Do we have enough evidence to use chloroquine/hydroxychloroquine as a public health panacea for COVID-19?

Palmeira, Vito ́ria Andrade; Costa, Larissa Braga; Perez, Lucas Giandoni; Ribeiro, Victor Teatini; Lanza, Katharina; Silva, Ana Cristina Simões e

doi:10.6061/clinics/2020/e1928

Cited by 20 publications

(12 citation statements)

References 7 publications

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“…1 There are currently no effective options of drug therapy. 2 As a result, since the beginning of the pandemic, non-pharmacological measures have been recommended by the World Health Organization, especially social distancing. 3 However, social distancing measures are not feasible for many workers during a pandemic.…”

Section: Introductionmentioning

confidence: 99%

Baixas na linha de frente: absenteísmo entre bombeiros durante o combate à pandemia da COVID-19

Lima

Vasconcelos

Corrêa³

et al. 2020

Rev. bras. saúde ocup.

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Resumo Objetivos: descrever o absenteísmo relacionado a casos suspeitos (com infecção respiratória aguda) e confirmados da COVID-19 e a outros diagnósticos entre bombeiros de Minas Gerais, Brasil. Métodos: foram analisados os registros oficiais sobre afastamento do trabalho por problemas de saúde (licença-saúde). A análise foi organizada em: 1) gráficos estratificados por grupo de diagnóstico; 2) análises descritivas da proporção de licenças-saúde e do percentual de dias de trabalho perdidos por infecção respiratória aguda; 3) comparação (qui-quadrado) da proporção de licenças-saúde e do percentual de dias de trabalho perdidos por infecção respiratória aguda e por outros diagnósticos entre 2019 e 2020. Resultados: a análise gráfica mostrou um padrão regular de licenças-saúde antes do início da pandemia, um pico de licenças-saúde por infecção respiratória aguda após o início da pandemia e um novo padrão de licenças-saúde após o período de pico. A proporção de licenças-saúde e o percentual de dias de trabalho perdidos por infecção respiratória aguda aumentaram, respectivamente, 312% e 580% em 2020. Em contraste, o percentual de dias de trabalho perdidos por outros diagnósticos diminuiu 16%. Conclusão: a mudança no perfil de absenteísmo entre bombeiros reflete o vínculo formal de emprego, as políticas institucionais e a percepção de risco sobre a COVID-19.

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Section: Introductionmentioning

confidence: 99%

Baixas na linha de frente: absenteísmo entre bombeiros durante o combate à pandemia da COVID-19

Lima

Vasconcelos

Corrêa³

et al. 2020

Rev. bras. saúde ocup.

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“…Using in silico prediction tools, a docking score of − 6.3 for HCQ for the COVID-19 main protease suggests higher ability to bind to and inhibit its function, as compared to the other tested drugs [ 77 ]. Moreover, it mediates its anti-inflammatory effects by inhibiting IL-6 and IFNα via reduction of T-cell activation, thus suppressing the cytokine storm [ 78 , 79 ]. Apart from this, it blocks cGAS (cyclic GMP–AMP synthase)-mediated synthesis of type I interferon (IFNβ) and also weakens NK cell cytotoxic function by controlling the conversion of perforins to its active form [ 80 , 81 ].…”

Section: Cardiovascular Involvement In Covid-19 Patientsmentioning

confidence: 99%

“…QTc prolongation, arrhythmias particularly torsades de pointes, cardiomyopathy, cardiac arrest and other cardiotoxicities are the most common cardiovascular manifestations [ 67 , 74 , 78 , 85 , 87 ]. The effects on the ocular system are also pronounced, ranging from retinopathy and blurry vision to possible blindness [ 67 , 74 , 78 , 86 ]. HCQ can also lead to gastrointestinal upsets presenting as nausea, vomiting, abdominal cramps, pancreatitis and hepatitis [ 67 , 86 ].…”

Section: Cardiovascular Involvement In Covid-19 Patientsmentioning

confidence: 99%

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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“…In this scenario, high research and public opinion attention has been devoted to the utilization of chloroquine and hydroxychloroquine against SARS-CoV-2 [ 43 ]. However, even with tests being currently developed in several countries [ 44 ], no sound scientific evidence of the usefulness of their utilization has been found [ 45 , 46 ]. Political reasons, alleging urgency, boosted the use of these drugs.…”

Section: Lesson Learned and Future Threatsmentioning

confidence: 99%

Lysenko and the Screwworm Fly—When Politics Interferes with Science and Public Health

Marcondes

Canale

Benelli

2020

IJERPH

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In the One Health scenario, a deep understanding of the dynamics potentially threatening the development and implementation of useful pest and vector management tools is of key importance. The New World screwworm fly, Cochliomyia hominivorax (Coquerel) (Diptera: Calliphoridae), is characterized by a wide host range. It acts as an important agent of myiasis in humans and warm-blooded animals in the Neotropics, and has been eliminated from a wide region through genetic methods. Of note, Serebrovsky had already proposed in 1940 the principles of autocidal control by the translocation of segments between two chromosomes, but his work was negated by Lysenko, based on the negation of Mendelian genetics. This entomological case study emphasizes the danger of politics interfering with science, a still contemporary hot issue. The negation of global warming or current pandemics are further examples of this noxious influence.

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Do we have enough evidence to use chloroquine/hydroxychloroquine as a public health panacea for COVID-19?

Cited by 20 publications

References 7 publications

Baixas na linha de frente: absenteísmo entre bombeiros durante o combate à pandemia da COVID-19

Baixas na linha de frente: absenteísmo entre bombeiros durante o combate à pandemia da COVID-19

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

Lysenko and the Screwworm Fly—When Politics Interferes with Science and Public Health

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