Cyrus le virus
2020-05-01 20:09:57 UTC
https://www.medrxiv.org/content/10.1101/2020.04.27.20073379v1
Abstract
Importance: Coronavirus disease 2019 (COVID-19) is a pandemic with no
specific drugs and high mortality. The most urgent thing is to find
effective treatments. Objective: To determine whether hydroxychloroquine
application may be associated with a decreased risk of death in
critically ill COVID-19 patients and what is potential mechanism.
Design, Setting and Patients: This retrospective study included all 568
critically ill COVID-19 patients who were confirmed by pathogen
laboratory tests despite antiviral treatment and had severe acute
respiratory distress syndrome, PAO2/FIO2 <300 with need of mechanical
ventilation in Tongji Hospital, Wuhan, between February 1 of 2020 to
April 8 of 2020. All 568 patients received comparable basic treatments
including antiviral drugs and antibiotics, and 48 of them additionally
received oral hydroxychloroquine (HCQ) treatment (200 mg twice a day for
7-10 days). Primary endpoint is mortality of patients, and inflammatory
cytokines levels were compared between hydroxychloroquine and
non-hydroxychloroquine (NHCQ) treatments.
MAIN OUTCOMES AND MEASURES: In-hospital death and hospital stay time
(day) were obtained, level of inflammatory cytokine (IL-6) was measured
and compared between HCQ and NHCQ treatments.
RESULTS: The median age of 568 critically ill patients is 68 (57, 76)
years old with 37.0% being female. Mortalities are 18.8% (9/48) in HCQ
group and 45.8% (238/520) in NHCQ group (p<0.001). The time of hospital
stay before patient death is 15 (10-21) days and 8 (4 - 14) days for the
HCQ and NHCQ groups, respectively (p<0.05). The level of inflammatory
cytokine IL-6 was significantly lowered from 22.2 (8.3-118.9) pg/mL at
the beginning of the treatment to 5.2 (3.0-23.4) pg/ml (p<0.05) at the
end of the treatment in the HCQ group but there is no change in the NHCQ
group.
CONCLUSIONS AND RELEVANCE: Hydroxychloroquine treatment is significantly
associated with a decreased mortality in critically ill patients with
COVID-19 through attenuation of inflammatory cytokine storm. Therefore,
hydroxychloroquine should be prescribed for treatment of critically ill
COVID-19 patients to save lives.
Abstract
Importance: Coronavirus disease 2019 (COVID-19) is a pandemic with no
specific drugs and high mortality. The most urgent thing is to find
effective treatments. Objective: To determine whether hydroxychloroquine
application may be associated with a decreased risk of death in
critically ill COVID-19 patients and what is potential mechanism.
Design, Setting and Patients: This retrospective study included all 568
critically ill COVID-19 patients who were confirmed by pathogen
laboratory tests despite antiviral treatment and had severe acute
respiratory distress syndrome, PAO2/FIO2 <300 with need of mechanical
ventilation in Tongji Hospital, Wuhan, between February 1 of 2020 to
April 8 of 2020. All 568 patients received comparable basic treatments
including antiviral drugs and antibiotics, and 48 of them additionally
received oral hydroxychloroquine (HCQ) treatment (200 mg twice a day for
7-10 days). Primary endpoint is mortality of patients, and inflammatory
cytokines levels were compared between hydroxychloroquine and
non-hydroxychloroquine (NHCQ) treatments.
MAIN OUTCOMES AND MEASURES: In-hospital death and hospital stay time
(day) were obtained, level of inflammatory cytokine (IL-6) was measured
and compared between HCQ and NHCQ treatments.
RESULTS: The median age of 568 critically ill patients is 68 (57, 76)
years old with 37.0% being female. Mortalities are 18.8% (9/48) in HCQ
group and 45.8% (238/520) in NHCQ group (p<0.001). The time of hospital
stay before patient death is 15 (10-21) days and 8 (4 - 14) days for the
HCQ and NHCQ groups, respectively (p<0.05). The level of inflammatory
cytokine IL-6 was significantly lowered from 22.2 (8.3-118.9) pg/mL at
the beginning of the treatment to 5.2 (3.0-23.4) pg/ml (p<0.05) at the
end of the treatment in the HCQ group but there is no change in the NHCQ
group.
CONCLUSIONS AND RELEVANCE: Hydroxychloroquine treatment is significantly
associated with a decreased mortality in critically ill patients with
COVID-19 through attenuation of inflammatory cytokine storm. Therefore,
hydroxychloroquine should be prescribed for treatment of critically ill
COVID-19 patients to save lives.
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