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0 0.5 1 1.5 2+ Case 91% Improvement Relative Risk HCQ for COVID-19  Zhong et al.  Prophylaxis Is pre-exposure prophylaxis with HCQ beneficial for COVID-19? Retrospective 43 patients in China Fewer cases with HCQ (p=0.044) Zhong et al., Lancent Rheumatology, Jul 2020 Favors HCQ Favors control

COVID-19 in patients with rheumatic disease in Hubei province, China: a multicentre retrospective observational study

Zhong et al., Lancent Rheumatology, doi:10.1016/S2665-9913(20)30227-7
Jul 2020  
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HCQ for COVID-19
1st treatment shown to reduce risk in March 2020
*, now known with p < 0.00000000001 from 422 studies, recognized in 42 countries.
No treatment is 100% effective. Protocols combine complementary and synergistic treatments. * >10% efficacy in meta analysis with ≥3 clinical studies.
4,000+ studies for 60+ treatments.
Rheumatic disease patients on HCQ had a lower risk of COVID-19 than those on other disease-modifying anti-rheumatic drugs, OR 0.09 (0.01–0.94), p=0.044 after adjusting for age, sex, smoking, systemic lupus erythematosus, infection in other family members, and comorbidities. 43 patients with rheumatic disease and COVID-19 exposure.
risk of case, 91.0% lower, RR 0.09, p = 0.04, treatment 7 of 16 (43.8%), control 20 of 27 (74.1%), NNT 3.3, adjusted per study.
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Zhong et al., 3 Jul 2020, retrospective, database analysis, China, peer-reviewed, 20 authors.
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COVID-19 in patients with rheumatic disease in Hubei province, China: a multicentre retrospective observational study
Prof Jixin Zhong, MD Guifen Shen, Huiqin Yang, MD Anbin Huang, MD Xiaoqi Chen, Li Dong, MD Bin Wu, MD Anbin Zhang, Linchong Su, Xiaoqiang Hou, Shulin Song, Huiling Li, Wenyu Zhou, MD Tao Zhou, MD Qin Huang, Aichun Chu, Zachary Braunstein, Xiaoquan Rao, MD Cong Ye, Prof Lingli Dong
The Lancet Rheumatology, doi:10.1016/s2665-9913(20)30227-7
Background In the ongoing COVID-19 pandemic, the susceptibility of patients with rheumatic diseases to COVID-19 remains unclear. We aimed to investigate susceptibility to COVID-19 in patients with autoimmune rheumatic diseases during the ongoing COVID-19 pandemic. Methods We did a multicentre retrospective study of patients with autoimmune rheumatic diseases in Hubei province, the epicentre of the COVID-19 outbreak in China. Patients with rheumatic diseases were contacted through an automated telephone-based survey to investigate their susceptibility to COVID-19. Data about COVID-19 exposure or diagnosis were collected. Families with a documented history of COVID-19 exposure, as defined by having at least one family member diagnosed with COVID-19, were followed up by medical professionals to obtain detailed information, including sex, age, smoking history, past medical history, use of medications, and information related to COVID-19. Findings Between March 20 and March 30, 2020, 6228 patients with autoimmune rheumatic diseases were included in the study. The overall rate of COVID-19 in patients with an autoimmune rheumatic disease in our study population was 0•43% (27 of 6228 patients). We identified 42 families in which COVID-19 was diagnosed between Dec 20, 2019, and March 20, 2020, in either patients with a rheumatic disease or in a family member residing at the same physical address during the outbreak. Within these 42 families, COVID-19 was diagnosed in 27 (63%) of 43 patients with a rheumatic disease and in 28 (34%) of 83 of their family members with no rheumatic disease (adjusted odds ratio [OR] 2•68 [95% CI 1•14-6•27]; p=0•023). Patients with rheumatic disease who were taking hydroxychloroquine had a lower risk of COVID-19 infection than patients taking other disease-modifying anti-rheumatic drugs (OR 0•09 [95% CI 0•01-0•94]; p=0•044). Additionally, the risk of COVID-19 was increased with age (adjusted OR 1•04 [95% CI 1•01-1•06]; p=0•0081). Interpretation Patients with autoimmune rheumatic disease might be more susceptible to COVID-19 infection than the general population.
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