COVID-19 infection in a northern-Italian cohort of systemic lupus erythematosus assessed by telemedicine

Cassione et al., Annals of the Rheumatic Diseases, doi:10.1136/annrheumdis-2020-217717, May 2020
Case -50% improvement lower risk ← → higher risk HCQ for COVID-19  Cassione et al.  PROPHYLAXIS Is pre-exposure prophylaxis with HCQ beneficial for COVID-19? Retrospective 165 patients in Italy More cases with HCQ (not stat. sig., p=0.59) c19early.org Cassione et al., Annals of the Rheumat.., May 2020 0 0.5 1 1.5 2+ RR
HCQ for COVID-19
1st treatment shown to reduce risk in March 2020, now with p < 0.00000000001 from 424 studies, used in 59 countries.
Lower risk for mortality, hospitalization, progression, recovery, cases, and viral clearance.
No treatment is 100% effective. Protocols combine treatments.
6,200+ studies for 200+ treatments. c19early.org
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Survey of 165 SLE patients, 127 on HCQ. 8 patients with suspected COVID-19 and 4 confirmed cases. No mortality, one ICU case. 7 patients had no symptoms despite contact with a COVID-19 patient.
No adjustment for concomitant medications or severity of SLE. Confounding by indication.
This study is excluded in the after exclusion results of meta analysis: not fully adjusting for the different baseline risk of systemic autoimmune patients.
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risk of case, 49.6% higher, RR 1.50, p = 0.59, treatment 10 of 127 (7.9%), control 2 of 38 (5.3%).
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Cassione et al., 12 May 2020, retrospective, Italy, peer-reviewed, survey, median age 52.5, 6 authors.
$0 $500 $1,000+ Efficacy vs. cost for COVID-19 treatment protocols c19early.org November 2025 Italy United Kingdom Russia USA Sudan Angola Colombia Kenya Mozambique Vietnam Peru Philippines China Uzbekistan Nepal Ethiopia Iran Ghana Mexico South Korea Germany Bangladesh Saudi Arabia Algeria Morocco Yemen Poland India DR Congo Madagascar Thailand Uganda Venezuela Nigeria Egypt Bolivia Taiwan Zambia Fiji Bosnia-Herzegovina Ukraine Côte d'Ivoire Bulgaria Greece Slovakia Singapore Iceland New Zealand Czechia Mongolia Israel Trinidad and Tobago Hong Kong North Macedonia Belarus Qatar Panama Serbia CAR Italy favored high-profit treatments.The average efficacy of treatments was very low.High-cost protocols reduce early treatment, andforgo complementary/synergistic benefits. More effective More expensive 75% 50% 25% ≤0%
$0 $500 $1,000+ Efficacy vs. cost for COVID-19treatment protocols worldwide c19early.org November 2025 Italy United Kingdom Russia USA Sudan Angola Colombia Kenya Mozambique Vietnam Peru Philippines China Uzbekistan Nepal Ethiopia Iran Ghana Mexico South Korea Germany Bangladesh Saudi Arabia Algeria Morocco Yemen Poland India DR Congo Madagascar Thailand Uganda Venezuela Nigeria Egypt Bolivia Taiwan Zambia Fiji Bosnia-Herzegovina Ukraine Côte d'Ivoire Eritrea Bulgaria Greece Slovakia Singapore New Zealand Malawi Czechia Mongolia Israel Trinidad and Tobago North Macedonia Belarus Qatar Panama Serbia Syria Italy favored high-profit treatments.The average efficacy was very low.High-cost protocols reduce early treatment,and forgo complementary/synergistic benefits. More effective More expensive 75% 50% 25% ≤0%
COVID-19 infection in a northern-Italian cohort of systemic lupus erythematosus assessed by telemedicine
Emanuele Bozzalla Cassione, Giovanni Zanframundo, Alessandro Biglia, Veronica Codullo, Professor Carlomaurizio Montecucco, Lorenzo Cavagna
Annals of the Rheumatic Diseases, doi:10.1136/annrheumdis-2020-217717
Handling editor Josef S Smolen Acknowledgements The authors wish to thank Dr Luciano Perotti from the ICU department of our Hospital for his invaluable contribution to the good outcome of the admitted SLE patient.
References
Ferner, Aronson, Chloroquine and hydroxychloroquine in covid-19, BMJ, doi:10.1136/bmj.m1432
Hollander, Carr, Virtually perfect? telemedicine for Covid-19, N Engl J Med, doi:10.1056/NEJMp2003539
Joob, Wiwanitkit, Sle, hydroxychloroquine and NO SLE patients with COVID-19: a comment, Ann Rheum Dis, doi:10.1136/annrheumdis-2020-217506
Mathian, Mahevas, Rohmer, Clinical course of coronavirus disease 2019 (COVID-19) in a series of 17 patients with systemic lupus erythematosus under longterm treatment with hydroxychloroquine, Ann Rheum Dis, doi:10.1136/annrheumdis-2020-217566
Monti, Balduzzi, Delvino, Clinical course of COVID-19 in a series of patients with chronic arthritis treated with immunosuppressive targeted therapies, Ann Rheum Dis, doi:10.1136/annrheumdis-2020-217424
Remuzzi, Remuzzi, COVID-19 and Italy: what next?, Lancet, doi:10.1016/S0140-6736(20)30627-9
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