1 - Pediatric Infectious Diseases Unit, Área Pediatria Médica, Hospital Dona Estefânia, Centro Hospitalar Universitário de Lisboa Central, Lisboa
2 - Pediatric Cardiology Department, Hospital Santa Marta, Centro Hospitalar Universitário de Lisboa Central, Lisboa
- Reunião Internacional - ESCMID Conference on Coronavirus Disease, publicação sob forma de e-poster (3 slides & voice-over)
Resumo:
Introdution Hydroxychloroquine (HCQ) is one of the options for treatment of COVID-19, included in various treatment protocols throughout the world. A number of questions have been raised regarding its efficacy and safety, surrounded by scandals and nonscientific information. It has been recently withdrawn from the Portuguese clinical treatment guidelines, along with its suspension from the Solidarity Trial by WHO, pending further studies. We present our experience during the treatment of COVID-19 pediatric patients with hydroxychloroquine.
Methods Retrospective, observational study of COVID-19 pediatric patients (age <18years), admitted from March to Abril 2020 (2 months), and treated with hydroxychloroquine in a Portuguese tertiary referral hospital.
Results Total of 14 patients with a median age of 10 years (min 4 months, max 17 years). Hydroxychloroquine was used with a load dose of 5 mg/kg/dose, BID on first day, and on the next days with a maintenance dose of 3,25 mg/kg/dose, BID. The median duration of treatment was 5 days (min 5, max 7). Six patients were treated only with hydroxychloroquine (mainly mild disease). Three severe patients admitted on the first four days of symptoms were also treated with lopinavir/ritonavir. Four severe patients and one moderate were treated with azithromycin for suspected respiratory co-infection. During treatment, two patients presented with prolongation of the QTc interval (>500msec), which corrected after temporary suspension of hydroxychloroquine, and were able to complete the treatment. No other side effects were noted. All patients were discharged home, after completion of the treatment.
Conclusion From our experience, hydroxychloroquine seems to be safe in pediatric patients, given that no major side effects were noted. Cardiac rhythm monitoring is fundamental during treatment. All patients clinically improved, and a number of them were also treated with other drugs. Further and reliable clinical trials are needed to shed some light upon the efficacy and safety of hydroxychloroquine.
Palavras Chave: COVID-19, Children, Hydroxychloroquine