Successful recovery of COVID-19 pneumonia in a patient from Colombia after receiving chloroquine and clarithromycin

Abstract

Background: COVID-19 pandemics is a challenge for public health and infectious diseases clinicians, especially for the therapeutical approach that is not yet adequately defined. Amid this situation, investigational agents are being used, including chloroquine. We report here the clinical features and therapeutic course of the first reported patient with confirmed COVID-19 pneumonia that recovered in Colombia, after the use of chloroquine and clarithromycin. Case presentation:A 34-year-old male, returning from Spain, presented with complaints of fever, and cough, and class-II obesity, being hospitalized. The respiratory viruses and bacteria tested by FilmArray ® PCR were negative. Two days later, clarithromycin was started because the patient was suspected as community-acquired pneumonia. At the third day, the rRT-PCR confirmed the SARS-CoV-2 infection. A day later, chloroquine was started because of that. His chest computed tomography was performed and showed bilateral multifocal ground-glass opacities with consolidation, which suggested viral pneumonia as a differential diagnosis. Progressively his clinical condition improved and at day 9, patient rRT-PCR for SARS-CoV-2 became negative. The patient was discharged and isolated at home per 14 days. Conclusions:Our patient improved significantly. This and other COVID-19 cases are urgently demanding results from clinical trials that support evidence-based therapeutical approaches to this pandemic and the clinical management of patients, especially those at critical care.

Macrolide-Clarithromycin Task-Force for the Treatment and Prophylaxis of Covid-19 as a Single Agent

“…Other small experiences appeared in the scientific literature later on in a similar direction. One study in Taiwan, reported two cases with community-acquired pneumonia caused by severe acute respiratory syndrome coronavi- In Colombia, as published, one patient received clarithromycin instead of azithromycin, in combination with chloroquine with the successful recovery of COVID-19 pneumonia, without any side adverse effects and become negative for the SARS-CoV-2 infection, as observed in the RT-PCR test [85].…”

Immune Modulation as a Therapeutic Option During the SARS-CoV-2 Outbreak: The Case for Antimalarial Aminoquinolines

“…During the preparation of this manuscript, the first reports on CQ/HCQ effects in COVID-19 patients were published ( 3 , 111 , 114 – 116 ). However, there was extreme variability in study design, study population, time after symptom onset, sample size, CQ/HCQ dosage and duration of treatment, concurrent administration of other molecules, while the methodology often did not meet the usual standards ( 117 ), leaving the reader without clear, comparable data.…”

“…In vitro and clinical data suggest that CQ/HCQ could be useful as a means of preventative control of type I IFN-induced immune activation in SARS-CoV-2 patients ( 116 , 121 ), although other randomized, controlled studies questioned these findings ( 122 , 123 ). Recent reports suggest that CQ/HCQ may not act as a rescue medication for severe cases or advanced forms with multiorgan failure ( 124 ).…”

Importância dos antibióticos no tratamento da Covid-19

“…Muitos estudos apoiam o uso clínico da combinação de medicamentos, especialmente da hidroxicloroquina e azitromicina, principalmente no estágio inicial da infecção por COVID-19, antes que os pacientes desenvolvam síndrome do desconforto respiratório. Além disso, alguns países precisam realizar estudos sequenciais e filogenéticos, pois seus isolados podem divergir de outros SARS-CoV-2 (Andreani J;Millán-oñate, J;.…”