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Background COVID-19 pandemic is the major public health problem in the world actually. It’s associated with high morbidity and mortality. To date, no therapeutic measure has a curative potential. Hydroxychloroquine (HCQ) is a drug with immunomodulatory properties that has demonstrated antiviral efficacy in in vitro experiments, with conflicting results in in vivo studies. Methods A single-center, prospective and interventional study, that evaluates the impact on mortality of the HCQ use in 154 patients hospitalized with COVID-19 in a Brazilian public hospital. The study also aims to determine prognostic factors that predict mortality, ICU admission and endotracheal intubation in this population. Results 154 patients diagnosed with COVID-19 confirmed by RT-PCR and hospitalized were included. There was a male predominance (87/154, 56.5%), median age 60 years and 88% (136/154) had comorbidities. Among these, 76% (117/154) were admitted to the ICU and 29.2% (45/154) experienced EOT. The OMR was 51.3% (79/154). There was no difference in mortality between patients treated with HCQ ( N  = 95) and non-HCQ ( N  = 59) (44.1% × 55.8%,  p  = 0.758). In univariate analysis, age ≥ 60 years (HR 3.62,  p  &lt; 0.001), need for mechanical ventilation (HR 2.17,  p  = 0.001), ≥ 2 comorbidities (HR 1.83,  p  = 0.049), SAH (HR: 1.56,  p  = 0.054) were predictors of mortality, as well as no use of prophylactic or therapeutic heparin (HR 3.60,  p  = 0.02). Multivariate analysis identified admission to the ICU (HR 8.98,  p  = 0.002) and advanced age (HR 3.37,  p  &lt; 0.01) as independent predictors of mortality, although, use of heparin (HR 0.25,  p  = 0.001) was independently associated with a favorable outcome. Conclusion This study confirmed the absence of a benefit associated with the use of HCQ in Brazilian patients hospitalized with COVID-19. However, prophylactic or therapeutic heparin was an independent predictor for reducing mortality in this population.

bmc infectious diseases

“H” is not for hydroxychloroquine—“H” is for heparin: lack of efficacy of hydroxychloroquine and the role of heparin in COVID-19—preliminary data of a prospective and interventional study from Brazil