meta-analysis', 'volume': '41', 'author': 'Wang', 'year': '2021', 'journal-title': 'Rheumatol. Int.'}, { 'key': 'ref_17', 'doi-asserted-by': 'crossref', 'first-page': '135', 'DOI': '10.5603/ARM.a2021.0036', 'article-title': 'Predictors of mortality in patients with severe COVID-19 pneumonia—A ' 'retrospective study', 'volume': '89', 'author': 'Mahendra', 'year': '2021', 'journal-title': 'Adv. Respir. Med.'}, { 'key': 'ref_18', 'doi-asserted-by': 'crossref', 'first-page': '1239', 'DOI': '10.1001/jama.2020.2648', 'article-title': 'Characteristics of and Important Lessons From the Coronavirus Disease ' '2019 (COVID-19) Outbreak in China: Summary of a Report of 72 314 Cases ' 'From the Chinese Center for Disease Control and Prevention', 'volume': '323', 'author': 'Wu', 'year': '2020', 'journal-title': 'JAMA'}, { 'key': 'ref_19', 'doi-asserted-by': 'crossref', 'unstructured': 'Flook, M., Jackson, C., Vasileiou, E., Simpson, C.R., Muckian, M.D., ' 'Agrawal, U., McCowan, C., Jia, Y., Murray, J.L.K., and Ritchie, L.D. ' '(2021). Informing the public health response to COVID-19: A systematic ' 'review of risk factors for disease, severity, and mortality. BMC Infect. ' 'Dis., 21.', 'DOI': '10.1186/s12879-021-05992-1'}, { 'key': 'ref_20', 'unstructured': 'Kelsey, J.L., Evans, A.S., and Alice, S. (1996). Methods in ' 'Observational Epidemiology, Oxford University Press. [2nd ed.].'}, { 'key': 'ref_21', 'unstructured': '(2003). Fleiss, Statistical Methods for Rates and Proportions, Formulas ' '3.18 &3.19, John Wiley & Sons.'}, { 'key': 'ref_22', 'doi-asserted-by': 'crossref', 'first-page': '2213', 'DOI': '10.1007/s10067-022-06087-1', 'article-title': 'Prevalence and risk of COVID-19 in patients with rheumatic diseases: A ' 'systematic review and meta-analysis', 'volume': '41', 'author': 'Wang', 'year': '2022', 'journal-title': 'Clin. Rheumatol.'}, { 'key': 'ref_23', 'doi-asserted-by': 'crossref', 'first-page': 'e698', 'DOI': '10.1016/S2665-9913(21)00151-X', 'article-title': 'Autoimmune inflammatory rheumatic diseases and COVID-19 outcomes in ' 'South Korea: A nationwide cohort study', 'volume': '3', 'author': 'Lu', 'year': '2021', 'journal-title': 'Lancet Rheumatol.'}, { 'key': 'ref_24', 'doi-asserted-by': 'crossref', 'first-page': '102778', 'DOI': '10.1016/j.autrev.2021.102778', 'article-title': 'Clinical outcomes of COVID-19 in patients with rheumatic diseases: A ' 'systematic review and meta-analysis of global data', 'volume': '20', 'author': 'Xu', 'year': '2021', 'journal-title': 'Autoimmun. Rev.'}, { 'key': 'ref_25', 'doi-asserted-by': 'crossref', 'first-page': 'e93', 'DOI': '10.1016/j.jinf.2020.05.065', 'article-title': 'The association between severe or dead COVID-19 and autoimmune ' 'diseases: A systematic review and meta analysis', 'volume': '81', 'author': 'Liu', 'year': '2020', 'journal-title': 'J. Infect.'}, { 'key': 'ref_26', 'doi-asserted-by': 'crossref', 'first-page': '888', 'DOI': '10.1016/j.it.2019.08.003', 'article-title': 'Rebalancing Immune Homeostasis to Treat Autoimmune Diseases', 'volume': '40', 'author': 'Horwitz', 'year': '2019', 'journal-title': 'Trends Immunol.'}, { 'key': 'ref_27', 'doi-asserted-by': 'crossref', 'first-page': 'e580', 'DOI': '10.1002/iid3.580', 'article-title': 'The relationship between COVID-19 viral load and disease severity: A ' 'systematic review', 'volume': '10', 'author': 'Dadras', 'year': '2022', 'journal-title': 'Immun. Inflamm. Dis.'}, { 'key': 'ref_28', 'doi-asserted-by': 'crossref', 'first-page': 'e557', 'DOI': '10.1016/S2665-9913(20)30227-7', 'article-title': 'COVID-19 in patients with rheumatic disease in Hubei province, China: A ' 'multicentre retrospective observational study', 'volume': '2', 'author': 'Zhong', 'year': '2020', 'journal-title': 'Lancet Rheumatol.'}, { 'key': 'ref_29', 'doi-asserted-by': 'crossref', 'first-page': '930', 'DOI': '10.1136/annrheumdis-2020-219498', 'article-title': 'Factors associated with COVID-19-related death in people with rheumatic ' 'diseases: Results from the COVID-19 Global Rheumatology Alliance ' 'physician-reported registry', 'volume': '80', 'author': 'Strangfeld', 'year': '2021', 'journal-title': 'Ann. Rheum. Dis.'}, { 'key': 'ref_30', 'doi-asserted-by': 'crossref', 'first-page': '766', 'DOI': '10.1002/art.42030', 'article-title': 'SARS-CoV-2 Infection and COVID-19 Outcomes in Rheumatic Diseases: A ' 'Systematic Literature Review and Meta-Analysis', 'volume': '74', 'author': 'Conway', 'year': '2022', 'journal-title': 'Arthritis Rheumatol.'}, { 'key': 'ref_31', 'doi-asserted-by': 'crossref', 'first-page': '3211', 'DOI': '10.1007/s10067-022-06257-1', 'article-title': 'Perception of risk and impact of the COVID-19 pandemic on patients with ' 'rheumatic diseases: A case-control study', 'volume': '41', 'author': 'Pascual', 'year': '2022', 'journal-title': 'Clin. Rheumatol.'}, { 'key': 'ref_32', 'doi-asserted-by': 'crossref', 'unstructured': '(2024, June 29). Outcomes Following SARS-CoV-2 Infection in Individuals ' 'with and without Inflammatory Rheumatic Diseases: A Danish Nationwide ' 'Cohort Study|Annals of the Rheumatic Diseases. Available online: ' 'https://ard.bmj.com/content/82/10/1359.', 'DOI': '10.1136/ard-2023-223974'}, { 'key': 'ref_33', 'doi-asserted-by': 'crossref', 'unstructured': 'Rorat, M., Zarębska-Michaluk, D., Kowalska, J., Kujawa, K., Rogalska, ' 'M., Kozielewicz, D., Lorenc, B., Sikorska, K., Czupryna, P., and ' 'Bolewska, B. (2022). The Course of COVID-19 in Patients with Systemic ' 'Autoimmune Rheumatic Diseases. J. Clin. Med., 11.', 'DOI': '10.3390/jcm11247342'}, { 'key': 'ref_34', 'doi-asserted-by': 'crossref', 'first-page': '1544', 'DOI': '10.1136/annrheumdis-2020-218296', 'article-title': 'Clinical Outcomes of Hospitalised Patients with COVID-19 and Chronic ' 'Inflammatory and Autoimmune Rheumatic Diseases: A Multicentric Matched ' 'Cohort Study', 'volume': '79', 'author': 'Pablos', 'year': '2020', 'journal-title': 'Ann. Rheum. Dis.'}, { 'key': 'ref_35', 'doi-asserted-by': 'crossref', 'first-page': '1353', 'DOI': '10.1007/s00296-020-04629-x', 'article-title': 'Systemic Autoimmune Diseases, Anti-Rheumatic Therapies, COVID-19 ' 'Infection Risk and Patient Outcomes', 'volume': '40', 'author': 'Kastritis', 'year': '2020', 'journal-title': 'Rheumatol. Int.'}, { 'key': 'ref_36', 'first-page': 'e1', 'article-title': 'American College of Rheumatology Guidance for the Management of ' 'Rheumatic Disease in Adult Patients During the COVID-19 Pandemic: ' 'Version 2', 'volume': '72', 'author': 'Mikuls', 'year': '2020', 'journal-title': 'Arthritis Rheumatol.'}, { 'key': 'ref_37', 'doi-asserted-by': 'crossref', 'first-page': '44', 'DOI': '10.46497/ArchRheumatol.2023.9289', 'article-title': 'Clinical Course and Prognostic Factors of COVID-19 Infection in ' 'Patients with Chronic Inflammatory-Rheumatic Disease: A Retrospective, ' 'Case-Control Study', 'volume': '38', 'author': 'Nas', 'year': '2023', 'journal-title': 'Arch. Rheumatol.'}, { 'key': 'ref_38', 'doi-asserted-by': 'crossref', 'first-page': '293', 'DOI': '10.1038/s41584-020-0418-0', 'article-title': 'The COVID-19 Global Rheumatology Alliance: Collecting data in a ' 'pandemic', 'volume': '16', 'author': 'Robinson', 'year': '2020', 'journal-title': 'Nat. Rev. Rheumatol.'}, { 'key': 'ref_39', 'doi-asserted-by': 'crossref', 'first-page': '631', 'DOI': '10.1002/path.1570', 'article-title': 'Tissue distribution of ACE2 protein, the functional receptor for SARS ' 'coronavirus. A first step in understanding SARS pathogenesis', 'volume': '203', 'author': 'Hamming', 'year': '2004', 'journal-title': 'J. Pathol.'}, { 'key': 'ref_40', 'doi-asserted-by': 'crossref', 'first-page': '102683', 'DOI': '10.1016/j.jaut.2021.102683', 'article-title': 'Autoantibodies against ACE2 and angiotensin type-1 receptors increase ' 'severity of COVID-19', 'volume': '122', 'author': 'Labandeira', 'year': '2021', 'journal-title': 'J. Autoimmun.'}, { 'key': 'ref_41', 'doi-asserted-by': 'crossref', 'first-page': 'eabn3777', 'DOI': '10.1126/sciadv.abn3777', 'article-title': 'Severe COVID-19 induces autoantibodies against angiotensin II that ' 'correlate with blood pressure dysregulation and disease severity', 'volume': '8', 'author': 'Briquez', 'year': '2022', 'journal-title': 'Sci. Adv.'}, { 'key': 'ref_42', 'doi-asserted-by': 'crossref', 'first-page': '1981', 'DOI': '10.1002/art.41456', 'article-title': 'COVID-19 in Patients With Inflammatory Arthritis: A Prospective Study ' 'on the Effects of Comorbidities and Disease-Modifying Antirheumatic ' 'Drugs on Clinical Outcomes', 'volume': '72', 'author': 'Haberman', 'year': '2020', 'journal-title': 'Arthritis Rheumatol.'}, { 'key': 'ref_43', 'doi-asserted-by': 'crossref', 'first-page': 'e168', 'DOI': '10.1016/S2665-9913(21)00005-9', 'article-title': 'Divergent Effects of Acute versus Chronic Glucocorticoids in COVID-19', 'volume': '3', 'author': 'Robinson', 'year': '2021', 'journal-title': 'Lancet Rheumatol.'}, { 'key': 'ref_44', 'doi-asserted-by': 'crossref', 'first-page': '21', 'DOI': '10.1038/s41514-023-00118-0', 'article-title': 'Severe COVID-19 patients exhibit elevated levels of autoantibodies ' 'targeting cardiolipin and platelet glycoprotein with age: A systems ' 'biology approach', 'volume': '9', 'author': 'Fonseca', 'year': '2023', 'journal-title': 'NPJ Aging.'}, { 'key': 'ref_45', 'doi-asserted-by': 'crossref', 'first-page': '1753466621995050', 'DOI': '10.1177/1753466621995050', 'article-title': 'Respiratory viral infections in the elderly', 'volume': '15', 'author': 'Watson', 'year': '2021', 'journal-title': 'Ther. Adv. Respir. Dis.'}, { 'key': 'ref_46', 'doi-asserted-by': 'crossref', 'first-page': '1449', 'DOI': '10.1002/jmv.26424', 'article-title': 'Epidemiology of COVID-19: A systematic review and meta-analysis of ' 'clinical characteristics, risk factors, and outcomes', 'volume': '93', 'author': 'Li', 'year': '2021', 'journal-title': 'J. Med. Virol.'}, { 'key': 'ref_47', 'doi-asserted-by': 'crossref', 'first-page': 'e044640', 'DOI': '10.1136/bmjopen-2020-044640', 'article-title': 'Demographic risk factors for COVID-19 infection, severity, ICU ' 'admission and death: A meta-analysis of 59 studies', 'volume': '11', 'author': 'Pijls', 'year': '2021', 'journal-title': 'BMJ Open.'}, { 'key': 'ref_48', 'doi-asserted-by': 'crossref', 'first-page': '44', 'DOI': '10.1016/j.bbi.2020.05.074', 'article-title': 'Ethnic disparities in hospitalisation for COVID-19 in England: The role ' 'of socioeconomic factors, mental health, and inflammatory and ' 'pro-inflammatory factors in a community-based cohort study', 'volume': '88', 'author': 'Lassale', 'year': '2020', 'journal-title': 'Brain Behav. Immun.'}, { 'key': 'ref_49', 'unstructured': 'Yan, B., Ng, F., and Nguyen, T. (2024, April 20). High Mortality from ' 'COVID-19 among Asian Americans in San Francisco. Asian American Research ' 'Center on Health. Available online: ' 'https://scholar.google.com/citations?view_op=view_citation&hl=en&user=SbnK3p8AAAAJ&citation_for_view=SbnK3p8AAAAJ:eQOLeE2rZwMC.'}, { 'key': 'ref_50', 'doi-asserted-by': 'crossref', 'first-page': '374', 'DOI': '10.1002/art.41567', 'article-title': 'Association of Race and Ethnicity With COVID-19 Outcomes in Rheumatic ' 'Disease: Data From the COVID-19 Global Rheumatology Alliance Physician ' 'Registry', 'volume': '73', 'author': 'Gianfrancesco', 'year': '2021', 'journal-title': 'Arthritis Rheumatol.'}, { 'key': 'ref_51', 'first-page': '1475', 'article-title': 'Health status disparities in ethnic minority patients with rheumatoid ' 'arthritis: A cross-sectional study', 'volume': '34', 'author': 'Bruce', 'year': '2007', 'journal-title': 'J. Rheumatol.'}, { 'key': 'ref_52', 'doi-asserted-by': 'crossref', 'first-page': '1089', 'DOI': '10.1016/j.amjmed.2013.09.002', 'article-title': 'Racial and ethnic disparities in disease activity in patients with ' 'rheumatoid arthritis', 'volume': '126', 'author': 'Greenberg', 'year': '2013', 'journal-title': 'Am. J. Med.'}, { 'key': 'ref_53', 'doi-asserted-by': 'crossref', 'unstructured': 'FAI2R/SFR/SNFMI/SOFREMIP/CRI/IMIDIATE consortium and contributors ' '(2021). Severity of COVID-19 and survival in patients with rheumatic and ' 'inflammatory diseases: Data from the French RMD COVID-19 cohort of 694 ' 'patients. Ann. Rheum. Dis., 80, 527–538.', 'DOI': '10.1136/annrheumdis-2020-218310'}, { 'key': 'ref_54', 'doi-asserted-by': 'crossref', 'first-page': '76', 'DOI': '10.20411/pai.v6i1.435', 'article-title': 'COVID-19 Outcomes in Patients Undergoing B Cell Depletion Therapy and ' 'Those with Humoral Immunodeficiency States: A Scoping Review', 'volume': '6', 'author': 'Jones', 'year': '2021', 'journal-title': 'Pathog. Immun.'}, { 'key': 'ref_55', 'doi-asserted-by': 'crossref', 'first-page': '2015', 'DOI': '10.1007/s00296-020-04699-x', 'article-title': 'High Rates of Severe Disease and Death Due to SARS-CoV-2 Infection in ' 'Rheumatic Disease Patients Treated with Rituximab: A Descriptive Study', 'volume': '40', 'author': 'Boteanu', 'year': '2020', 'journal-title': 'Rheumatol. Int.'}, { 'key': 'ref_56', 'doi-asserted-by': 'crossref', 'first-page': '185', 'DOI': '10.1111/bjh.16896', 'article-title': 'Persisting SARS-CoV-2 Viraemia after Rituximab Therapy: Two Cases with ' 'Fatal Outcome and a Review of the Literature', 'volume': '190', 'author': 'Tepasse', 'year': '2020', 'journal-title': 'Br. J. Haematol.'}, { 'key': 'ref_57', 'doi-asserted-by': 'crossref', 'first-page': '1087', 'DOI': '10.1016/j.semarthrit.2020.06.013', 'article-title': 'Long, Relapsing, and Atypical Symptomatic Course of COVID-19 in a ' 'B-Cell-Depleted Patient after Rituximab', 'volume': '50', 'author': 'Leipe', 'year': '2020', 'journal-title': 'Semin. Arthritis Rheum.'}, { 'key': 'ref_58', 'doi-asserted-by': 'crossref', 'first-page': '412', 'DOI': '10.1080/03009742.2022.2063376', 'article-title': 'Risk of Severe COVID-19 in Patients with Inflammatory Rheumatic ' 'Diseases Treated with Immunosuppressive Therapy in Scotland', 'volume': '52', 'author': 'McKeigue', 'year': '2023', 'journal-title': 'Scand. J. Rheumatol.'}, { 'key': 'ref_59', 'doi-asserted-by': 'crossref', 'first-page': '428', 'DOI': '10.1111/all.14657', 'article-title': 'Risk Factors for Severe and Critically Ill COVID-19 Patients: A Review', 'volume': '76', 'author': 'Gao', 'year': '2021', 'journal-title': 'Allergy'}, { 'key': 'ref_60', 'doi-asserted-by': 'crossref', 'unstructured': 'RECOVERY Collaborative Group, Horby, P., Lim, W.S., Emberson, J.R., ' 'Mafham, M., Bell, J.L., Linsell, L., Staplin, N., Brightling, C., and ' 'Ustianowski, A. (2021). Dexamethasone in Hospitalized Patients with ' 'COVID-19. N. Engl. J. Med., 384, 693–704.', 'DOI': '10.1056/NEJMoa2021436'}], 'container-title': 'Medicina', 'original-title': [], 'language': 'en', 'link': [ { 'URL': 'https://www.mdpi.com/1648-9144/60/9/1377/pdf', 'content-type': 'unspecified', 'content-version': 'vor', 'intended-application': 'similarity-checking'}], 'deposited': { 'date-parts': [[2024, 8, 23]], 'date-time': '2024-08-23T19:19:19Z', 'timestamp': 1724440759000}, 'score': 1, 'resource': {'primary': {'URL': 'https://www.mdpi.com/1648-9144/60/9/1377'}}, 'subtitle': [], 'short-title': [], 'issued': {'date-parts': [[2024, 8, 23]]}, 'references-count': 60, 'journal-issue': {'issue': '9', 'published-online': {'date-parts': [[2024, 9]]}}, 'alternative-id': ['medicina60091377'], 'URL': 'http://dx.doi.org/10.3390/medicina60091377', 'relation': {}, 'ISSN': ['1648-9144'], 'subject': [], 'container-title-short': 'Medicina', 'published': {'date-parts': [[2024, 8, 23]]}}
Loading..
Please send us corrections, updates, or comments. c19early involves the extraction of 100,000+ datapoints from thousands of papers. Community updates help ensure high accuracy. Treatments and other interventions are complementary. All practical, effective, and safe means should be used based on risk/benefit analysis. No treatment or intervention is 100% available and effective for all current and future variants. We do not provide medical advice. Before taking any medication, consult a qualified physician who can provide personalized advice and details of risks and benefits based on your medical history and situation. FLCCC and WCH provide treatment protocols.
  or use drag and drop   
Submit