.Toto a écrit : ↑10 avril 2020 12:59C'est intéressant de mettre en ligne un texte où tu ne comprends rien ! Encore un acte de pédago raté !AAAgora a écrit : ↑10 avril 2020 12:29 Je mets ci dessous la synthèse et une table de l'essai effectué à l'IHU sur 1061 patients.
Ceux qui le souhaitent peuvent le consulter sur le site de l'IHU.
J'ai une maitrise limitée de la langue anglaise, mais il me semble que sur ce forum il y a des personnes qui se débrouillent plus que bien.
Autre point : la table (deuxième partie) est présentée en format Excel mais en copié/collé elle se présente en format Word.
Je ne sais pas faire mieux.
Allez sur leur site : https://www.mediterranee-infection.com/pre-prints-ihu/ ( c'est la N°6)
ABSTRACT
Background
In a recent survey, most physicians worldwide considered that hydroxychloroquine (HCQ) and azithromycin (AZ) are the two most effective drugs among available molecules against COVID-19. Nevertheless, to date, one preliminary clinical trial only has demonstrated its efficacy on the viral load. Additionally, a clinical study including 80 patients was published, and in vitro efficiency of this association was demonstrated.
Methods
The study was performed at IHU Méditerranée Infection, Marseille, France. A cohort of 1061 COVID-19 patients, treated for at least 3 days with the HCQ-AZ combination and a follow-up of at least 9 days was investigated. Endpoints were death, worsening and viral shedding persistence.
Findings
From March 3rd to April 9th, 2020, 59,655 specimens from 38,617 patients were tested for COVID-19 by PCR. Of the 3,165 positive patients placed in the care of our institute, 1061 previously unpublished patients met our inclusion criteria. Their mean age was 43.6 years old and 492 were male (46.4%). No cardiac toxicity was observed. A good clinical outcome and virological cure was obtained in 973 patients within 10 days (91.7%). Prolonged viral carriage at completion of treatment was observed in 47 patients (4.4%) and was associated to a higher viral load at diagnosis (p < 10-2) but viral culture was negative at day 10 and all but one were PCR-cleared at day 15. A poor outcome was observed for 46 patients (4.3%); 10 were transferred to intensive care units, 5 patients died (0.47%) (74-95 years old) and 31 required 10 days of hospitalization or more. Among this group, 25 patients are now cured and 16 are still hospitalized (98% of patients cured so far). Poor clinical outcome was significantly associated to older age (OR 1.11), initial higher severity (OR 10.05) and low
1
hydroxychloroquine serum concentration. In addition, both poor clinical and virological outcomes were associated to the use of selective beta-blocking agents and angiotensin II receptor blockers (P<0.05). Mortality was significantly lower in patients who had received > 3 days of HCQ-AZ than in patients treated with other regimens both at IHU and in all Marseille public hospitals (p< 10-2).
Interpretation
The HCQ-AZ combination, when started immediately after diagnosis, is a safe and efficient treatment for COVID-19, with a mortality rate of 0.5%, in elderly patients. It avoids worsening and clears virus persistence and contagiosity in most cases."
"Table 1. Baseline characteristics according to clinical and virological outcome of 1061 patients treated with HCQ + AZ ≥ 3 days at IHU Méditerranée infection Marseille, France with Day 0 between March 3 and March 31, 2020.
Poor virological Poor clinical
outcomea Good outcome outcomea,b Total
Group size
Age (years)
Mean (SD)
Male
Chronic condition(s) and treatment(s)
Chronic conditions
Cancer
Diabetes
Coronary artery disease
Hypertension
Chronic respiratory diseases
Obesity
Comedication(s)
Biguanides (metformin)
Selective beta blocking agents
Dihydropyridine derivatives
Angiotensin II receptor blockers
HMG CoA reductase inhibitors
Diuretics
Time between onset of symptoms and first day of treatment start (days)c
Mean (SD)
Median [Min-Max]
Clinical classification (NEWS score)
0 – 4 (low)
5 – 6 (medium)
≥ 7 (high)
Low-dose pulmonary CT-scanner within 72 hours of admissiond
Normal
Limited
Medium
Severe
Viral load at inclusion (Ct - nasal)e
Mean (SD)
Median [Min-Max]
Hydroxychloroquine levels at day 2 (μg/mL)f
Mean (SD)
Median [Min-Max]
Number ≤ 0.1μg/mL
n (%)
47 (4.4%)
47.9 (17.5)*
19 (40.4%)
0 (0.0%) 3 (6.4%) 2 (4.3%) 8 (17%) 8 (17%) 1 (2.1%)
1 (2.1%)
6 (12.8%)**
3 (6.4%)
6 (12.8%)**
4 (8.5%) 2 (4.3%)
4.3 (2.5)
4.0 [0.0-9.0]*** 43 (91.5%)*
2 (4.3%) 2 (4.3%)
11/37 (29.7%) 23/37 (62.2%) 3/37 (8.1%) 0/37 (0.0%)
23.4 (5.1)
22.1 [14.8-34.0]***
0.25 (0.17) 0.19 [0.07-0.70] 4/24 (16.7%)
n (%)
973 (91.7%)
42.4 (14.7) 450 (46.3%)
21 (2.2%) 66 (6.8%) 36 (3.7%) 120 (12.3%) 96 (9.9%) 57 (5.9%)
15 (1.5%) 22 (2.3%)
23 (2.4%) 22 (2.3%) 28 (2.9%) 28(2.9%)
6.5 (3.9) 6.0 [0.0-27.0]
948 (97.4%) 14 (1.4%) 11 (1.1%)
231/642 (36.0%) 277/642 (43.2%) 123/642 (19.2%) 11/642 (1.7%)
26.8 (4.9) 27.3 [12.8-34.0]
0.26 (0.16) 0.22 [0.00-1.01] 15/206 (7.3%)
n (%)
46 (4.3%)
69.2 (14.0)***
23 (50%)
7 (15.2%)*** 9 (19.6%)*** 9 (19.6%)*** 23 (50.0%)*** 8 (17.4%)
4 (8.7%)
4 (8.7%)** 9 (19.6%)*** 8 (17.4%)*** 14 (30.4%)*** 7 (15.2%)*** 5 (10.9%)*
5.9 (4.0)
5.0 [0.0-16.0]*** 19 (41.3%)***
10 (21.7%) 17 (37.0%)
4/39 (10.3%)***
10/39 (25.6%) 20/39 (51.3%) 5/39 (12.8%)
25.6 (4. 25.8 [15.0-33.2]
0.20 (0.17)
0.15 [0.00-0.75]** 12/37 (32.4%)***
n (%)
1061 (100%)
43.6 (15.6) 492 (46.4)
28 (2.6%) 78 (7.4%) 46 (4.3%) 149 (14%) 111 (10.5%) 62 (5.8%)
20 (1.9%) 34 (3.2%) 34 (3.2%) 40 (3.8%) 38 (3.6%) 35(3.3%)
6.4 (3. 6.0 [0.0-27.0]
1008 (95.0%) 25 (2.4%) 28 (2.6%)
245/714 (34.3%) 307/714 (43.0%) 146/714 (20.5%) 16/714 (2.2%)
26.6 (5.0) 27.0 [12.8-34.0]
0.25 (0.16) 0.21 [0.00-1.01] 30/263 (11.4%)
Poor virological outcome (PVirO): viral shedding persistence at day 10, Poor clinical outcome (PClinO): either death or transfer to intensive care unit (ICU) or hospitalization for 10 days or more, Good outcome: individuals who belonged neither to the PClinO group nor the PVirO group. aFive patients belonged to both the PVirO and PClinO outcome so the sum of frequencies may be above 1061. SD: standard deviation. bIncluding 5 deaths. cData available for 928 patients (56 patients who did not declare any symptom before treatment start were excluded and 77 with missing data); dfor 714 patients; efor 992 patients, and ffor 263 patients. On low-dose pulmonary CT-scanner, patients were classified as no involvement (lack of lung involvement (ground glass opacities, consolidation or crazy paving pattern) ; minimal involvement (subtle ground glass opacities); intermediate involvement (less than 50% of segment involvement in no more than 5 segments) and severe involvement (involvement of more than 5 segments). The denominator was mentioned when the result was not available for all patients. *: p<0.05; **p<0.01; ***p<0.001 (Fisher's exact test, Student t-test, Wilcoxon-Mann-Whitney where appropriate; reference group is good outcome).
Je ne veut pas faire de la pédagogie.
J'ai précisé avant de mettre en ligne que ce rapport est celui que le professeur Rault a donné à Macron et que surement il a envoyé au Conseil Scientifique à Paris.
Il y aura une version en français qui suivra.
Vous n'y comprenez rien et moi non plus, c'est un langage d'experts, et les experts trancheront, et après les experts ça sera au tour du Président de trancher.
En attendant Macron (lundi soir) au IHU continuent leur travail de traitement (à hier 2.285 patients traités en 10 morts).