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Hydroxychloroquine (HCQ) treatment for hospitalized patients with COVID-19

Tsanovska et al., Infectious Disorders - Drug Targets, doi:10.2174/1871526522666220303121209
Mar 2022  
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Mortality 58% Improvement Relative Risk Ventilation 74% ICU admission 70% HCQ for COVID-19  Tsanovska et al.  LATE TREATMENT Is late treatment with HCQ beneficial for COVID-19? PSM prospective study of 140 patients in Bulgaria (Nov - Dec 2020) Lower mortality (p=0.031) and ventilation (p=0.00066) Tsanovska et al., Infectious Disorders.., Mar 2022 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.
PSM prospective study of 260 COVID-19 patients in Bulgaria, showing lower mortality, ventilation, and ICU admission with HCQ treatment.
risk of death, 57.9% lower, RR 0.42, p = 0.03, treatment 8 of 70 (11.4%), control 19 of 70 (27.1%), NNT 6.4, propensity score matching.
risk of mechanical ventilation, 73.9% lower, RR 0.26, p < 0.001, treatment 6 of 70 (8.6%), control 23 of 70 (32.9%), NNT 4.1, propensity score matching.
risk of ICU admission, 70.4% lower, RR 0.30, p < 0.001, treatment 8 of 70 (11.4%), control 27 of 70 (38.6%), NNT 3.7, propensity score matching.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Tsanovska et al., 3 Mar 2022, prospective, Bulgaria, peer-reviewed, 8 authors, study period 6 November, 2020 - 28 December, 2020.
This PaperHCQAll
{ 'indexed': {'date-parts': [[2022, 3, 4]], 'date-time': '2022-03-04T07:13:26Z', 'timestamp': 1646378006763}, 'reference-count': 0, 'publisher': 'Bentham Science Publishers Ltd.', 'content-domain': {'domain': [], 'crossmark-restriction': False}, 'short-container-title': ['IDDT'], 'published-print': {'date-parts': [[2022, 3, 3]]}, 'abstract': '<jats:sec>\n' '<jats:title>Objective:</jats:title>\n' '<jats:p>Studies have indicated that hydroxychloroquine (HCQ) exerts antiviral effects against ' 'SARS-CoV-2 in vitro. However, trials regarding its effects in patients are very ' 'controversial. This study aims to evaluate the efficacy of (HCQ) in the treatment of ' 'hospitalized patients with COVID-19.</jats:p>\n' '</jats:sec>\n' '<jats:sec>\n' '<jats:title>Methods:</jats:title>\n' '<jats:p>We prospectively enrolled 260 patients hospitalized for COVID-19 in Heart and Brain ' 'Center of Excellence- Pleven, Bulgaria, for the period from November 6 to December 28, 2020. ' 'This study is not randomized, which we compensated for with Propensity Score Matching. ' 'Patients in the HCQ group were given HCQ 200 mg 3 times a day (600mg daily) for the duration ' 'of their hospitalization plus conventional treatment, while those in the control group were ' 'given conventional treatment only. The primary endpoints were transferred to the intensive ' 'care unit, needed for mechanical ventilation, and in-hospital death.</jats:p>\n' '</jats:sec>\n' '<jats:sec>\n' '<jats:title>Results:</jats:title>\n' '<jats:p>Of the 260 COVID-19 patients, 178 (68,5%) were male and the mean age was of 63,78 ± ' '12.45 years, with the most prevalent comorbidity hypertension (68,5%). We had two subgroups: ' 'treated with HCQ and conventional treatment (128 patients) and treated with conventional ' 'treatment only (132 patients). In the primary analysis, patients in HCQ group presented with ' 'less comorbidities and were younger than the group without HCQ. Patients treated with HCQ ' 'demonstrated a significant benefit in the primary endpoints compared to those without HCQ, ' 'namely, transferred to ICU – 20 (20,8%) vs 41 (36,9%), p=0,011, need for mechanical ' 'ventilation 13 (13,4%) vs 33 (28,2%), p=0,009 and in- hospital death 14 (10,9%) vs 35 ' '(26,5%), p=0,001, respectively. We repeated this analysis with PSM, where 70 matched pairs ' 'were identified. Regarding the primary endpoints, we found again a statistically significant ' 'difference between the groups. Comparing transferring to ICU, better outcomes were presented ' 'in the HCQ group: 8 (17,4%) vs 27 (44,3%), with p= 0,003. Besides, a smaller proportion of ' 'the patients needed mechanical ventilation: 6 (12,8%), compared to the control group, 23 ' '(35,4%), p= 0,007. Notably, patients from the HCQ group died during hospitalization: 8 ' '(11,4%) in comparison with 19 (27,1%) from the control group, p= 0,018.</jats:p>\n' '</jats:sec>\n' '<jats:sec>\n' '<jats:title>Conclusion:</jats:title>\n' '<jats:p>Patients treated with HCQ demonstrated a significant benefit in the primary endpoints ' 'in our study, namely, transfer to the intensive care unit, need for mechanical ventilation, ' 'and in-hospital death. HCQ improves prognosis in hospitalized patients with COVID- ' '19.</jats:p>\n' '</jats:sec>', 'DOI': '10.2174/1871526522666220303121209', 'type': 'journal-article', 'created': {'date-parts': [[2022, 3, 4]], 'date-time': '2022-03-04T06:46:47Z', 'timestamp': 1646376407000}, 'source': 'Crossref', 'is-referenced-by-count': 0, 'title': ['Hydroxychloroquine (HCQ) treatment for hospitalized patients with COVID- 19.'], 'prefix': '10.2174', 'volume': '22', 'author': [ { 'given': 'Hristina.', 'family': 'Tsanovska', 'sequence': 'first', 'affiliation': [{'name': 'Heart and Brain—University Hospital, Pleven, Bulgaria'}]}, { 'given': 'Iana.', 'family': 'Simova', 'sequence': 'additional', 'affiliation': [ { 'name': 'Heart and Brain—University Hospital, Pleven, Bulgaria | ' 'Bulgarian Cardiac Institute | Medical University, Pleven, ' 'Bulgaria'}]}, { 'given': 'Vladislav', 'family': 'Genov', 'sequence': 'additional', 'affiliation': [{'name': 'Heart and Brain—University Hospital, Pleven, Bulgaria'}]}, { 'given': 'Todor.', 'family': 'Kundurzhiev', 'sequence': 'additional', 'affiliation': [{'name': 'Medical University, Sofia, Bulgaria'}]}, { 'given': 'Jordan.', 'family': 'Krasnaliev', 'sequence': 'additional', 'affiliation': [{'name': 'Heart and Brain—University Hospital, Pleven, Bulgaria;'}]}, { 'given': 'Vladimir.', 'family': 'Kornovski', 'sequence': 'additional', 'affiliation': [{'name': 'Heart and Brain Hospital, Burgas, Bulgaria'}]}, { 'given': 'Nikolai.', 'family': 'Dimitrov', 'sequence': 'additional', 'affiliation': [ { 'name': 'Heart and Brain—University Hospital, Pleven, Bulgaria; | Medical ' 'University, Pleven, Bulgaria | Heart and Brain Hospital, Burgas, ' 'Bulgaria'}]}, { 'given': 'Toni.', 'family': 'Vekov', 'sequence': 'additional', 'affiliation': [ { 'name': 'Bulgarian Cardiac Institute | Medical University, Pleven, ' 'Bulgaria'}]}], 'member': '965', 'container-title': ['Infectious Disorders - Drug Targets'], 'original-title': [], 'language': 'en', 'link': [ { 'URL': '', 'content-type': 'application/pdf', 'content-version': 'vor', 'intended-application': 'text-mining'}, { 'URL': '', 'content-type': 'text/html', 'content-version': 'vor', 'intended-application': 'text-mining'}, { 'URL': '', 'content-type': 'unspecified', 'content-version': 'vor', 'intended-application': 'similarity-checking'}], 'deposited': { 'date-parts': [[2022, 3, 4]], 'date-time': '2022-03-04T06:46:51Z', 'timestamp': 1646376411000}, 'score': 1, 'resource': {'primary': {'URL': None}}, 'subtitle': [], 'short-title': [], 'issued': {'date-parts': [[2022, 3, 3]]}, 'references-count': 0, 'alternative-id': ['LiveAll1'], 'URL': '', 'relation': {}, 'ISSN': ['1871-5265'], 'issn-type': [{'value': '1871-5265', 'type': 'print'}], 'subject': ['Microbiology (medical)', 'Pharmacology', 'Molecular Medicine', 'General Medicine'], 'published': {'date-parts': [[2022, 3, 3]]}}
Late treatment
is less effective
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