ADL-dependency, D-Dimers, LDH and absence of anticoagulation are independently associated with one-month mortality in older inpatients with Covid-19

Bousquet, Guilhem; Falgarone, Géraldine; Deutsch, David; Derolez, Sophie; Lopez‐Sublet, Marilucy; Goudot, François‐Xavier; Amari, Khadaoudj; Uzunhan, Y.; Bouchaud, Olivier; Pamoukdjian, Frédéric

doi:10.18632/aging.103583

Cited by 40 publications

(54 citation statements)

References 23 publications

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“…Ten articles from Medrxiv/Google Scholar were added, so 29 articles were included, of which 25 were observational studies, one was an interventional non-randomized study and three were RCT. These studies included 27 articles for hydroxychloroquine [ [14] , [15] , [16] , [17] , [18] , [19] , 23 , 24 , 36 , [39] , [40] , [41] , [42] , [43] , [44] , [45] , [46] , [47] , [48] , [49] , [50] , [51] , [52] , [53] , [54] , [55] , [56] ] and 12 articles for hydroxychloroquine + azithromycin [ 18 , 36 , 41 , 42 , 47 , 48 , 50 , 51 , [57] , [58] , [59] , [60] ]. For chloroquine, after searching PubMed, Cochrane Review, Embase and Web of Science, 449 articles were identified.…”

Section: Resultsmentioning

confidence: 99%

“…Ten studies were conducted in the USA [ 15 , 18 , 23 , 41 , 42 , 49 , 50 , 53 , 56 , 58 ], four in Spain [ 16 , 17 , 44 , 57 ], seven in France [ 13 , 24 , 46 , 48 , 54 , 59 , 60 ], one in the UK [ 40 ], two in Italy [ 43 , 65 ], one in China [ 14 ], one in Brazil [ 51 ] and three in several other countries (USA, Canada, Italy and Spain) [ 39 , 47 , 52 ]. Twenty-two articles were published [ [13] , [14] , [15] , 17 , 18 , 24 , 39 , 41 , 43 , 44 , 46 , 47 , [49] , [50] , [51] , [52] , [53] , [54] , 56 , 57 , 59 , 60 , 65 ] and six articles were preprints [ 16 , 23 , 40 , 42 , 48 , 58 ]. Mean daily dose of hydroxychloroquine ranged from 333 mg/day to 945 mg/day.…”

Section: Resultsmentioning

confidence: 99%

“…Among the observational studies, fourteen articles had a moderate or serious risk of bias [ [13] , [14] , [15] , [16] , [17] , [18] , 41 , 42 , 44 , [46] , [47] , [48] , 56 , 58 ] and eleven studies had a critical risk of bias [ 23 , 43 , 49 , 50 , [52] , [53] , [54] , 57 , 59 , 60 , 65 ]. Eleven observational studies did not report adjusted effect sizes to control confusion and selection bias [ 23 , 24 , 43 , 44 , 49 , 53 , 54 , 57 , 59 , 60 , 65 ]. Quality of studies was lowered by the lack of information about the assignment of treatment, the time between start of follow up and start of intervention, some unbalanced co-intervention with other antiviral and antibiotic drugs and imbalance between groups for confounders such as co-morbidities and age.…”

Section: Resultsmentioning

confidence: 99%

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Effect of hydroxychloroquine with or without azithromycin on the mortality of coronavirus disease 2019 (COVID-19) patients: a systematic review and meta-analysis

Fiolet

Guihur

Rebeaud

et al. 2021

Clinical Microbiology and Infection

266

207

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Background Hydroxychloroquine or chloroquine with or without azithromycin have been widely promoted to treat coronavirus disease 2019 (COVID-19) following early in vitro antiviral effects against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Objective The aim of this systematic review and meta-analysis was to assess whether chloroquine or hydroxychloroquine with or without azithromycin decreased COVID-19 mortality compared with the standard of care. Data sources PubMed, Web of Science, Embase Cochrane Library, Google Scholar and MedRxiv were searched up to 25 July 2020. Study eligibility criteria We included published and unpublished studies comparing the mortality rate between patients treated with chloroquine or hydroxychloroquine with or without azithromycin and patients managed with standard of care. Participants Patients ≥18 years old with confirmed COVID-19. Interventions Chloroquine or hydroxychloroquine with or without azithromycin. Methods Effect sizes were pooled using a random-effects model. Multiple subgroup analyses were conducted to assess drug safety. Results The initial search yielded 839 articles, of which 29 met our inclusion criteria. All studies except one were conducted on hospitalized patients and evaluated the effects of hydroxychloroquine with or without azithromycin. Among the 29 articles, three were randomized controlled trials, one was a non-randomized trial and 25 were observational studies, including 11 with a critical risk of bias and 14 with a serious or moderate risk of bias. After excluding studies with critical risk of bias, the meta-analysis included 11 932 participants for the hydroxychloroquine group, 8081 for the hydroxychloroquine with azithromycin group and 12 930 for the control group. Hydroxychloroquine was not significantly associated with mortality: pooled relative risk (RR) 0.83 (95% CI 0.65–1.06, n = 17 studies) for all studies and RR = 1.09 (95% CI 0.97–1.24, n = 3 studies) for randomized controlled trials. Hydroxychloroquine with azithromycin was associated with an increased mortality (RR = 1.27; 95% CI 1.04–1.54, n = 7 studies). We found similar results with a Bayesian meta-analysis. Conclusion Hydroxychloroquine alone was not associated with reduced mortality in hospitalized COVID-19 patients but the combination of hydroxychloroquine and azithromycin significantly increased mortality.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Effect of hydroxychloroquine with or without azithromycin on the mortality of coronavirus disease 2019 (COVID-19) patients: a systematic review and meta-analysis

Fiolet

Guihur

Rebeaud

et al. 2021

Clinical Microbiology and Infection

266

207

View full text Add to dashboard Cite

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“…Coronavirus disease 2019 (COVID- 19) is a disease that could cause multiple organ injuries including heart [9][10][11][12], liver and kidney injuries [13][14][15][16]. Similarly, a growing number of studies demonstrated that elevated LDH value was associated with significantly increased mortality in patients with COVID-19 [12,17]. But in most studies, patients with various levels of COVID-19 severity were pooled and analyzed, this may prevent accurate evaluation of the relationship between LDH and disease progression and in-hospital death because the majority of deaths were from severe and critically ill patients.…”

Section: Introductionmentioning

confidence: 99%

Prognostic value of lactate dehydrogenase for in-hospital mortality in severe and critically ill patients with COVID-19

Dong¹,

Sun²,

Li³

2020

Int. J. Med. Sci.

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Background: Lactate dehydrogenase (LDH) has been proved to be a prognostic factor for the severity and poor outcomes of coronavirus disease 2019 (COVID-19). In most studies, patients with various levels of COVID-19 severity were pooled and analyzed which may prevent accurate evaluation of the relationship between LDH and disease progression and in-hospital death. In this study, we aimed to evaluate the association of LDH with in-hospital mortality in severe and critically ill patients with COVID-19. Methods: This single-center retrospective study enrolled 119 patients. Survival curves were plotted using Kaplan-Meier method and compared by log-rank test. Multivariate Cox regression models were used to determine the independent risk factors for in-hospital mortality. Receiver-operator curves (ROCs) were constructed to evaluate the predictive accuracy of LDH and other prognostic biomarkers. Results: Compared to the survival group, LDH levels in the dead group were significantly higher [559.5 (172, 7575) U/L vs 228 (117, 490) U/L, (P < 0.001)]. In Multivariate Cox regression, it remained an independent risk factor for in-hospital mortality (Hazard ratio 5.985, 95.0%CI: 1.498-23.905; P=0.011). A cutoff value of 353.5 U/L predicted the in-hospital mortality with a sensitivity of 94.4% and a specificity of 89.2% respectively. Conclusion: LDH is a favorable prognostic biomarker with high accuracy for predicting in-hospital mortality in severe and critically ill patients with COVID-19. This may direct physicians worldwide to effectively prioritize resources for patients at high risk of death and to implement more aggressive treatments at an earlier phase to save patients' lives.

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“…This result indicated that age, itself, may not in uence on the viral shedding period. One study reported that activity of daily living was associated with prognosis in older patients with COVID-19 [25]. If all the elderly patients are not always at high risk of prolonged viral clearance or worsening of COVID-19, it may be better to identify higher risk populations among them, and more careful prevention strategies for COVID-19 may only be applied to these population.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of SARS-CoV-2 clearance period in patients with COVID-19: a systematic review and meta-analysis

Okita¹,

Morita²,

Kumanogoh³

2020

Preprint

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Background: There is insufficient consensus on the viral shedding period in each background of patients with coronavirus disease 2019 (COVID-19).Methods: We conducted a comprehensive systematic review and meta-analysis according to the PRISMA guidelines. PubMed and Web of Science were searched for original studies reporting the viral shedding period in patients with COVID-19. A random effects model was used to calculate the mean number of days from the onset. Subanalysis was performed focusing on age, sex, severity, locality, and treatment.Results Of 55 studies identified, 12 met the selection criteria. The viral shedding period tended to be longer in sputum (19.03 days) than in nasopharynx (14.58 days). The viral shedding period in nasopharynx tended to be longer in severe patients (23.65 days) than in nonsevere patients (12.67 days). It also tended to be longer in patients treated with steroid (21.24 days) than in patients treated without steroid (12.20 days). This period tended to be longer in Asia (16.07 days) than in Europe (12.57 days). Age, sex, and anti-viral drugs did not affect the viral shedding period.Conclusions Severity, steroid usage, and locality may affect the viral shedding period.

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ADL-dependency, D-Dimers, LDH and absence of anticoagulation are independently associated with one-month mortality in older inpatients with Covid-19

Cited by 40 publications

References 23 publications

Effect of hydroxychloroquine with or without azithromycin on the mortality of coronavirus disease 2019 (COVID-19) patients: a systematic review and meta-analysis

Effect of hydroxychloroquine with or without azithromycin on the mortality of coronavirus disease 2019 (COVID-19) patients: a systematic review and meta-analysis

Prognostic value of lactate dehydrogenase for in-hospital mortality in severe and critically ill patients with COVID-19

Evaluation of SARS-CoV-2 clearance period in patients with COVID-19: a systematic review and meta-analysis

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