Efficacy of hydroxychloroquine in a group of subjectswith SARS-CoV 2 infection

Introduction and Aim of the study: Hydroxychloroquine has beenauthorized in the therapy of patients with COVID-19. Many publications have not clarified the real efficacy of the drug. Really, thedrug was widely used during the pandemic. A single-center observational cohort study was conducted to evaluate the effectiveness of hydroxychloroquine therapy in a group of subjects admittedin the sub-intensive therapy of the COVID Unit Hospital F. Miulli(Acquaviva delle Fonti, Bari, Italy) from 17 march to 17 may 2020.Materials and Methods: The data contained in the medicalrecords were studied. The sample was divided into two groups withrespect to therapy with or without hydroxychloroquine'. Clinicaland laboratory data were analyzed.Results: A total of 174 patients hospitalized (60.4% males),mean age 68 yrs, with diagnosis of SARS-CoV2, were analyzed.118 patients were treated with hydroxychloroquine. The treatment group consisted of 66.1% males, mean age 63 years. Thetwo groups were homogeneous in comorbidity and in the severityof clinical presentation of SARS-CoV2 infection. The death ratewas significantly higher in the group of untreated than in thosereceiving hydroxychloroquine, 40% vs 2.6% respectively. Therewere no significant differences on QTc prolongation between thetwo groups (467+47 ms control group, 446 + 35 ms, treatmentgroup).Discussion and Conclusions: The data of our study, although referring to a reduced sample, show the effectiveness of hydroxychloroquine in reducing mortality in subjects suffering fromSARS-CoV2 infection.

The activity of the 'gray Area' in the era of SARS-Cov2

Background and Aim of the study: The sensitivity of genomic testsfor the diagnosis of SARS CoV2, (RT-PCR) can be estimated ataround 60%, therefore it is inevitable to find negative subjects. Alot of patients, in the absence of a clear virological diagnosis, during an epidemic, were hospitalized in a 'gray area' to defined thereal negativity. A retrospective observational cohort study was conducted to analyze the clinical and laboratory characteristics of agroup of patients hospitalized in the gray area of F. Miulli Hospital(Acquaviva delle Fonti, BA)Materials and Methods: A cohort of 42 (23 M, 19 F, average age78.6 years) patients was studied retrospectively with respect toclinical and instrumental findings.Results: All patients had fever and in 14 of them also acute hypoxemic respiratory failure. The most represented comorbiditieswere: hypertension 14, ischemic heart disease 2, diabetes 4, ar rhythmias 4, renal failure 4,. The radiological pictures observedwere of: radiological alterations with areas of 'ground glass' in 14subjects;outbreak bronchopneumonia in 26;bronchiolitis ('treein bud') in 1 patient. Only one patient tested positive for SARSCoV2 virus infection detected by the third swab.Conclusions: Subjects hospitalized in 'gray area' were characterized by nonspecific elements, negative RT-PCR genomic test andradiological findings correlated with an intermediate probabilityfor SARS CoV2 virus infection (radiological pictures indeterminatebut suggestive). Most of the clinical and radiological pictures weretherefore related to other infections.