key: cord-0878189-4owtfn0b
authors: Corrêa, Thiago Domingos; de Matos, Gustavo Faissol Janot; Bravim, Bruno de Arruda; Cordioli, Ricardo Luiz; Garrido, Alejandra del Pilar Gallardo; de Assuncao, Murillo Santucci Cesar; Barbas, Carmen Silvia Valente; Timenetsky, Karina Tavares; Rodrigues, Roseny dos Reis; Guimarães, Hélio Penna; Rabello, Roberto; Lomar, Frederico Polito; Scarin, Farah Christina de La Cruz; Batista, Carla Luciana; Pereira, Adriano José; Guerra, João Carlos de Campos; Carneiro, Bárbara Vieira; Nawa, Ricardo Kenji; Brandão, Rodrigo Martins; Pesaro, Antônio Eduardo Pereira; Silva, Moacyr; de Carvalho, Fabricio Rodrigues Torres; Silva, Cilene Saghabi de Medeiros; de Almeida, Ana Claudia Ferraz; Franken, Marcelo; Pesavento, Marcele Liliane; Eid, Raquel Afonso Caserta; Ferraz, Leonardo José Rolim
title: Comment to: Intensive support recommendations for critically-ill patients with suspected or confirmed COVID-19 infection
date: 2020-07-31
journal: Einstein
DOI: 10.31744/einstein_journal/2020ce5931
sha: 421123bdce691c22bc15e842538143c0747ba100
doc_id: 878189
cord_uid: 4owtfn0b

nan

Dear Editor, In this issue of einstein journal (São Paulo), Corrêa et al., reported intensive support recommendations for critically-ill patients with suspected or confirmed infection by the new coronavirus (COVID-19). (1) Based on preliminary demonstration of efficacy of chloroquine, the authors suggested the use of hydroxychloroquine in monotherapy or combined with a macrolide (azithromycin or clarithromycin), to treat severe patients with COVID-19, admitted to the intensive care unit (ICU), to inhibit in vitro replication of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). (2) However, evidence from observational studies (3, 4) involving hospitalized COVID-19 patients demonstrated the use of hydroxychloroquine in monotherapy (3) or combined with a macrolide (4) was not associated with reduced mortality when compared to patients who did not receive such medications (controls). Yet, the use of hydroxychloroquine in monotherapy or combined with a macrolide may be associated with greater incidence of major cardiovascular complications. (4) Therefore, based on new evidence available, we exclude the recommendation to use hydroxychloroquine in monotherapy or combined with a macrolide for treating inpatients with severe acute respiratory syndrome caused by COVID-19. 

Intensive support recommendations for critically-ill patients with suspected or confirmed COVID-19 infection. einstein (São Paulo)

Hydroxychloroquine, a less toxic derivative of chloroquine, is effective in inhibiting SARS-CoV-2 infection in vitro

Observational study of hydroxychloroquine in hospitalized patients with Covid-19

Association of treatment with hydroxychloroquine or azithromycin with in-hospital mortality in patients with COVID-19 in New York State