Efficacy and Safety of Ivermectin and Hydroxychloroquine in Patients with Severe COVID-19: A Randomized Controlled Trial.

During the first year of the COVID-19 pandemic, unauthorized drugs were widely used. Ivermectin and hydroxychloroquine are drugs that inhibit viral replication in vitro and that have been used in several medical centers. This clinical trial analyzes their efficacy in hospitalized patients with moderate COVID-19. Methods: This a controlled, clinical, randomized, double-blind trial that included hospitalized patients with COVID-19-induced pneumonia, without severe respiratory failure. Patients were randomized to one of three groups: Group 1-hydroxychloroquine, 400 mg every 12 h on the first day and, subsequently, 200 mg every 12 h for 4 days; Group 2-ivermectin, 12 mg or 18 mg, according to patient weight; and Group 3-placebo. At inclusion, blood samples for arterial blood gases and biochemical markers were obtained. The primary outcome was established as the length of stay due to patient improvement and the rate of respiratory deterioration or death. Results: During the month of August 2020, the admission of patients requiring hospitalization mostly encompassed cases with severe respiratory failure, so we ended the recruitment process and analyzed the data that was available at the time. One hundred and six (106) patients with an average age of 53 yrs (±16.9) were included, with a greater proportion of males (n = 66, 62.2%). Seventy-two percent (72%) (n = 76) had an associated comorbidity. Ninety percent (90%) of patients were discharged due to improvement (n = 96). The average duration of hospitalization was 6 days (IQR, 3-10). No difference in hospitalization duration was found between the treatment groups (Group1: 7 vs. Group 2: 6 vs. Group 3: 5, p = 0.43) nor in respiratory deterioration or death (Group 1: 18% vs. Group 2: 22.2% vs. Group 3: 24.3%, p = 0.83). Conclusions: In non-critical hospitalized patients with COVID-19 pneumonia, neither ivermectin nor hydroxychloroquine decreases the number of in-hospital days, respiratory deterioration, or deaths.

Kawasaki disease presenting with hoarseness: A multinational study of the REKAMLATINA network.

BACKGROUND: Recently, hoarseness affecting the supraglottic structure has been reported in Kawasaki disease (KD). The objective of this study was to characterize the frequency of hoarseness in acute KD patients in Latin America. METHODS: We used prospective data from the multinational Red de Enfermedad de Kawasaki en America Latina (REKAMLATINA) network. A total of 865 patients from 20 countries were enrolled during the 3 year study period. Data on hoarseness were available in 858 (99.2%) patients. The clinical and laboratory characteristics between hoarse and non-hoarse KD were compared. RESULTS: Hoarseness was documented in 100 (11.6%) patients. Hoarse patients were younger than those with KD without hoarseness (median age 18 vs 26 months; P = 0.002) and presented with lower hemoglobin (10.7 g/dL vs 11.3 g/dL; P = 0.040) and hematocrit levels (32% vs 33%, P = 0.048). CONCLUSIONS: Hoarseness was found to be prevalent as a presenting sign of acute KD in younger children. Anemia may indicate the presence of active inflammation.

Consenso sobre la infección por COVID-19 (SARS-COV-2)

On January 15, 2020, the World Health Organization (WHO) made the first recommendations regarding the epidemiological surveillance of a new coronavirus detected on December 31, 2019 in the Hubei province of Wuhan city, China --which later (January 7, 2020) was identified as a new coronavirus, or an emerging corona-virus, initially called "2019-nCoV"-- and issued the first case definitions, when was detected 27 cases of acute respiratory syndrome of unknown etiology. This virus would eventually be called "COVID-19" or "SARS-CoV-2". It's spread around the world did not take long, and despite the fact that the WHO delayed declaring this outbreak as a pandemic event, it finally did so on March 11 of the current year. The Mexican Academy of Pediatrics (advisory body of the Secretary of Health) considered made up prudent to compile the facts to issue, as soon as possible, an expanded overview of infection-disease by this emerging virus and, at the same time, as its main objective is to contribute, support and work together with the Secretary of Health to combat the SARS-CoV-2 epidemic in order to provide the best care and treatment measures to mitigate its spread throughout the Mexican territory. (English) [ABSTRACT FROM AUTHOR] El 15 de enero de 2020, la Organización Mundial de la Salud (OMS) realizó las primeras recomendaciones respecto a la vigilancia epidemiológica de un nuevo co-ronavirus, detectado el 31 de diciembre de 2019 en la provincia de Hubei, ciudad de Wuhan, en China --que, posteriormente (07 de enero de 2020) fue identificado como un nuevo coronavirus, o bien, un coronavirus emergente, inicialmente denominado "2019-nCoV"--, y emitió las primeras definiciones de caso, tras haberse detectado en 27 sujetos con síndrome respiratorio agudo de etiología desconocida. Dicho virus, a la postre, se denominaría "COVID-19" o "SARS-CoV-2". Su diseminación en todo el mundo no tardó mucho, y a pesar de que la OMS retrasó la declaración del brote como un evento pandémico, finalmente lo hizo el 11 de marzo del año en curso. La Academia Mexicana de Pediatría (órgano asesor de la Secretaría de Salud) consideró prudente hacer una recopilación de los hechos para emitir, en lo posible, un panorama ampliado de la infección-enfermedad por este virus emergente y, a la vez, se planteó como principal objetivo contribuir, apoyar y trabajar en conjunto con la Secretaría de Salud para enfrentar la epidemia asociada con el SARS-CoV-2 para que se implementen las mejores medidas de atención y tratamiento a fin de mitigar su diseminación en el territorio mexicano. (Spanish) [ABSTRACT FROM AUTHOR] Copyright of Revista de Enfermedades Infecciosas en Pediatria is the property of Ediciones Franco S.A. de C.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)