Evidence map›Paper›PMID 35120461›Full record

ArticleBMC infectious diseases2022

"H" is not for hydroxychloroquine-"H" is for heparin: lack of efficacy of hydroxychloroquine and the role of heparin in COVID-19-preliminary data of a prospective and interventional study from Brazil.

Renata de Oliveira Costa, Joyce Santos Nascimento, Cadiele Oliana Reichert, Adriana Pedroso Augusto da Costa, Maria Aparecida Pedrosa Dos Santos, Alberto Macedo Soares, Carlos Eduardo Mendonça Tomé, Ricardo Leite Hayden, Cassiano Waldanski Dos Santos, Bruno Barreiro and 4 more

Open access · goldAbstract read
In one paragraph

Article in BMC infectious diseases, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.1field-weighted citation impact, top 59% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 1 citations in OpenAlex.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors at 3 institutions in 1 country.

Renata de Oliveira CostaFaculdade de Ciências Médicas de Santos - Centro Universitário Lusíada (FCMS, UNILUS), Santos, São Paulo, Brazil.
Joyce Santos NascimentoHospital Estadual Guilherme Álvaro (HGA), Santos, São Paulo, Brazil.
Cadiele Oliana ReichertLaboratory of Immunology and Histocompatibility (LIM-19), University of São Paulo (USP), São Paulo, Brazil.
Adriana Pedroso Augusto da CostaHospital Estadual Guilherme Álvaro (HGA), Santos, São Paulo, Brazil.
Maria Aparecida Pedrosa Dos SantosFaculdade de Ciências Médicas de Santos - Centro Universitário Lusíada (FCMS, UNILUS), Santos, São Paulo, Brazil.
Alberto Macedo SoaresFaculdade de Ciências Médicas de Santos - Centro Universitário Lusíada (FCMS, UNILUS), Santos, São Paulo, Brazil.
Carlos Eduardo Mendonça ToméFaculdade de Ciências Médicas de Santos - Centro Universitário Lusíada (FCMS, UNILUS), Santos, São Paulo, Brazil.
Ricardo Leite HaydenHospital Estadual Guilherme Álvaro (HGA), Santos, São Paulo, Brazil.
Cassiano Waldanski Dos SantosHospital Estadual Guilherme Álvaro (HGA), Santos, São Paulo, Brazil.
Bruno BarreiroHospital Estadual Guilherme Álvaro (HGA), Santos, São Paulo, Brazil.
Amer Abdul Basset El-KhatibHospital Estadual Guilherme Álvaro (HGA), Santos, São Paulo, Brazil.
Luís Alberto de Pádua Covas LageDepartment of Hematology, Hemotherapy & Cell Therapy, University of São Paulo (USP), Av. Dr. Enéas de Carvalho Aguiar, 155 - 1st. Floor. Room 61, SP, São Paulo, Brazil. luis.lage@hc.fm.usp.br.
Juliana PereiraDepartment of Hematology, Hemotherapy & Cell Therapy, University of São Paulo (USP), Av. Dr. Enéas de Carvalho Aguiar, 155 - 1st. Floor. Room 61, SP, São Paulo, Brazil.
Mônica Mazzurana BenettiHospital Estadual Guilherme Álvaro (HGA), Santos, São Paulo, Brazil.
Hospital Estadual Centra · BRUniversidade de São Paulo · BRCentro Universitário Lusíada · BR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundCOVID-19 pandemic is the major public health problem in the world actually. It's associated with high morbidity and mortality. To date, no therapeutic measure has a curative potential. Hydroxychloroquine (HCQ) is a drug with immunomodulatory properties that has demonstrated antiviral efficacy in in vitro experiments, with conflicting results in in vivo studies.

methodsA single-center, prospective and interventional study, that evaluates the impact on mortality of the HCQ use in 154 patients hospitalized with COVID-19 in a Brazilian public hospital. The study also aims to determine prognostic factors that predict mortality, ICU admission and endotracheal intubation in this population.

results154 patients diagnosed with COVID-19 confirmed by RT-PCR and hospitalized were included. There was a male predominance (87/154, 56.5%), median age 60 years and 88% (136/154) had comorbidities. Among these, 76% (117/154) were admitted to the ICU and 29.2% (45/154) experienced EOT. The OMR was 51.3% (79/154). There was no difference in mortality between patients treated with HCQ (N = 95) and non-HCQ (N = 59) (44.1% × 55.8%, p = 0.758). In univariate analysis, age ≥ 60 years (HR 3.62, p < 0.001), need for mechanical ventilation (HR 2.17, p = 0.001), ≥ 2 comorbidities (HR 1.83, p = 0.049), SAH (HR: 1.56, p = 0.054) were predictors of mortality, as well as no use of prophylactic or therapeutic heparin (HR 3.60, p = 0.02). Multivariate analysis identified admission to the ICU (HR 8.98, p = 0.002) and advanced age (HR 3.37, p < 0.01) as independent predictors of mortality, although, use of heparin (HR 0.25, p = 0.001) was independently associated with a favorable outcome.

conclusionThis study confirmed the absence of a benefit associated with the use of HCQ in Brazilian patients hospitalized with COVID-19. However, prophylactic or therapeutic heparin was an independent predictor for reducing mortality in this population.

Indexed as

COVID-19 Drug TreatmentHydroxychloroquineAntiviral AgentsBrazilHeparinHumansMaleMiddle AgedPandemicsPreliminary DataProspective StudiesSARS-CoV-2Treatment OutcomeAntiviral AgentsHeparinHydroxychloroquineCOVID-19HeparinHydroxychloroquineOutcomesPrognostic factors

Identifiers

PMID35120461
PMCPMC8814785
OpenAlexW4225080035

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.