Published in:
Open Access
01-12-2022 | Oseltamivir | Research
“H” is not for hydroxychloroquine—“H” is for heparin: lack of efficacy of hydroxychloroquine and the role of heparin in COVID-19—preliminary data of a prospective and interventional study from Brazil
Authors:
Renata de Oliveira Costa, Joyce Santos Nascimento, Cadiele Oliana Reichert, Adriana Pedroso Augusto da Costa, Maria Aparecida Pedrosa dos Santos, Alberto Macedo Soares, Carlos Eduardo Mendonça Tomé, Ricardo Leite Hayden, Cassiano Waldanski dos Santos, Bruno Barreiro, Amer Abdul Basset El-Khatib, Luís Alberto de Pádua Covas Lage, Juliana Pereira, Mônica Mazzurana Benetti
Published in:
BMC Infectious Diseases
|
Issue 1/2022
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Abstract
Background
COVID-19 pandemic is the major public health problem in the world actually. It’s associated with high morbidity and mortality. To date, no therapeutic measure has a curative potential. Hydroxychloroquine (HCQ) is a drug with immunomodulatory properties that has demonstrated antiviral efficacy in in vitro experiments, with conflicting results in in vivo studies.
Methods
A single-center, prospective and interventional study, that evaluates the impact on mortality of the HCQ use in 154 patients hospitalized with COVID-19 in a Brazilian public hospital. The study also aims to determine prognostic factors that predict mortality, ICU admission and endotracheal intubation in this population.
Results
154 patients diagnosed with COVID-19 confirmed by RT-PCR and hospitalized were included. There was a male predominance (87/154, 56.5%), median age 60 years and 88% (136/154) had comorbidities. Among these, 76% (117/154) were admitted to the ICU and 29.2% (45/154) experienced EOT. The OMR was 51.3% (79/154). There was no difference in mortality between patients treated with HCQ (N = 95) and non-HCQ (N = 59) (44.1% × 55.8%, p = 0.758). In univariate analysis, age ≥ 60 years (HR 3.62, p < 0.001), need for mechanical ventilation (HR 2.17, p = 0.001), ≥ 2 comorbidities (HR 1.83, p = 0.049), SAH (HR: 1.56, p = 0.054) were predictors of mortality, as well as no use of prophylactic or therapeutic heparin (HR 3.60, p = 0.02). Multivariate analysis identified admission to the ICU (HR 8.98, p = 0.002) and advanced age (HR 3.37, p < 0.01) as independent predictors of mortality, although, use of heparin (HR 0.25, p = 0.001) was independently associated with a favorable outcome.
Conclusion
This study confirmed the absence of a benefit associated with the use of HCQ in Brazilian patients hospitalized with COVID-19. However, prophylactic or therapeutic heparin was an independent predictor for reducing mortality in this population.