The Severe Acute Respiratory Syndrome COronaVirus 2 (SARS-CoV2) is a new and recognized infectious disease of the respiratory tract. Around 20% of those infected have severe pneumonia and currently there is no specific or effective therapy to treat this disease. Therapeutic options using malaria drugs chloroquine and hydroxychloroquine have shown promising results in vitro and in vivo test. But those efforts have not involved large, carefully-conducted controlled studies that would provide the global medical community the proof that these drugs work on a significant scale. In this way, the present study will evaluate the effectiveness and safety of the use of hydroxychloroquine combined with azithromycin compared to hydroxychloroquine monotherapy in patients hospitalized with pneumonia by SARS-CoV2 virus.
The Severe Acute Respiratory Syndrome COronaVirus 2 (SARS-CoV2) is a new and recognized infectious disease of the respiratory tract that is now spreading to several countries in the world, including Brazil. Mortality rates after infection are higher in adults over 60 and with a history of comorbidities. The most serious patients need care in intensive care units (ICU). Most of the time they depend on mechanical ventilation support due to acute respiratory distress syndrome (ARDS). Infection rates are higher than the capacity for intensive care, which represents a serious problem in medical care. Around 20% of those infected have severe pneumonia and so far it does not have a specific therapy, or even, an effective clinical management. Therapeutic options using malaria drugs chloroquine and hydroxychloroquine have shown promising results in vitro and in vivo test. A recent, small, non-randomized study with hydroxychloroquine in 36 patients infected with SARS-Cov-2 proved to be promising in the ability to reset the viral load in 6 days after starting treatment. Thus, the present study will evaluate the effectiveness and safety of the use of hydroxychloroquine combined with azithromycin compared to hydroxychloroquine monotherapy in the clinical evolution by the ordinal scale of 6 points in adult patients hospitalized with pneumonia caused by infection by the SARS-CoV2 virus in Brazil.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
440
Intervention Group: Hydroxychloroquine + azithromycin. After randomization, Hydroxychloroquine \[400mg 2x/day, 12/12h\] + azithromycin \[500mg 1x/day\]) for 10 days. Standard treatment is according to the treatment protocol for 2019-nCoV infection.
Active Control Group: Hydroxychloroquine. After randomization, Hydroxychloroquine \[400mg 2x/day, 12/12h\] for 10 days. Standard treatment is according to the treatment protocol for 2019-nCoV infection.
Hospital de Urgência e Emergência de Rio Branco
Rio Branco, Acre, Brazil
Hospital Maternidade São Vicente de Paulo
Barbalha, Ceará, Brazil
Hospital de Messejana Dr. Carlos Alberto Studart Gomes
Fortaleza, Ceará, Brazil
Hospital Unimed Cariri
Juazeiro do Norte, Ceará, Brazil
Hospital Estadual Jayme dos Santos Neves
Serra, Espírito Santo, Brazil
Evaluation of the clinical status
Evaluation of the clinical status of patients on the 15th day after randomization defined by the Ordinal Scale of 6 points (score ranges from 1 to 6, with 6 being the worst score)
Time frame: 15 days after randomization
All-cause mortality
All-cause mortality rates at 29 days after randomization
Time frame: 29 days after randomization
Evaluation of the clinical status
Evaluation of the clinical status of patients on the 7th and 29th day after randomization defined by the Ordinal Scale of 6 points (score ranges from 1 to 6, with 6 being the worst score)
Time frame: 7 and 29 days after randomization
Number of days free from mechanical ventilation
Number of days free from mechanical ventilation at 29 days after randomization
Time frame: 29 days after randomization
Duration of mechanical ventilation
Number of days that the patient was on mechanical ventilation after randomization
Time frame: 29 days after randomization
Duration of hospitalization
Length of hospital stay on survivors
Time frame: 29 days after randomization
Other secondary infections
Presence of other secondary infections
Time frame: 29 days after randomization
Time from treatment start to death
Time from treatment start to death
Time frame: 29 days after randomization
Medium and long-term outcomes of SARS-CoV2 infection on morbimortality, daily life activities, mental health, and quality of life
Morbimortality, daily life activities, mental health, and quality of life
Time frame: 3, 6, 9 and 12 months
Assess whether the tested therapies may be affected by leucocyte phenotype
Leucocyte transcriptome
Time frame: Baseline
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Vila Velha, Espírito Santo, Brazil
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Ipiaú, Estado de Bahia, Brazil
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Secretaria de Estado de Saúde de Goias
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...and 48 more locations