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Determinants of COVID-19 disease severity in patients with underlying rheumatic disease

Santos et al., Clinical Rheumatology, doi:10.1007/s10067-020-05301-2
Jul 2020  
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Mortality, combined 26% Improvement Relative Risk Mortality, HCQ 10% Mortality, CQ 51% HCQ for COVID-19  Santos et al.  LATE TREATMENT Is late treatment with HCQ beneficial for COVID-19? Prospective study of 38 patients in Spain (March - June 2020) Lower mortality with HCQ (not stat. sig., p=0.6) Santos et al., Clinical Rheumatology, Jul 2020 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 411 studies, recognized in 46 countries.
No treatment is 100% effective. Protocols combine treatments. * >10% efficacy, ≥3 studies.
4,300+ studies for 75 treatments.
Prospective study of 38 hospitalized rheumatic disease patients with COVID-19 in Spain, showing no mortality with existing HCQ use compared to 32% without, not reaching statistical significance. Authors also report on the use of HCQ/CQ after hospitalization. The prophylaxis and late treatment results are listed separately1,2.
Although the 26% lower mortality is not statistically significant, it is consistent with the significant 26% lower mortality [22‑30%] from meta analysis of the 249 mortality results to date.
This study is excluded in the after exclusion results of meta analysis: unadjusted results with no group details.
risk of death, 25.8% lower, RR 0.74, p = 0.60, treatment 31, control 7, combined.
risk of death, 9.7% lower, RR 0.90, p = 1.00, treatment 8 of 31 (25.8%), control 2 of 7 (28.6%), NNT 36, HCQ.
risk of death, 50.8% lower, RR 0.49, p = 0.65, treatment 1 of 7 (14.3%), control 9 of 31 (29.0%), NNT 6.8, CQ.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Santos et al., 27 Jul 2020, prospective, Spain, peer-reviewed, median age 78.4, mean age 75.3, 6 authors, study period 1 March, 2020 - 1 June, 2020. Contact:
This PaperHCQAll
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Late treatment
is less effective
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