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Risk of hospitalization for Covid-19 outpatients treated with various drug regimens in Brazil: Comparative analysis.
Szente Fonseca, Silvia Nunes; de Queiroz Sousa, Anastasio; Wolkoff, Alexandre Giandoni; Moreira, Marcelo Sampaio; Pinto, Bruno Castro; Valente Takeda, Christianne Fernandes; Rebouças, Eduardo; Vasconcellos Abdon, Ana Paula; Nascimento, Anderson L A; Risch, Harvey A.
Afiliação
  • Szente Fonseca SN; Hospital São Francisco, Ribeirão Preto, Brazil.
  • de Queiroz Sousa A; Federal University of Ceará, Ceará, Brazil.
  • Wolkoff AG; Hapvida Saúde HMO, Fortaleza, Brazil.
  • Moreira MS; Hapvida Saúde HMO, Fortaleza, Brazil.
  • Pinto BC; Hapvida Saúde HMO, Fortaleza, Brazil.
  • Valente Takeda CF; Hapvida Saúde HMO, Fortaleza, Brazil.
  • Rebouças E; Hapvida Saúde HMO, Fortaleza, Brazil.
  • Vasconcellos Abdon AP; University of Fortaleza, Fortaleza, Brazil.
  • Nascimento ALA; Hapvida Saúde HMO, Fortaleza, Brazil.
  • Risch HA; Yale School of Public Health, New Haven, CT, USA. Electronic address: harvey.risch@yale.edu.
Travel Med Infect Dis ; 38: 101906, 2020.
Article em En | MEDLINE | ID: mdl-33137493
BACKGROUND: For the past few months, HMOs have faced crowded emergency rooms and insufficient hospital and intensive-care-unit beds, all from the worst pandemic of this century, COVID-19. METHODS: In a large HMO in Brazil, our approach was to allow treating physicians to prescribe antiviral medications immediately at presentation, and prednisone starting on day-6 of symptoms to treat pulmonary inflammation. We implemented this COVID-19 protocol for outpatients and studied 717 consecutive SARS-CoV-2-positive patients age 40 years or older presenting at our emergency rooms. RESULTS: Use of hydroxychloroquine (HCQ), prednisone or both significantly reduced hospitalization risk by 50-60%. Ivermectin, azithromycin and oseltamivir did not substantially reduce risk further. Hospitalization risk was doubled for people with type-2 diabetes or obesity, increased by two-thirds for people with heart disease, and by 75% for each decade of age over age 40. Similar magnitudes of reduced risk with HCQ and prednisone use were seen for mortality risk, though were not significant because of only 11 deaths among the 717 patients. No cardiac arrhythmias requiring medication termination were observed for any of the medications. CONCLUSIONS: This work adds to the growing literature of studies that have found substantial benefit for use of HCQ combined with other agents in the early outpatient treatment of COVID-19, and adds the possibility of steroid use to enhance treatment efficacy.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: SARS-CoV-2 / Tratamento Farmacológico da COVID-19 / Hospitalização Tipo de estudo: Etiology_studies / Guideline / Risk_factors_studies Limite: Adult / Aged / Female / Humans / Male / Middle aged País/Região como assunto: America do sul / Brasil Idioma: En Revista: Travel Med Infect Dis Assunto da revista: DOENCAS TRANSMISSIVEIS Ano de publicação: 2020 Tipo de documento: Article País de afiliação: Brasil País de publicação: Holanda
Texto completo
Adicionar na Minha BVS
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XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: SARS-CoV-2 / Tratamento Farmacológico da COVID-19 / Hospitalização Tipo de estudo: Etiology_studies / Guideline / Risk_factors_studies Limite: Adult / Aged / Female / Humans / Male / Middle aged País/Região como assunto: America do sul / Brasil Idioma: En Revista: Travel Med Infect Dis Assunto da revista: DOENCAS TRANSMISSIVEIS Ano de publicação: 2020 Tipo de documento: Article País de afiliação: Brasil País de publicação: Holanda