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0 0.5 1 1.5 2+ ICU admission 81% Improvement Relative Risk ICU admission (b) 86% Mortality -50% Mortality (b) -35% Goren et al. NCT04368897 Antiandrogens LATE TREATMENT Is late treatment with antiandrogens beneficial for COVID-19? Prospective study of 77 patients in Brazil Lower ICU admission with antiandrogens (not stat. sig., p=0.082) Goren et al., J. the European Academy of Dermato.., doi:10.1111/jdv.16953 Favors various Favors control
Anti-androgens may protect against severe COVID-19 outcomes: results from a prospective cohort study of 77 hospitalized men
Goren et al., Journal of the European Academy of Dermatology and Venereology, doi:10.1111/jdv.16953, NCT04368897 (history)
Goren et al., Anti-androgens may protect against severe COVID-19 outcomes: results from a prospective cohort study of 77.., Journal of the European Academy of Dermatology and Venereology, doi:10.1111/jdv.16953, NCT04368897
Sep 2020   Source   PDF  
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Prospective study of 77 men hospitalized with COVID-19, 12 taking antiandrogens (9 dutasteride, 2 finasteride, 1 spironolactone), showing lower ICU admission with treatment (statistically significant with age-matched controls only when excluding the spironolactone patient). NCT04368897 (history).
risk of ICU admission, 81.0% lower, RR 0.19, p = 0.08, treatment 1 of 12 (8.3%), control 17 of 36 (47.2%), NNT 2.6, adjusted per study, age-matched controls.
risk of ICU admission, 86.0% lower, RR 0.14, p = 0.04, treatment 1 of 12 (8.3%), control 38 of 65 (58.5%), NNT 2.0, adjusted per study, all controls.
risk of death, 50.0% higher, RR 1.50, p = 1.00, treatment 1 of 12 (8.3%), control 2 of 36 (5.6%), age-matched controls.
risk of death, 35.4% higher, RR 1.35, p = 0.58, treatment 1 of 12 (8.3%), control 4 of 65 (6.2%), all controls.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Goren et al., 25 Sep 2020, prospective, Brazil, peer-reviewed, 15 authors, trial NCT04368897 (history).
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Abstract: Letters to the Editor was positive in eight cases, borderline in two, and negative in three, including the COVID-19 patient. Overall, serology for S1-specific IgA and IgG in the 30 patients shows that 16 (53.3%) were positive for IgA, whereas IgG was detectable in five (16.6%; Fig. 1f). We have recently reported that high levels of IgG and IgA can be detected in adult patients with severe COVID-19, while IgA, and to a lower extent IgG, is increased in asymptomatic individuals.6 As IgA is the most abundant antibody at mucosal sites, a strong local protection may prevent viral spread and damage to the respiratory tract, explaining the lack of symptoms. The ELISA used for the detection of antiS1 IgG and IgA has been demonstrated to be specific and sensitive.7,8 Of note, antibodies against S1 are often neutralizing9 and may prevent severe disease and further immune responses.6 Our findings indicate that, similar to asymptomatic adults, paediatric patients would respond to SARSCoV-2 producing more IgA than IgG. On the other hand, a single patient had detectable IgG against SARS-CoV-2 nucleoprotein. Anti-nucleoprotein IgG is present in the great majority of hospitalized adult patients, but only in one-third of paucisymptomatic individuals, suggesting that disease severity influences the specificity of the antibodies produced.10 In conclusion, the detection of S1-specific IgA in paediatric patients with chilblain-like lesions strongly points to a previous, mostly asymptomatic SARS-CoV-2 infection with inflammatory sequelae. Acknowledgements We thank the patients and their parents for accepting to participate in this study. The patients in this manuscript have given written informed consent to publication of their case details. We thank Mr. Gabriele Bacile for iconography preparation. Three of the authors (MEH, AD and GZ) of this publication are members of the European Reference Network ERN-SKIN and two of them (MEH, AD) are also members of vascular anomalies working group (VASCA WG) of the ERN for rare multisystemic vascular diseases (VASCERN). Conflicts of interest None to be reported for all authors. S. Giancristoforo,1,† S. Terreri,2 A. Diociaiuti,1,*,† 1 M. Corbeddu, C. Concato,3 M. Ciofi Degli Atti,4 G. Zambruno,5 R. Carsetti,6,† M. El Hachem1,† 1  Children’s Hospital, IRCCS, Rome, Dermatology Unit, Bambino Gesu Italy, 2B Cell Pathophysiology Unit, Immunology Research Area, Bambino  Children’s Hospital, IRCCS, Rome, Italy, 3Virology Unit, Bambino Gesu  Gesu Children’s Hospital, IRCCS, Rome, Italy, 4Clinical Epidemiology Unit,  Children’s Hospital, IRCCS, Rome, Italy, 5Genetics and Bambino Gesu  Children’s Hospital, Rare Diseases Research Division, Bambino Gesu JEADV 2021, 35, e1–e96 e13 IRCCS, Rome, Italy, 6Diagnostic Immunology Unit, Dept. of Laboratories,  B Cell Pathophysiology Unit, Immunology Research Area, Bambino Gesu Children’s Hospital, IRCCS, Rome, Italy *Correspondence: A. Diociaiuti. E-mail: † Equal contribution References 1 Freeman EE, McMahon DE, Lipoff JB et al. Pernio-like skin lesions associated with COVID-19: a case series of 318 patients from 8 countries. J Am Acad Dermatol 2020; 83: 486–492. 2 Andina D, Noguera-Morel L, Bascuas-Arribas M et al. Chilblains in children in the setting of COVID-19 pandemic. Pediatr Dermatol 2020; 37: 406–411. 3 Le Cleach L, Dousset L, Assier H et al. Most chilblains observed during the COVID-19 outbreak occur in patients who are negative for COVID-19..
Late treatment
is less effective
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