Correspondence on ‘ Festina lente : hydroxychloroquine, COVID-19 and the role of the rheumatologist’ by Graef et al
2020; BMJ; Volume: 81; Issue: 9 Linguagem: Inglês
10.1136/annrheumdis-2020-218589
ISSN1468-2060
AutoresChien Hsien Lo, Yu-Hsun Wang, Chin Feng Tsai, Kuei Chuan Chan, Li Ching Li, Tse Hsien Lo, Chun-Hung Su, James Cheng‐Chung Wei,
Tópico(s)Hematological disorders and diagnostics
ResumoWe read with interest the study by Graef et al ,1 who mentioned about the treatment and safety of hydroxychloroquine (HCQ) for the current COVID-19 pandemic. They described that decades of research strongly support the well control of disease activity and survival benefit of HCQ use in rheumatic diseases, such as systemic lupus erythematosus and rheumatoid arthritis (RA). They also highlight that HCQ should be used with caution in patients with COVID-19, including the safety concern, especially when combined with administration of azithromycin because both of them are known corrected QT interval (QTc) prolongation agents. During early outbreak, HCQ, combined with azithromycin, has been used as a treatment option for COVID-19.2 3 Recently, an observational study with 1446 patients with COVID-19 reported that HCQ administration was not associated with a lower risk of intubation or death.4 However, the reasons for mortality were not illustrated. Multiple confounding factors like histories of ischaemic heart disease, heart failure and cardiac arrhythmia were not well adjusted. The main functional site of HCQ in COVID-19 is the entry via ACE2 preceptor.5 6 We believe that patient selection in early phases of COVID-19 infection would be more appropriate than well-established pneumonia or cytokines storm cases. The risk of cardiac arrhythmias is an important safety issue. HCQ …
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