Dados de Vida Real sobre o Uso da Hidroxicloroquina ou da Cloroquina Combinadas ou Não à Azitromicina em Pacientes com Covid-19: Uma Análise Retrospectiva no Brasil
Maíra Viana Rego Souza-Silva, Daniella Nunes Pereira, Magda Carvalho Pires, Isabela Muzzi Vasconcelos, Alexandre Vargas Schwarzbold, Diego Henrique De Vasconcelos, Elayne Crestani Pereira, Euler Roberto Fernandes Manenti, Felício Roberto Costa, Filipe Carrilho De Aguiar, Fernando Anschau, Frederico Bartolazzi, Guilherme Fagundes Nascimento, Heloisa Reniers Vianna, Joanna D’arc Lyra Batista, Juliana Machado-Rugolo, Karen Brasil Ruschel, Maria Angélica Pires Ferreira, Leonardo Seixas De Oliveira, Luanna Silva Monteiro Menezes, Patricia Klarmann Ziegelmann, Marcela Gonçalves Trindade Tofani, Maria Aparecida Camargos Bicalho, Matheus Carvalho Alves Nogueira, Milton Henriques Guimarães-Júnior, Rúbia Laura Oliveira Aguiar, Danyelle Romana Alves Rios, Carisi Anne Polanczyk, Milena Soriano Marcolino
Arquivos Brasileiros de Cardiologia, doi:10.36660/abc.20220935
Background: Despite no evidence showing benefits of hydroxychloroquine and chloroquine with or without azithromycin for COVID-19 treatment, these medications have been largely prescribed in Brazil. Objectives: To assess outcomes, including in-hospital mortality, electrocardiographic abnormalities, hospital length-of-stay, admission to the intensive care unit, and need for dialysis and mechanical ventilation, in hospitalized COVID-19 patients who received chloroquine or hydroxychloroquine, and to compare outcomes between those patients and their matched controls. Methods: A retrospective multicenter cohort study that included consecutive laboratory-confirmed COVID-19 patients from 37 Brazilian hospitals from March to September 2020. Propensity score was used to select matching controls by age, sex, cardiovascular comorbidities, and in-hospital use of corticosteroid. A p-value <0.05 was considered statistically significant. Results: From 7,850 COVID-19 patients, 673 (8.6%) received hydroxychloroquine and 67 (0.9%) chloroquine. The median age in the study group was 60 years (46 -71) and 59.1% were women. During hospitalization, 3.2% of patients presented side effects and 2.2% required therapy discontinuation. Electrocardiographic abnormalities were more prevalent in the chloroquine/hydroxychloroquine group (13.2% vs. 8.2%, p=0.01), and the long corrected QT interval was the main difference (3.6% vs. 0.4%, p<0.001). The median hospital length of stay was longer in the HCQ/CQ + AZT group than in controls (9.0 [5.0, 18.0] vs. 8.0 [4.0, 14.0] days). There was no statistical differences between groups in intensive care unit admission (35.1% vs. 32.0%; p=0.282), invasive mechanical ventilation support (27.0% vs. 22.3%; p=0.074) or mortality (18.9% vs. 18.0%; p=0.682). Conclusion: COVID-19 patients treated with chloroquine or hydroxychloroquine had a longer hospital length of stay, when compared to matched controls. Intensive care unit admission, invasive mechanical ventilation, dialysis and inhospital mortality were similar.
Potential conflict of interest No potential conflict of interest relevant to this article was reported.
Sources of funding
Study association This study is not associated with any thesis or dissertation work.
Ethics approval and consent to participate This study was approved by the Comitê Nacional de Ética em Pesquisa under the protocol number CAAE 30350820.5.1001.0008. All the procedures in this study were in accordance with the 1975 Helsinki Declaration, updated in 2013.
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'date-time': '2023-10-04T11:41:38Z',
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'relation': {},
'ISSN': ['0066-782X', '1678-4170'],
'subject': ['Cardiology and Cardiovascular Medicine'],
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