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All Studies   Meta Analysis    Recent:   

Risk factors for mortality in hospitalized patients with COVID-19 at the start of the pandemic in Belgium: a retrospective cohort study

van Halem et al., BMC Infect Dis., doi:10.1186/s12879-020-05605-3
Nov 2020  
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Mortality 32% Improvement Relative Risk HCQ for COVID-19  van Halem et al.  LATE TREATMENT Is late treatment with HCQ beneficial for COVID-19? Retrospective 319 patients in Belgium Lower mortality with HCQ (not stat. sig., p=0.054) c19hcq.org van Halem et al., BMC Infect Dis., Nov 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. c19hcq.org
Retrospective 319 hospitalized patients in Belgium showing lower mortality with HCQ, although not reported to be statistically significant.
Although the 32% 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.
risk of death, 31.6% lower, RR 0.68, p = 0.05, treatment 34 of 164 (20.7%), control 47 of 155 (30.3%), NNT 10.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
van Halem et al., 27 Nov 2020, retrospective, Belgium, peer-reviewed, 10 authors.
This PaperHCQAll
Risk factors for mortality in hospitalized patients with COVID-19 at the start of the pandemic in Belgium: a retrospective cohort study
Karlijn Van Halem, Robin Bruyndonckx, Jeroen Van Der Hilst, Janneke Cox, Paulien Driesen, Matthias Opsomer, Eveline Van Steenkiste, Björn Stessel, Jasperina Dubois, Peter Messiaen
BMC Infectious Diseases, doi:10.1186/s12879-020-05605-3
Background: Belgium was among the first countries in Europe with confirmed coronavirus disease 2019 cases. Since the first diagnosis on February 3rd, the epidemic has quickly evolved, with Belgium at the crossroads of Europe, being one of the hardest hit countries. Although risk factors for severe disease in COVID-19 patients have been described in Chinese and United States (US) cohorts, good quality studies reporting on clinical characteristics, risk factors and outcome of European COVID-19 patients are still scarce. Methods: This study describes the clinical characteristics, complications and outcomes of 319 hospitalized COVID-19 patients, admitted to a tertiary care center at the start of the pandemic in Belgium, and aims to identify the main risk factors for in-hospital mortality in a European context using univariate and multivariate logistic regression analysis. Results: Most patients were male (60%), the median age was 74 (IQR 61-83) and 20% of patients were admitted to the intensive care unit, of whom 63% needed invasive mechanical ventilation. The overall case fatality rate was 25%. The best predictors of in-hospital mortality in multivariate analysis were older age, and renal insufficiency, higher lactate dehydrogenase and thrombocytopenia. Patients admitted early in the epidemic had a higher mortality compared to patients admitted later in the epidemic. In univariate analysis, patients with obesity did have an overall increased risk of death, while overweight on the other hand showed a trend towards lower mortality. Conclusions: Most patients hospitalized with COVID-19 during the first weeks of the epidemic in Belgium were admitted with severe disease and the overall case fatality rate was high. The identified risk factors for mortality are not easily amenable at short term, underscoring the lasting need of effective therapeutic and preventative measures.
Supplementary Information The online version contains supplementary material available at https://doi. org/10.1186/s12879-020-05605-3. Additional file 1: Table S1 Ethics approval and consent to participate The study was approved by the Ethics Committee of Jessa Hospital, Hasselt, Belgium (ethical approval number 20.38-infect20.06). The requirement for informed consent was waived because of the retrospective nature of the study. Consent for publication Not applicable. Competing interests The authors declare that they have no competing interests. Publisher's Note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
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' 'https://doi.org/10.1111/jth.14888.', 'DOI': '10.1111/jth.14888'}, { 'issue': '6', 'key': '5605_CR26', 'doi-asserted-by': 'publisher', 'first-page': '757', 'DOI': '10.1007/s00134-019-05594-1', 'volume': '45', 'author': 'M Schetz', 'year': '2019', 'unstructured': 'Schetz M, De Jong A, Deane AM, Druml W, Hemelaar P, Pelosi P, et al. ' 'Obesity in the critically ill: a narrative review. Intensive Care Med. ' '2019;45(6):757–69.', 'journal-title': 'Intensive Care Med'}, { 'key': '5605_CR27', 'doi-asserted-by': 'publisher', 'first-page': '61', 'DOI': '10.1186/1741-7015-12-61', 'volume': '12', 'author': 'W Nie', 'year': '2014', 'unstructured': 'Nie W, Zhang Y, Jee SH, Jung KJ, Li B, Xiu Q. Obesity survival paradox ' 'in pneumonia: a meta-analysis. BMC Med. 2014;12:61.', 'journal-title': 'BMC Med'}, { 'issue': '3', 'key': '5605_CR28', 'doi-asserted-by': 'publisher', 'first-page': '568', 'DOI': '10.1378/chest.10-0014', 'volume': '138', 'author': 'RD Stapleton', 'year': '2010', 'unstructured': 'Stapleton RD, Dixon AE, Parsons PE, Ware LB, Suratt BT. The association ' 'between BMI and plasma cytokine levels in patients with acute lung ' 'injury. Chest. 2010;138(3):568–77.', 'journal-title': 'Chest.'}, { 'issue': '25', 'key': '5605_CR29', 'doi-asserted-by': 'publisher', 'first-page': '2411', 'DOI': '10.1056/NEJMoa2012410', 'volume': '382', 'author': 'J Geleris', 'year': '2020', 'unstructured': 'Geleris J, Sun Y, Platt J, Zucker J, Baldwin M, Hripcsak G, et al. ' 'Observational study of Hydroxychloroquine in hospitalized patients with ' 'Covid-19. N Engl J Med. 2020;382(25):2411–8.', 'journal-title': 'N Engl J Med'}, { 'key': '5605_CR30', 'doi-asserted-by': 'publisher', 'unstructured': 'Cavalcanti AB, Zampieri FG, Rosa RG, Azevedo LCP, Veiga VC, Avezum A, ' 'Damiani LP, Marcadenti A, Kawano-Dourado L, Lisboa T, Junqueira DLM,de ' 'Barros E Silva PGM, Tramujas L, Abreu-Silva EO, Laranjeira LN, Soares ' 'AT, Echenique LS, Pereira AJ, Freitas FGR, Gebara OCE, Dantas VCS, ' 'Furtado RHM, Milan EP, Golin NA, Cardoso FF, Maia IS, Hoffmann Filho CR, ' 'Kormann APM, Amazonas RB, Bocchi de Oliveira MF, Serpa-Neto A, Falavigna ' 'M, Lopes RD, Machado FR, Berwanger O. Coalition Covid-19 Brazil I ' 'Investigators. Hydroxychloroquine with or without Azithromycin in ' 'Mild-to-Moderate Covid-19. N Engl J Med. 2020:NEJMoa2019014. ' 'https://doi.org/10.1056/NEJMoa2019014.', 'DOI': '10.1056/NEJMoa2019014'}, { 'issue': '24', 'key': '5605_CR31', 'doi-asserted-by': 'publisher', 'first-page': '2493', 'DOI': '10.1001/jama.2020.8630', 'volume': '323', 'author': 'ES Rosenberg', 'year': '2020', 'unstructured': 'Rosenberg ES, Dufort EM, Udo T, Wilberschied LA, Kumar J, Tesoriero J, ' 'et al. Association of Treatment with Hydroxychloroquine or azithromycin ' 'with in-hospital mortality in patients with COVID-19 in New York state. ' 'Jama. 2020;323(24):2493–502.', 'journal-title': 'Jama.'}, { 'key': '5605_CR32', 'doi-asserted-by': 'publisher', 'unstructured': 'RECOVERY Collaborative Group, Horby P, Lim WS, Emberson JR, Mafham M, ' 'Bell JL, Linsell L, Staplin N, Brightling C, Ustianowski A, Elmahi ' 'E,Prudon B, Green C, Felton T, Chadwick D, Rege K, Fegan C, Chappell LC, ' 'Faust SN, Jaki T, Jeffery K, Montgomery A, Rowan K, Juszczak E, Baillie ' 'JK, Haynes R, Landray MJ. Dexamethasone in Hospitalized Patients with ' 'Covid-19 - Preliminary Report. N Engl J Med. 2020;17:NEJMoa2021436. ' 'https://doi.org/10.1056/NEJMoa2021436. Epub ahead of print.', 'DOI': '10.1056/NEJMoa2021436'}, { 'key': '5605_CR33', 'doi-asserted-by': 'publisher', 'unstructured': 'Beigel JH, Tomashek KM, Dodd LE, Mehta AK, Zingman BS, Kalil AC, Hohmann ' 'E, Chu HY, Luetkemeyer A, Kline S, Lopez de Castilla D, Finberg RW, ' 'Dierberg K, Tapson V, Hsieh L, Patterson TF, Paredes R, Sweeney DA, ' 'Short WR, Touloumi G, Lye DC, Ohmagari N, Oh MD, Ruiz-Palacios GM, ' 'Benfield T, Fätkenheuer G, Kortepeter MG, Atmar RL, Creech CB, Lundgren ' 'J, Babiker AG, Pett S, Neaton JD, Burgess TH, Bonnett T, Green M, ' 'Makowski M, Osinusi A, Nayak S, Lane HC; ACTT-1 Study Group Members. ' 'Remdesivir for the Treatment of Covid-19 - Final Report. N Engl J Med. ' '2020;8:NEJMoa2007764. https://doi.org/10.1056/NEJMoa2007764. Epub ahead ' 'of print.', 'DOI': '10.1056/NEJMoa2007764'}, { 'issue': '15', 'key': '5605_CR34', 'doi-asserted-by': 'publisher', 'first-page': '706', 'DOI': '10.1093/cid/ciaa199', 'volume': '71', 'author': 'J Wu', 'year': '2020', 'unstructured': 'Wu J, Liu J, Zhao X, Liu C, Wang W, Wang D, et al. Clinical ' 'characteristics of imported cases of coronavirus disease 2019 (COVID-19) ' 'in Jiangsu Province: a multicenter descriptive study. Clin Infect Dis. ' '2020;71(15):706–12.', 'journal-title': 'Clin Infect Dis'}], 'container-title': 'BMC Infectious Diseases', 'original-title': [], 'language': 'en', 'link': [ { 'URL': 'http://link.springer.com/content/pdf/10.1186/s12879-020-05605-3.pdf', 'content-type': 'application/pdf', 'content-version': 'vor', 'intended-application': 'text-mining'}, { 'URL': 'http://link.springer.com/article/10.1186/s12879-020-05605-3/fulltext.html', 'content-type': 'text/html', 'content-version': 'vor', 'intended-application': 'text-mining'}, { 'URL': 'http://link.springer.com/content/pdf/10.1186/s12879-020-05605-3.pdf', 'content-type': 'application/pdf', 'content-version': 'vor', 'intended-application': 'similarity-checking'}], 'deposited': { 'date-parts': [[2020, 12, 14]], 'date-time': '2020-12-14T12:14:32Z', 'timestamp': 1607948072000}, 'score': 1, 'resource': { 'primary': { 'URL': 'https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-020-05605-3'}}, 'subtitle': [], 'short-title': [], 'issued': {'date-parts': [[2020, 11, 27]]}, 'references-count': 34, 'journal-issue': {'issue': '1', 'published-print': {'date-parts': [[2020, 12]]}}, 'alternative-id': ['5605'], 'URL': 'http://dx.doi.org/10.1186/s12879-020-05605-3', 'relation': {}, 'ISSN': ['1471-2334'], 'subject': ['Infectious Diseases'], 'container-title-short': 'BMC Infect Dis', 'published': {'date-parts': [[2020, 11, 27]]}, 'assertion': [ { 'value': '8 June 2020', 'order': 1, 'name': 'received', 'label': 'Received', 'group': {'name': 'ArticleHistory', 'label': 'Article History'}}, { 'value': '9 November 2020', 'order': 2, 'name': 'accepted', 'label': 'Accepted', 'group': {'name': 'ArticleHistory', 'label': 'Article History'}}, { 'value': '27 November 2020', 'order': 3, 'name': 'first_online', 'label': 'First Online', 'group': {'name': 'ArticleHistory', 'label': 'Article History'}}, { 'value': '14 December 2020', 'order': 4, 'name': 'change_date', 'label': 'Change Date', 'group': {'name': 'ArticleHistory', 'label': 'Article History'}}, { 'value': 'Correction', 'order': 5, 'name': 'change_type', 'label': 'Change Type', 'group': {'name': 'ArticleHistory', 'label': 'Article History'}}, { 'value': 'An amendment to this paper has been published and can be accessed via the ' 'original article.', 'order': 6, 'name': 'change_details', 'label': 'Change Details', 'group': {'name': 'ArticleHistory', 'label': 'Article History'}}, { 'value': 'The study was approved by the Ethics Committee of Jessa Hospital, Hasselt, ' 'Belgium (ethical approval number 20.38-infect20.06). The requirement for ' 'informed consent was waived because of the retrospective nature of the study.', 'order': 1, 'name': 'Ethics', 'group': {'name': 'EthicsHeading', 'label': 'Ethics approval and consent to participate'}}, { 'value': 'Not applicable.', 'order': 2, 'name': 'Ethics', 'group': {'name': 'EthicsHeading', 'label': 'Consent for publication'}}, { 'value': 'The authors declare that they have no competing interests.', 'order': 3, 'name': 'Ethics', 'group': {'name': 'EthicsHeading', 'label': 'Competing interests'}}], 'article-number': '897'}
Late treatment
is less effective
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.
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