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0 0.5 1 1.5 2+ Mortality 48% Improvement Relative Risk Strangfeld et al. HCQ for COVID-19 PrEP Is pre-exposure prophylaxis with HCQ beneficial for COVID-19? Retrospective 1,165 patients in multiple countries (Mar - Jul 2020) Lower mortality with HCQ (p=0.000084) Strangfeld et al., Annals of the Rheumatic Disea.., doi:10.1136/annrheumdis-2020-219498 Favors HCQ Favors control
Factors associated with COVID-19-related death in people with rheumatic diseases: results from the COVID-19 Global Rheumatology Alliance physician-reported registry
Strangfeld et al., Annals of the Rheumatic Diseases, doi:10.1136/annrheumdis-2020-219498
Strangfeld et al., Factors associated with COVID-19-related death in people with rheumatic diseases: results from the COVID-19.., Annals of the Rheumatic Diseases, doi:10.1136/annrheumdis-2020-219498
Jan 2021   Source   PDF  
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Retrospective 3,729 rheumatic disease patients showing lower risk of mortality with HCQ/CQ use (HCQ/CQ vs. no DMARD therapy).
risk of death, 48.0% lower, RR 0.52, p < 0.001, treatment 27 of 426 (6.3%), control 124 of 739 (16.8%), NNT 9.6, adjusted per study, inverted to make RR<1 favor treatment, odds ratio converted to relative risk, HCQ/CQ vs. no DMARD therapy, multivariable.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Strangfeld et al., 27 Jan 2021, retrospective, multiple countries, peer-reviewed, 37 authors, study period 24 March, 2020 - 1 July, 2020.
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Abstract: EPIDEMIOLOGICAL SCIENCE Factors associated with COVID-­19-­related death in people with rheumatic diseases: results from the COVID-­19 Global Rheumatology Alliance physician-­reported registry Handling editor Josef S Smolen Anja Strangfeld ‍ ‍,1 Martin Schäfer,1 Milena A Gianfrancesco,2 Saskia Lawson-­Tovey,3,4 Jean W Liew,5 Lotta Ljung ‍ ‍,6,7 Elsa F Mateus,8,9 Christophe Richez ‍ ‍,10 Maria J Santos ‍ ‍,11,12,13 Gabriela Schmajuk,2 Carlo A Scirè ‍ ‍,14 Emily Sirotich,15,16 Jeffrey A Sparks,17 Paul Sufka,18 Thierry Thomas,19,20,21 Laura Trupin,2 Zachary S Wallace,22 Sarah Al-­Adely,4,23 Javier Bachiller-­Corral ‍ ‍,24,25 Suleman Bhana,26 Patrice Cacoub,27,28,29 Loreto Carmona ‍ ‍,30 Ruth Costello ‍ ‍,23 Wendy Costello,31 Laure Gossec ‍ ‍,32,33 Rebecca Grainger,34 Eric Hachulla ‍ ‍,35 Rebecca Hasseli ‍ ‍,36 Jonathan S Hausmann ‍ ‍,37,38 Kimme L Hyrich ‍ ‍,4,23 Zara Izadi,2 Lindsay Jacobsohn,2 Patricia Katz,2 Lianne Kearsley-­Fleet ‍ ‍,23 Philip C Robinson ‍ ‍,39,40 Jinoos Yazdany,2 Pedro M Machado ‍ ‍,41,42,43 COVID-­19 Global Rheumatology Alliance ABSTRACT Objectives To determine factors associated with COVID-­19-­related death in people with rheumatic diseases. Methods Physician-­reported registry of adults with rheumatic disease and confirmed or presumptive For numbered affiliations see end of article. COVID-­19 (from 24 March to 1 July 2020). The primary outcome was COVID-­19-­related death. Age, sex, smoking Correspondence to status, comorbidities, rheumatic disease diagnosis, Dr Pedro M Machado, Centre for disease activity and medications were included as Rheumatology, UCL Division of covariates in multivariable logistic regression models. Medicine, University College Analyses were further stratified according to rheumatic London, London WC1E 6JF, UK; ​p.​machado@u​ cl.​ac.​uk disease category. Results Of 3729 patients (mean age 57 years, 68% AS and MS contributed equally. female), 390 (10.5%) died. Independent factors PCR, JY and PMM contributed associated with COVID-­19-­related death were age equally. (66–75 years: OR 3.00, 95% CI 2.13 to 4.22; >75 Received 11 November 2020 years: 6.18, 4.47 to 8.53; both vs ≤65 years), male Revised 17 December 2020 sex (1.46, 1.11 to 1.91), hypertension combined with Accepted 2 January 2021 cardiovascular disease (1.89, 1.31 to 2.73), chronic Published Online First 27 January 2021 lung disease (1.68, 1.26 to 2.25) and prednisolone-­ equivalent dosage >10 mg/day (1.69, 1.18 to 2.41; vs no glucocorticoid intake). Moderate/high disease activity (vs remission/low disease activity) was associated with higher odds of death (1.87, 1.27 to 2.77). Rituximab (4.04, 2.32 to 7.03), sulfasalazine (3.60, 1.66 to 7.78), ​ard.​bmj.​com immunosuppressants (azathioprine, cyclophosphamide, ciclosporin, mycophenolate or tacrolimus: 2.22, 1.43 to 3.46) and not receiving any disease-­modifying anti-­ © Author(s) (or their rheumatic drug (DMARD) (2.11, 1.48 to 3.01) were employer(s)) 2021. Re-­use associated with higher odds of death, compared with permitted under CC BY. Published by BMJ. methotrexate monotherapy. Other synthetic/biological DMARDs were not associated with COVID-­19-­related To cite: Strangfeld A, death. Schäfer M, Conclusion Among people with rheumatic disease, Gianfrancesco MA, et al. Ann Rheum Dis COVID-­19-­related death was associated with known 2021;80:930–942. general factors (older age, male sex and specific ► Additional material is published online only. To view, please visit the journal..
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