Costa Rica to reevaluate use of hydroxychloroquine for COVID-19 treatment

Costa Rican health authorities said Monday that the country will reevaluate its strategy of using hydroxychloroquine to treat coronavirus patients after the World Health Organization (WHO) suspended clinical trials of the drug.

The WHO decision came after publication of a study in The Lancet which indicated that using the drug on COVID-19 patients could increase their chances of dying, WHO chief Tedros Adhanom Ghebreyesus told a virtual press conference.

The Lancet study found that hydroxychloroquine, as well as the anti-malarial chloroquine, can produce potentially serious side effects, particularly heart arrhythmia.

And neither drug benefitted patients hospitalized with COVID-19, according to the Lancet study, which looked at the records of 96,000 patients across hundreds of hospitals.

Tedros stressed Monday that the two drugs “are accepted as generally safe for use in patients with autoimmune diseases or malaria.”

The decision on suspending enrollment for trials using hydroxychloroquine was “a temporary measure,” WHO chief scientist Soumya Swaminathan said.

“We’re just acting by precaution,” WHO emergencies chief Michael Ryan agreed.

Costa Rica to reevaluate use of drug

Román Macaya, executive president of Costa Rica’s Social Security Fund (CCSS), acknowledged the hydroxychloroquine news and said Monday that the country is convening an urgent meeting of pharmaceutical experts to determine next steps.

At the same time, Macaya said Costa Rica has used hydroxychloroquine differently than what was studied by researchers, who analyzed 96,032 patients who were hospitalized with COVID-19.

In Costa Rica, all patients — including those with minor symptoms or who are asymptomatic — are offered the option to take hydroxychloroquine upon their diagnosis, as long as they don’t have contraindications to the drug, Macaya said.

Costa Rica has a low case fatality rate (1.07%), and fewer than 5% of known active coronavirus cases are currently hospitalized.

“We can’t say that’s a result of this medication, but we can’t discard it either,” Macaya said. 

The Costa Rican health system has not released data comparing the outcomes of patients treated with hydroxychloroquine to other methods.

It has used the drug for treatment since conferencing with Chinese experts in April, according to Mario Ruíz, Medical Manager of the CCSS.