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Effet d’un traitement par hydroxychloroquine prescrit comme traitement de fond de rhumatismes inflammatoires chroniques ou maladies auto-immunes systémiques sur les tests diagnostiques et l’évolution de l’infection à SARS CoV-2: étude de 871 patients

Trefond et al., Revue du Rhumatisme, doi:10.1016/j.rhum.2021.09.004 (date from preprint)
Jan 2021  
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Mortality -17% Improvement Relative Risk Death/ICU -78% Hospitalization -45% HCQ for COVID-19  Trefond et al.  Prophylaxis Is pre-exposure prophylaxis with HCQ beneficial for COVID-19? Retrospective 262 patients in France Higher death/ICU (p=0.21) and hospitalization (p=0.12), not sig. c19hcq.org Trefond et al., Revue du Rhumatisme, Jan 2021 FavorsHCQ Favorscontrol 0 0.5 1 1.5 2+
HCQ for COVID-19
1st treatment shown to reduce risk in March 2020
 
*, now with p < 0.00000000001 from 418 studies, recognized in 46 countries.
No treatment is 100% effective. Protocols combine treatments. * >10% efficacy, ≥3 studies.
5,000+ studies for 104 treatments. c19hcq.org
Retrospective 71 chronic HCQ patients compared with 191 matched controls, analyzing only those with a highly suspected or confirmed diagnosis of COVID-19. No significant difference was found in outcomes, however matching failed with extreme confounding - 77.5% of HCQ patients with systemic autoimmune diseases vs. 21.5% of control patients.
Other research shows that the risk of COVID-19 for systemic autoimmune disease patients is much higher overall, Ferri et al. show OR 4.42, p<0.0011.
This study is excluded in the after exclusion results of meta analysis: not fully adjusting for the different baseline risk of systemic autoimmune patients; significant unadjusted confounding possible; excessive unadjusted differences between groups.
risk of death, 16.6% higher, RR 1.17, p = 0.80, treatment 4 of 68 (5.9%), control 12 of 183 (6.6%), adjusted per study, odds ratio converted to relative risk.
risk of death/ICU, 78.2% higher, RR 1.78, p = 0.21, treatment 8 of 71 (11.3%), control 18 of 191 (9.4%), adjusted per study, odds ratio converted to relative risk.
risk of hospitalization, 44.9% higher, RR 1.45, p = 0.12, treatment 24 of 71 (33.8%), control 53 of 191 (27.7%), adjusted per study, odds ratio converted to relative risk.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Trefond et al., 27 Jan 2021, retrospective, France, peer-reviewed, 21 authors.
This PaperHCQAll
Effet d’un traitement par hydroxychloroquine prescrit comme traitement de fond de rhumatismes inflammatoires chroniques ou maladies auto-immunes systémiques sur les tests diagnostiques et l’évolution de l’infection à SARS CoV-2 : étude de 871 patients
Ludovic Trefond, Elodie Drumez, Marc Andre, Nathalie Costedoat-Chalumeau, Raphaèle Seror, Mathilde Devaux, Emmanuelle Dernis, Yannick Dieudonne, Soumaya El Mahou, Aurelia Lanteri, Isabelle Melki, Viviane Queyrel, Mathilde Roumier, Jean Schmidt, Thomas Barnetche, Thierry Thomas, Patrice Cacoub, Alexandre Belot, Olivier Aumaitre, Christophe Richez, Eric Hachulla
Revue du Rhumatisme, doi:10.1016/j.rhum.2021.09.004
Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre -including this research content -immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active. This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.
Nous remercions Elodie Drumez, Julien Labreuche (biostatisticien, CHU-Lille), et Thomas Barnetche (chef de projet, CHU-Bordeaux), pour l'analyse statistique et pour l'aide à la préparation de ce manuscrit. Nick Barton a aidé à la préparation de ce manuscrit, conformément aux Good Publication Practice (GPP3) guidelines. J o u r n a l P r e -p r o o f
References
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