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Journal of clinical medicine research ; 12(8):483-491, 2020.
Artículo | WHO COVID | ID: covidwho-732647


BACKGROUND: During the initial phases of the coronavirus disease 2019 (COVID-19) epidemic, there was an unfounded fervor surrounding the use of hydroxychloroquine (HCQ);however, recently, the Centers for Disease Control and Prevention (CDC) has recommended against routine use of HCQ outside of study protocols citing possible adverse outcomes METHODS: Multiple databases were searched to identify articles on COVID-19 An unadjusted odds ratio (OR) was used to calculate the safety and efficacy of HCQ on a random effect model RESULTS: Twelve studies comprising 3,912 patients (HCQ 2,512 and control 1400) were included The odds of all-cause mortality (OR: 2 23, 95% confidence interval (CI): 1 58 - 3 13, P value < 0 00001) were significantly higher in patients on HCQ compared to patients on control agent The response to therapy assessed by negative repeat polymerase chain reaction (PCR) (OR: 1 83, 95% CI: 0 50 - 6 75, P = 0 36), radiological resolution (OR: 1 98, 95% CI: 0 47 - 8 36, P value = 0 36) and the need for invasive mechanical ventilation (IMV) (OR: 1 21, 95% CI: 0 34 - 4 33, P value = 0 76) were identical between the two groups Overall, four times higher odds of net adverse events (NAEs) were observed in the HCQ group (OR: 4 59, 95% CI 1 73 - 12 20, P value = 0 02) The measures for individual safety endpoints were also numerically lower in the control arm;however, none of these values reached the level of statistical significance CONCLUSIONS: HCQ might offer no benefits in terms of decreasing the viral load and radiological improvement in patients with COVID-19 HCQ appears to be associated with higher odds of all-cause mortality and NAEs

Int J Cardiol Heart Vasc ; 30: 100613, 2020 Oct.
Artículo en Inglés | MEDLINE | ID: covidwho-696633
Int J Cardiol Heart Vasc ; 29: 100589, 2020 Aug.
Artículo en Inglés | MEDLINE | ID: covidwho-642152


Coronavirus Disease 2019 (COVID-19) is a rapidly progressing global pandemic that may present with a variety of cardiac manifestations including, but not limited to, myocardial injury, myocardial infarction, arrhythmias, heart failure, cardiomyopathy, shock, thromboembolism, and cardiac arrest. These cardiovascular effects are worse in patients who have pre-existing cardiac conditions such as coronary artery disease, hypertension, diabetes mellitus, and coagulation abnormalities. Other predisposing risk factors include advanced age, immunocompromised state, and underlying systemic inflammatory conditions. Here we review the cellular pathophysiology, clinical manifestations and treatment modalities of the cardiac manifestations seen in patients with COVID-19.

Cardiology Research ; 11(3):196-199, 2020.
Artículo | WHO COVID | ID: covidwho-459301


A 67-year-old man with a prior heart failure presented with fever, cough and dyspnea for 4 days Physical examination showed bilateral rales on the lung exam, yet no lower extremity edema The combination of symptoms, elevated inflammatory markers, normal baseline pro-B-type natriuretic peptide, PaO2/FiO(2) < 300 and positive swab suggested coronavirus disease 2019 (COVID-19) with acute respiratory distress syndrome (ARDS) rather than heart failure exacerbation We discuss the challenges in management of ARDS in COVID-19 patients that may initially mimic as acute exacerbation of heart failure