Resolutive Results with Oral Corticosteroids for Patients with COVID-19 in Pulmonary Inflammatory Phase. Successful Outpatient Experience during the Collapse of Belem Do Para Health System—Brazil
- 1 Clinical Care, Sao Paulo, Brazil
- 2 Clinical Care, Sao Paulo, Brazil
- 3 Instituto de Ciencias da Saude, Faculdade de Medicina, Universidade Federal do Para, Belem, Brazil
- 4 Fundacao Publica Estadual Hospital de Clinicas Gaspar Vianna, Belem, Brazil
- 5 Hospital da Policia Militar do Para, Belem, Brazil
- 6 Instituto de Ciencias da Saude, Faculdade de Medicina, Universidade Federal do Para, Belem, Brazil
- 7 Imunoclinic, Belem, Brazil
- 8 Universidade Estadual do Para, Fundacao Santa Casa de Misericordia do Para, Belem, Brazil
- 9 Clinica Barros Cirurgia Plastica, Belem, Brazil
- 10 Secretaria de Estado de Saude Publica, Castanhal, Brazil
- 11 Centro de Tratamento Oncologico, Belem, Brazil
- 12 Sociedade Brasileira de Valorização das Sociedades Medicas—SOBEMED, São Paulo, Brazil
- 13 Clinica de Nutrologia, Sao Luiz, Brazil
- 14 Hospital Nipo Brasileiro de Olhos, Belem, Brazil
- 15 Centro de Ciencias Biologicas e da Saude, Universidade do Estado do Para, Belem, Brazil
- 16 Hospital Regional do Baixo Amazonas, Santarem, Brazil
- 17 Clinica Vallinoto Secretaria de Saude de Barcarena, Barcarena, Brazil
- 18 Centro de Ciencias Biologicas e da Saude, Universidade do Estado do Para, Belem, Brazil
- 19 Estrategia Saude da Familia Secretaria Municipal de Saude de Ananindeua, Centro Universitario do Estado do Para, Belem, Brazil
- 20 A. M. P. Endocrinologia, Belem, Brazil
- 21 Instituto Avertano Rocha, Belem, Brazil
- 22 Departamento de Neurocirurgia, Hospital Militar de Area De Sao Paulo, Sao Paulo, Brazil
- 23 Fundacao Publica Estadual Hospital de Clinicas Gaspar Vianna, Belem, Brazil
Abstract
In the face of new diseases, medicine needs to reinvent itself in order to contain and control epidemics, such as the one we have recently faced, COVID-19, a disease with a wide spectrum of clinical severity. A new moment has been established, since the application of well-known, effective and safe medications for other diseases, has shown high success rates in the treatment of COVID-19. Thereunto, studies with early intervention are needed, which can change the unfavorable outcome of patients. In this article, we report the successful experience using an oral strategy during the collapse of Belem (Para, Brazil) Health System. Two hundred and ten patients were diagnosed with respiratory failure due to COVID-19, with no option of hospital treatment due to lack of beds and resources. These patients were then started on therapeutic regimen consisting of 40 mg prednisolone, 40 mg enoxaparin and macrolides (500 mg clarithromycin, 500 mg axetylcefuroxime) associated and followed in outpatient facilities. Two hundred and eight patients had an excellent therapeutic response and there were only two fatalities. These results push research boundaries, valuing outpatient treatment with early use of prednisolone in the initial pulmonary phase, preventing severe COVID-19 pneumonitis. Adoption of the proposed treatment intends to reduce the need for hospitalization, as well as lethality, with social robust benefits and incalculable economic savings since involves the use of accessible, safe and not expensive medications.
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