Experience in the management of severe COVID-19 patients in an intensive care unit
et al., Cir Cir. 2020, 88:5, 569-575, doi:10.24875/CIRU.20000675, Jun 2020
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.
No treatment is 100% effective. Protocols
combine treatments.
6,200+ studies for
200+ treatments. c19early.org
|
Small retrospective study of 56 ICU patients in Mexico showing HCQ RR 1.1, p = 1.0.
This study is excluded in the after exclusion results of meta
analysis:
very late stage, >50% on oxygen/ventilation at baseline; substantial unadjusted confounding by indication likely.
|
risk of death, 10.5% higher, RR 1.11, p = 1.00, treatment 7 of 38 (18.4%), control 3 of 18 (16.7%).
|
| Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates |
Sosa-García et al., 29 Jun 2020, retrospective, Mexico, peer-reviewed, baseline oxygen required 100.0%, 6 authors, average treatment delay 9.0 days.
Experiencia en el manejo de pacientes graves con COVID-19 en una unidad de terapia intensiva
Cirugía y Cirujanos, doi:10.24875/ciru.20000675
Objetivo: Describir las características clínicas y el manejo de pacientes graves con COVID-19. Método: Estudio observacional, descriptivo, longitudinal y restrospectivo. Resultados: Ingresaron 56 pacientes, el 80.3% (n = 45) de sexo masculino, con un promedio de edad de 58 [46-67] años. Las principales condiciones de comorbilidad fueron obesidad, hipertensión y diabetes. El tiempo de inicio de los síntomas al ingreso fue de 9 [7-14] días, siendo los más frecuentes disnea, fiebre y tos seca. Los datos de laboratorio fueron linfopenia y elevación de deshidrogenasa láctica, fibrinógeno, dímero D, ferritina y proteína C reactiva. El 100% de los pacientes requirieron ventilación mecánica, con una mediana de tiempo de ventilación de 12 [6-17] días, y el 66% (n = 37) requirieron posición en prono. El tratamiento farmacólogico fue a base de azitromicina, hidroxicloroquina, tocilizumab y esteroides, principalmente. Las complicaciones más frecuentes fueron lesión renal aguda, enfermedad tromboembólica venosa e infarto agudo al miocardio. La tasa de mortalidad fue del 17.8% (n = 10). Conclusión: Los pacientes graves en nuestro hospital fueron en su mayoría personas de la tercera edad y con obesidad, siendo las variables de mayor puntaje SOFA y lesión renal aguda las asociadas con mayor mortalidad.
References
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Late treatment
is less effective
is less effective
