Effect of High vs Low Doses of Chloroquine Diphosphate as Adjunctive Therapy for Patients Hospitalized With Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Infection: A Randomized Clinical Trial.

There is no specific antiviral therapy recommended for coronavirus disease 2019 (COVID-19). In vitro studies indicate that the antiviral effect of chloroquine diphosphate (CQ) requires a high concentration of the drug.To evaluate the safety and efficacy of 2 CQ dosages in patients with severe COVID-19. This parallel, double-masked, randomized, phase IIb clinical trial with 81 adult patients who were hospitalized with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection was conducted from March 23 to April 5, 2020, at a tertiary care facility in Manaus, Brazilian Amazon. - Patients were allocated to receive high-dosage CQ (ie, 600 mg CQ twice daily for 10 days) or low-dosage CQ (ie, 450 mg twice daily on day 1 and once daily for 4 days). - Label: Main Outcomes and Measures Primary outcome was reduction in lethality by at least 50% in the high-dosage group compared with the low-dosage group. Data presented here refer primarily to safety and lethality outcomes during treatment on day 13. Secondary end points included participant clinical status, laboratory examinations, and electrocardiogram results. Outcomes will be presented to day 28. Viral respiratory secretion RNA detection was performed on days 0 and 4. Out of a predefined sample size of 440 patients, 81 were enrolled (41 [50.6%] to high-dosage group and 40 [49.4%] to low-dosage group). Enrolled patients had a mean (SD) age of 51.1 (13.9) years, and most (60 [75.3%]) were men. Older age (mean [SD] age, 54.7 [13.7] years vs 47.4 [13.3] years) and more heart disease (5 of 28 [17.9%] vs 0) were seen in the high-dose group. Viral RNA was detected in 31 of 40 (77.5%) and 31 of 41 (75.6%) patients in the low-dosage and high-dosage groups, respectively. Lethality until day 13 was 39.0% in the high-dosage group (16 of 41) and 15.0% in the low-dosage group (6 of 40). The high-dosage group presented more instance of QTc interval greater than 500 milliseconds (7 of 37 [18.9%]) compared with the low-dosage group (4 of 36 [11.1%]). Respiratory secretion at day 4 was negative in only 6 of 27 patients (22.2%). - Label: Conclusions and Relevance The preliminary findings of this study suggest that the higher CQ dosage should not be recommended for critically ill patients with COVID-19 because of its potential safety hazards, especially when taken concurrently with azithromycin and oseltamivir. These findings cannot be extrapolated to patients with nonsevere COVID-19

PERFIL SOCIODEMOGRÁFICO E CLÍNICO DAS PARTICIPANTES DE UM CURSO PARA GESTANTES

Identificar a clientela assistida em um Curso para Gestantes e observar a qualidade de vida dessas mulheres. Estudo descritivo no qual foi aplicado um questionário semi-estruturado, abordando os aspectos sócio-econômicos e culturais, bem como o protocolo Medical Outcomes Study 36-item Short-form Health Survey (SF-36) para a análise da qualidade de vida. 41 gestantes com idades entre 19 e 38 anos, em sua maioria primigestas (95%), casadas (85,4%), empregadas (70,7%) e sedentárias (80,5%), com idade gestacional média de 21 semanas e nível superior de escolaridade (65,9%) e estado nutricional adequado (58,6%). A amostra apresentou média acima do escore médio do protocolo SF-36, com exceção do domínio aspectos físicos (46,95 ±37,58). Em relação à população feminina geral, considerada em outros estudos, as participantes também apresentaram pontuação média significativamente maior em seis dos oito domínios: saúde geral (81,21±16,45), capacidade funcional (66,09±21,98), aspectos emocionais (67,47±43,13), dor (63,58 ±24,30), função social (76,52 ±18,37) e saúde mental (71,70 ±14,32). As mulheres que procuram o Curso para Gestantes são em sua grande maioria adultas, casadas, com nível superior de escolaridade, empregadas e relatam renda familiar alta. Apresentam escores de qualidade de vida acima da população feminina em geral, com exceção dos domínios aspectos físicos e vitalidade, que parecem estar comprometidos nesse período. 

Núcleos de Ensino da Unesp: artigos 2008

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq