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Evaluation of patients treated by telemedicine in the beginning of the COVID-19 pandemic in São Paulo, Brazil: A non-randomized clinical trial preliminary study

We performed a pilot open-label, non-randomized controlled clinical trial in a clinic in São Paulo, Brazil in the beginning of the COVID-19 pandemic. “This medical pilot project was carried out during the pandemic of a new and unknown agent. It was necessary to find a new and safe therapeutic approa...

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Autores principales: Chechter, Michelle, Dutra da Silva, Gustavo Maximiliano, e Costa, Rute Alves Pereira, Miklos, Thomas Gabriel, Antonio da Silva, Nilzio, Lorber, Gabriel, Vasconcellos Mota, Natacha Rivero, dos Santos Cortada, Aline Pinheiro, de Nazare Lima da Cruz, Luciana, de Melo, Paulo Macio Porto, de Souza, Bruno Campello, Emmerich, Francisco G., de Andrade Zanotto, Paolo Marinho, Aaron Scheinberg, Morton
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10089670/
https://www.ncbi.nlm.nih.gov/pubmed/37073324
http://dx.doi.org/10.1016/j.heliyon.2023.e15337
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author Chechter, Michelle
Dutra da Silva, Gustavo Maximiliano
e Costa, Rute Alves Pereira
Miklos, Thomas Gabriel
Antonio da Silva, Nilzio
Lorber, Gabriel
Vasconcellos Mota, Natacha Rivero
dos Santos Cortada, Aline Pinheiro
de Nazare Lima da Cruz, Luciana
de Melo, Paulo Macio Porto
de Souza, Bruno Campello
Emmerich, Francisco G.
de Andrade Zanotto, Paolo Marinho
Aaron Scheinberg, Morton
author_facet Chechter, Michelle
Dutra da Silva, Gustavo Maximiliano
e Costa, Rute Alves Pereira
Miklos, Thomas Gabriel
Antonio da Silva, Nilzio
Lorber, Gabriel
Vasconcellos Mota, Natacha Rivero
dos Santos Cortada, Aline Pinheiro
de Nazare Lima da Cruz, Luciana
de Melo, Paulo Macio Porto
de Souza, Bruno Campello
Emmerich, Francisco G.
de Andrade Zanotto, Paolo Marinho
Aaron Scheinberg, Morton
author_sort Chechter, Michelle
collection PubMed
description We performed a pilot open-label, non-randomized controlled clinical trial in a clinic in São Paulo, Brazil in the beginning of the COVID-19 pandemic. “This medical pilot project was carried out during the pandemic of a new and unknown agent. It was necessary to find a new and safe therapeutic approach for pathogens with high potential for severity and contamination. The repositioning of safe and accessible pre-existing and approved medications and the telemedicine approach improved treated covid patients’ symptoms and reduced the risk of disease transmission. The emergency application of a new medical technology was the major limitation of the study. This innovative care model is a low-cost safe strategy, and we understand that applicability can be expanded to other regions in emergency situations.” The 187 patients of the study (mean age of 37.6 ± 15,6 years) were divided into four groups: (1) asymptomatic, (2) mild symptoms, (3) moderate symptoms and (4) severe symptoms and were followed up for five days. A drug intervention was performed in group 3 and the patients of Group 4 were oriented to seek hospital care. Of all the patients, 23.0% were asymptomatic, 29.4% reported mild symptoms, 43.9% moderate symptoms and 3.7% severe symptoms. Three patients were hospitalized and discharged after recovery. Our results indicate that the use of telemedicine with diagnosis and drug treatment is a safe and effective strategy to reduce overload of health services and the exposure of healthcare providers and the population. The patients that initiated the treatment in the early stages of the disease presented satisfactory clinical response, reducing the need of face-to-face consultations and hospitalizations. The patients who followed the protocol treatment for COVID-19 with hydroxychloroquine and azithromycin for five days presented statistically significant improvement of clinical symptoms when compared to moderate patients who opted for not following the protocol (p < 0.05) and to all no treatment patients (p < 0.001).
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spelling pubmed-100896702023-04-12 Evaluation of patients treated by telemedicine in the beginning of the COVID-19 pandemic in São Paulo, Brazil: A non-randomized clinical trial preliminary study Chechter, Michelle Dutra da Silva, Gustavo Maximiliano e Costa, Rute Alves Pereira Miklos, Thomas Gabriel Antonio da Silva, Nilzio Lorber, Gabriel Vasconcellos Mota, Natacha Rivero dos Santos Cortada, Aline Pinheiro de Nazare Lima da Cruz, Luciana de Melo, Paulo Macio Porto de Souza, Bruno Campello Emmerich, Francisco G. de Andrade Zanotto, Paolo Marinho Aaron Scheinberg, Morton Heliyon Research Article We performed a pilot open-label, non-randomized controlled clinical trial in a clinic in São Paulo, Brazil in the beginning of the COVID-19 pandemic. “This medical pilot project was carried out during the pandemic of a new and unknown agent. It was necessary to find a new and safe therapeutic approach for pathogens with high potential for severity and contamination. The repositioning of safe and accessible pre-existing and approved medications and the telemedicine approach improved treated covid patients’ symptoms and reduced the risk of disease transmission. The emergency application of a new medical technology was the major limitation of the study. This innovative care model is a low-cost safe strategy, and we understand that applicability can be expanded to other regions in emergency situations.” The 187 patients of the study (mean age of 37.6 ± 15,6 years) were divided into four groups: (1) asymptomatic, (2) mild symptoms, (3) moderate symptoms and (4) severe symptoms and were followed up for five days. A drug intervention was performed in group 3 and the patients of Group 4 were oriented to seek hospital care. Of all the patients, 23.0% were asymptomatic, 29.4% reported mild symptoms, 43.9% moderate symptoms and 3.7% severe symptoms. Three patients were hospitalized and discharged after recovery. Our results indicate that the use of telemedicine with diagnosis and drug treatment is a safe and effective strategy to reduce overload of health services and the exposure of healthcare providers and the population. The patients that initiated the treatment in the early stages of the disease presented satisfactory clinical response, reducing the need of face-to-face consultations and hospitalizations. The patients who followed the protocol treatment for COVID-19 with hydroxychloroquine and azithromycin for five days presented statistically significant improvement of clinical symptoms when compared to moderate patients who opted for not following the protocol (p < 0.05) and to all no treatment patients (p < 0.001). Elsevier 2023-04-11 /pmc/articles/PMC10089670/ /pubmed/37073324 http://dx.doi.org/10.1016/j.heliyon.2023.e15337 Text en © 2023 The Authors https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Research Article
Chechter, Michelle
Dutra da Silva, Gustavo Maximiliano
e Costa, Rute Alves Pereira
Miklos, Thomas Gabriel
Antonio da Silva, Nilzio
Lorber, Gabriel
Vasconcellos Mota, Natacha Rivero
dos Santos Cortada, Aline Pinheiro
de Nazare Lima da Cruz, Luciana
de Melo, Paulo Macio Porto
de Souza, Bruno Campello
Emmerich, Francisco G.
de Andrade Zanotto, Paolo Marinho
Aaron Scheinberg, Morton
Evaluation of patients treated by telemedicine in the beginning of the COVID-19 pandemic in São Paulo, Brazil: A non-randomized clinical trial preliminary study
title Evaluation of patients treated by telemedicine in the beginning of the COVID-19 pandemic in São Paulo, Brazil: A non-randomized clinical trial preliminary study
title_full Evaluation of patients treated by telemedicine in the beginning of the COVID-19 pandemic in São Paulo, Brazil: A non-randomized clinical trial preliminary study
title_fullStr Evaluation of patients treated by telemedicine in the beginning of the COVID-19 pandemic in São Paulo, Brazil: A non-randomized clinical trial preliminary study
title_full_unstemmed Evaluation of patients treated by telemedicine in the beginning of the COVID-19 pandemic in São Paulo, Brazil: A non-randomized clinical trial preliminary study
title_short Evaluation of patients treated by telemedicine in the beginning of the COVID-19 pandemic in São Paulo, Brazil: A non-randomized clinical trial preliminary study
title_sort evaluation of patients treated by telemedicine in the beginning of the covid-19 pandemic in são paulo, brazil: a non-randomized clinical trial preliminary study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10089670/
https://www.ncbi.nlm.nih.gov/pubmed/37073324
http://dx.doi.org/10.1016/j.heliyon.2023.e15337
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