European Journal of Internal Medicine: Use of Hydroxychloroquine in hospitalised COVID-19 patients is associated with reduced mortality: Findings from the observational multicentre Italian CORIST study

European Journal of Internal Medicine ^ | 08/25/2020

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Published: August 25, 2020; DOI: https://doi.org/10.1016/j.ejim.2020.08.019

Abstract

Background

Hydroxychloroquine (HCQ) was proposed as potential treatment for COVID-19.

Objective

We set-up a multicenter Italian collaboration to investigate the relationship between HCQ therapy and COVID-19 in-hospital mortality.

Methods

In a retrospective observational study, 3,451 unselected patients hospitalized in 33 clinical centers in Italy, from February 19, 2020 to May 23, 2020, with laboratory-confirmed SARS-CoV-2 infection, were analyzed. The primary end-point in a time-to event analysis was in-hospital death, comparing patients who received HCQ with patients who did not.

We used multivariable Cox proportional-hazards regression models with inverse probability for treatment weighting by propensity scores, with the addition of subgroup analyses.

Results

Out of 3,451 COVID-19 patients, 76.3% received HCQ. Death rates (per 1,000 person-days) for patients receiving or not HCQ were 8.9 and 15.7, respectively.

After adjustment for propensity scores, we found 30% lower risk of death in patients receiving HCQ (HR=0.70; 95%CI: 0.59 to 0.84; E-value=1.67). .

Secondary analyses yielded similar results. The inverse association of HCQ with inpatient mortality was particularly evident in patients having elevated C-reactive protein at entry.

Conclusions

HCQ use was associated with a 30% lower risk of death in COVID-19 hospitalized patients. Within the limits of an observational study and awaiting results from randomized controlled trials, these data do not discourage the use of HCQ in inpatients with COVID-19.

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CLICK ABOVE ARTICLE LINK FOR THE DETAILS OF THE STUDY

[ClearCase_guy]

Well, as far as anecdotes go ... this is a good one.

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Fig. 1: The unadjusted standardized differences and standardized differences adjusted by propensity scores between HCQ-treated and non-HCQ treated patients for the variables included in the propensity score. All differences for the matched observations are within the recommended limits of –0.25 and 0.25, which are indicated by reference lines.

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Fig. 2Survival curves according to hydroxychloroquine use. The curves are adjusted by propensity score analysis (inverse probability for treatment weighting) and hospital index as random effect, and are generated using the first imputed dataset. The other imputed datasets are similar and thus omitted.

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Table 3: Hazard ratios for mortality according to hydroxychloroquine use in different subgroups

	Hydroxychloroquine NO (N=817)	Hydroxychloroquine YES (N=2,634)
Subgroups	No. death/patient at risk	No. death/patient at risk	HR (95% CI)*
Women	80/361	116/940	0.63 (0.46 to 0.86)
Men	110/456	270/1,694	0.74 (0.60 to 0.93)
Age <70 years	22/357	93/1,542	0.76 (0.50 to 1.16)
Age ≥70 years	168/460	293/1,092	0.68 (0.56 to 0.83)
Highest degree of COVID-19 severity experienced at hospital
Mild pneumonia or less	28/424	40/1,358	0.70 (0.41 to 1.18)
Severe pneumonia	80/253	172/764	0.76 (0.58 to 0.99)
Acute respiratory distress syndrome	82/140	174/512	0.68 (0.52 to 0.90)
Use of other COVID-19 treatments^
No	101/439	64/570	0.63 (0.45 to 0.88)
Yes	89/378	322/2,064	0.77 (0.61 to 0.99)
C-Reactive Protein at basal**
<10 mg/L	56/412	125/1,138	1.23 (0.86 to 1.77)
≥10 mg/L	123/361	241/1,362	0.59 (0.47 to 0.73)

Abbreviations: HR, hazard ratios; CI, confidence intervals; *Propensity score analysis, inverse probability weighting, including hospital clustering as random effect covariate; multiple imputed analysis.

^Lopinavir/ritonavir or darunavir/cobicistat or tocilizumab or sarilumab or remdesivir or corticosteroids.

**Missing data for N=178. Frequencies and hazard ratios are based on a case complete analysis (N=3,273) without missing data for C-reactive Protein; multiple imputed analysis (N=3,451) yielded very similar results.

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Ping as per your request

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SOURCE: https://www.thegatewaypundit.com/2020/09/hydroxychloroquine-reduces-risk-death-covid-19-30-italian-study-shows/

An Italian study finds that hydroxychloroquine substantially reduces the risk of death for COVID-19 patients.

“We observed that patients treated with hydroxychloroquine had a 30% lower in-hospital mortality rate compared to those not receiving this treatment,” lead study author Augusto Di Castelnuovo said in a media release. Di Castelnuovoa is an epidemiologist with IRCCS Neuromed at the Mediterranean Neurological Institute.

The report, which has been published in the European Journal of Internal Medicine, looked at outcomes of 3,451 patients in 33 coronavirus-focused hospitals throughout Italy. “After comparing drug improvements and final outcomes, the results remain consistent in showing a benefit to using hydroxychloroquine,” StudyFinds.com reports.

“Our data were subjected to extremely rigorous statistical analysis, taking into account all the variables and possible confounding factors that could come into play. The drug efficacy was evaluated in various subgroups of patients,” Di Castelnuovo said.

“The positive results of hydroxychloroquine treatment remained unchanged,” the study author adds. “Especially in those patients showing a more evident inflammatory state at the moment of admission to hospital.”

Hydroxychloroquine, best known as an antimalarial drug, was deemed the most highly rated treatment for the novel coronavirus in an international poll of more than 6,000 doctors.

The survey, released in April and conducted by Sermo, a global health care polling company, asked 6,227 physicians in 30 countries to find out what works against SARS-CoV-2. The poll found that 37% of those treating patients suffering frm the coronavirusa that causes COVID-19 patients rated hydroxychloroquine as the “most effective therapy.”

The physicians picked hydroxychloroquine from a list of 15 choices.

Azithromycin, known by the brand name Zithromax or Z-Pak, camed in as the second-most effective therapy at 32%, followed by “nothing.”

“Outside the U.S., hydroxychloroquine was equally used for diagnosed patients with mild to severe symptoms whereas in the U.S. it was most commonly used for high risk diagnosed patients,” the survey found.

[gas_dr]

I think its also probably a pretty damn good prophylactic.
theoretically speaking.

[DOC44]

So was Trump right in the beginning. Seems like a lot was lost because they didn’t want Trump to be right and help lead us out of this early on. Didn’t fit their agenda. Falci need to do time.

[Jane Long]

Yep.

What is Dr Z’s recommended prophylactic dosage?

1/day x 5 days, then 1/week, after that.

Taken with zinc, and Vit D, of course.

[Jane Long]

Who has the authority to fire FRAUDci?

I was wondering about this, earlier.

They guy has been at the same, govt agency job for over two decades.....and, has been a dismal failure, more than just w/China Flu.

Seriously....who does this guy answer to? Anyone?

[gas_dr]

800 mg day #1 in divided doses
400 mg every 7 days thereafter

Five days is the treatment regiment.
This is the standard (”anecdotal”) prophylaxis

[Jane Long]

Thanks!!

Seems like Dr Z’s Protocol was half the mg, ongoing/weekly.

I wonder why?

I have no idea the half life......7 days, I guess??

[gas_dr]

No ma’am (I hope I am not taking a liberty). The half life of HCQ is 42 days. This is why it confers (anecdotal) protection for up to a month after you stop. Hypothetically speaking.

[gas_dr]

I will say once the disease is in PHASE 3 or beyond — HCQ simply does not work. It must be as a prophylaxis or early treatment with AZI or DOXY (in my experience)

[Jane Long]

Ahhh...okay....that explains it.

Appreciate the confirmation :-)

[gas_dr]

I am trying to behave tonight. But I appreciate you as well.

[gas_dr]

The only side effect that I have hypothetically experienced were I on HCQ is that is gives you wild and vivid dreams. I have never done drugs, but I suspect, hypothetically, this is what a trip must be like. Holy cow, hypothetically speaking.

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RE: I will say once the disease is in PHASE 3 or beyond — HCQ simply does not work.

The interesting thing is this particular study looked at HOSPITALIZED Covid-19 patients and STILL found reduced mortality!

[Jane Long]

:-)