Chloroquine and hydroxychloroquine repositioning in times of COVID-19 pandemics, all that glitters is not gold

Paumgartten, Francisco José Roma; Delgado, Isabella Fernandes; Pitta, Luciana da Rocha; Oliveira, Ana Raquel Soares de

doi:10.1590/0102-311x00088520

Cited by 7 publications

(10 citation statements)

References 15 publications

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“…Both CQ and HCQ are narrow MOS medicines causing a number of severe adverse events including ophthalmologic sequelae (retinopathy and loss of vision) and life-threatening heart disorders, such as QT interval prolongation, arrhythmias and cardiac arrest 4,11,21 . Along this line, the US FDA has issued a warning (April 24 th 2020) about serious adverse events, such as QT interval prolongation, ventricular tachycardia and ventricular fibrillation, and deaths, in patients with Covid-19 who had made use of CQ/ HCQ, either alone or combined with AZM 22 .…”

Section: Off Label Use Of Chloroquine (Cq) and Hydroxychloroquine (Hcq)mentioning

confidence: 99%

“…In the early 2000s, it was proposed that the antimalarials chloroquine (CQ), hydroxychloroquine (HCQ) and artemisinin [9][10][11] , the anthelmintics ivermectin, nitazoxanide and niclosamide, and indomethacin (anti-inflammatory) could be useful compounds to treat a diversity of viral infections including the then emerging virus SARS-CoV-1 [12][13][14][15][16] . This hypothesis was based on results from cell culture-based assays showing that all these antiparasitic drugs exhibited potent antiviral activity against a variety of viruses.…”

Section: Introductionmentioning

confidence: 99%

“…This hypothesis was based on results from cell culture-based assays showing that all these antiparasitic drugs exhibited potent antiviral activity against a variety of viruses. In the case of the antimalarial 4-aminoquinolines (CQ and HCQ) and indomethacin it was also speculated that their anti-inflammatory and/or immunosuppressive action would add to the inhibition of viral replication in the clinical management of the lung hyperinflammation and Acute Respiratory Distress Syndrome caused by SARS-CoV-1 (and also SARS-CoV-2) infection 10,11 .…”

Section: Introductionmentioning

confidence: 99%

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Off label, compassionate and irrational use of medicines in Covid-19 pandemic, health consequences and ethical issues

Paumgartten

Oliveira

2020

Ciênc. saúde coletiva

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When Covid-19 emerged in December last year, there was no vaccine nor was there specific effective treatment for this fast-spreading and life-threatening viral respiratory infection. Clinical trials were planned and are in progress to investigate whether drugs used for influenza, HIV and other viruses, and also anthelmintics (ivermectin, nitazoxanide, niclosamide), and antimalarials (chloroquine, hydroxychloroquine) showing antiviral activity in in vitro assays, are effective and safe for Covid-19. So far there is no convincing evidence that these antiviral and antiparasitic drugs are of any benefit for Covid-19. Notwithsanding the absence of evidence of clinical efficacy, these drugs are widely used outside of clinical trials (off label) for prophylaxis and treatment of this viral infection. The rationale behind the prescription of macrolide antibiotics (azithromycin) for Covid-19 is obscure as well. The widespread prescription and use of drugs of unproven efficacy and safety for Covid-19 is at odds with the rational use of medicines, a cornerstone principle of pharmacotherapy advanced by WHO in 1985. This irrational use of drugs is cause for concern because some of them are associated with serious heart disorders and deaths.

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Section: Off Label Use Of Chloroquine (Cq) and Hydroxychloroquine (Hcq)mentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Off label, compassionate and irrational use of medicines in Covid-19 pandemic, health consequences and ethical issues

Paumgartten

Oliveira

2020

Ciênc. saúde coletiva

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“…11 Por fim, enquanto não surgir efetivas ferramentas para o embate da pandemia, a prevenção nunca ganhou tamanha importância. [37][38][39] Neste contexto, a educação em saúde terá um duplo desafio, além de ensinar e reforçar a prática de necessários hábitos diários, Lave com frequência as mãos até a altura dos punhos, com água e sabão, ou então higienize com álcool em gel 70%; Ao tossir ou espirrar, cubra nariz e boca com lenço ou com o braço, e não com as mãos; Evite tocar olhos, nariz e boca com as mãos não lavadas; Ao tocar, lave sempre as mãos como já indicado; Mantenha uma distância mínima de cerca de 2 metros de qualquer pessoa tossindo ou espirrando; Evite abraços, beijos e apertos de mãos -adote um comportamento amigável sem contato físico, mas sempre com um sorriso no rosto; Higienize com frequência o celular e os brinquedos das crianças; Não compartilhe objetos de uso pessoal, como talheres, toalhas, pratos e copos; Mantenha os ambientes limpos e bem ventilados; Evite circulação desnecessária nas ruas, estádios, teatros, shoppings, shows, cinemas e igrejas -se puder, fique em casa; Se estiver doente, evite contato físico com outras pessoas, principalmente idosos e doentes crônicos, e fique em casa até melhorar; Durma bem e tenha uma alimentação saudável; Utilize máscaras caseiras ou artesanais feitas de tecido em situações de saída de sua residência. 5, p. 1 terá um papel no combate da disseminação, principalmente pelas redes sociais, de falsos conteúdos, as fake news.…”

Section: Covid-19: O Que Estamos Enfrentando?unclassified

“…5, p. 1 terá um papel no combate da disseminação, principalmente pelas redes sociais, de falsos conteúdos, as fake news. [37][38][39] Reflexões sobre o processo formativo da Odontologia em interface com a pandemia Em linhas gerais, antes da Pandemia, como a Odontologia se encontrava? A retratação deste cenário ganha sentido nas colocações de Reis et al, 40, p. 88 "O paradoxo da odontologia brasileira: dentistas sem pacientes versus pacientes sem dentistas".…”

Section: Covid-19: O Que Estamos Enfrentando?unclassified

Odontologia e a COVID-19

Almeida¹,

Oliveira²,

Pereira³

et al. 2020

J Manag Prim Health Care

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De forma global, muito tem se falado sobre uma nova doença causada por coronavírus, que ultrapassou fronteiras e se propagou por todo o mundo, tornando-se uma pandemia ameaçadora para mais de 7 bilhões de vidas. Nesse contexto, através de um debate crítico e reflexivo, esse estudo fundamentou seu objetivo, o de analisar os possíveis impactos da Pandemia da COVID-19 no sistema educacional superior odontológico. Para tal, foi estrategicamente delineado por dois pontos de discussão, sendo eles: “COVID-19: o que estamos enfrentando?” e “Reflexões sobre o processo formativo da Odontologia em interface com a pandemia”. Do primeiro ponto, inicialmente, foram abordadas a descrição, a origem e a transmissibilidade do vírus (SARSCoV-2), seguindo-se para o enfoque da doença, abarcando seus sinais e sintomas, diagnóstico, possíveis percursos, controle coletivo, grupos de risco e seus possíveis tratamentos e prevenção. Já no segundo, de forma temporal, buscou-se uma compreensão de como o processo educativo odontológico foi afetado pela pandemia, partindo do seu ingresso, essencialmente cientificista, em direção às reflexões durante o enfrentamento da doença e, por fim, às expectativas dos possíveis apontamentos para o seu futuro. De tudo, em conclusão, a intenção dessa pesquisa não foi a de conceber uma visão negativista do futuro da Odontologia, pelo contrário, acredita-se que, imersa às complexidades políticas e econômicas em que o mundo está atravessando, a academia odontológica ainda se dedicará a refletir mais sobre outras habilidades, pautadas na plasticidade do adaptar, do criar, do suprimir, do postergar, do (re)inventar e, principalmente, do contextualizar-se.

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COVID-19, hydroxychloroquine and sudden cardiac death: implications for clinical practice in patients with rheumatic diseases

et al. 2021

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Sudden cardiac death is commonly seen due to arrhythmias, which is a common cardiac manifestation seen in COVID-19 patients, especially those with underlying cardiovascular disease (CVD). Administration of hydroxychloroquine (HCQ) as a potential treatment option during SARS-CoV-2, initially gained popularity, but later, its safe usage became questionable due to its cardiovascular safety, largely stemming from instances of cardiac arrhythmias in COVID-19. Moreover, in the setting of rheumatic diseases, in which patients are usually on HCQ for their primary disease, there is a need to scale the merits and demerits of HCQ usage for the treatment of COVID-19. In this narrative review, we aim to address the association between usage of HCQ and sudden cardiac death in COVID-19 patients. MEDLINE, EMBASE, ClinicalTrials.gov and SCOPUS databases were used to review articles in English ranging from case reports, case series, letter to editors, systematic reviews, narrative reviews, observational studies and randomized control trials. HCQ is a potential cause of sudden cardiac death in COVID-19 patients. As opposed to the reduction in CVD with HCQ in treatment of systemic lupus erythematous, rheumatoid arthritis, and other rheumatic diseases, safe usage of HCQ in COVID-19 patients is unclear; whereby, it is observed to result in QTc prolongation and Torsades de pointes even in patients with no underlying cardiovascular comorbidity. This is occasionally associated with sudden cardiac death or cardiac arrest; hence, its clinical efficacy needs further investigation by large-scale clinical trials.

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Chloroquine and hydroxychloroquine repositioning in times of COVID-19 pandemics, all that glitters is not gold

Cited by 7 publications

References 15 publications

Off label, compassionate and irrational use of medicines in Covid-19 pandemic, health consequences and ethical issues

Off label, compassionate and irrational use of medicines in Covid-19 pandemic, health consequences and ethical issues

Odontologia e a COVID-19

COVID-19, hydroxychloroquine and sudden cardiac death: implications for clinical practice in patients with rheumatic diseases

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