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Costa Rica will temporarily stop using hydroxychloroquine as treatment for COVID-19

May 29, 2020

The Costa Rican Social Security System (CCSS) will temporarily suspend the use of hydroxychloroquine and lopinavir-ritonavir as treatments for COVID-19 patients, following the recommendation of its Central Committee for Pharmacotherapy (CCF).

The measure was announced Thursday by the medical manager of the institution, Mario Ruíz.

The Pharmacotherapy Committee reviewed evidence published regarding the effectiveness of the drugs at an international level and is further investigating their use in Costa Rica.

“Every time new information on therapies for COVID-19 appears, the CCF analyzes it to assess whether the therapies that are implemented in the CCSS are modified,” Ruíz said.

He added that protocols are subject to change, especially in situations of health emergencies and in light of the scientific evidence generated worldwide.

For her part, the Head of Medicine and Clinical Therapeutics of the Pharmacoepidemiology department, Angélica Vargas, stressed that suspending the use of hydroxychloroquine and lopinavir-ritonavir for coronavirus patients was a precautionary measure based on new scientific information and considering World Health Organization (WHO) recommendations.

Use of hydroxychloroquine in Costa Rica

Vargas said that the use of hydroxychloroquine for COVID-19 in Costa Rica has been “based on the scientific information available to date and on the clinical experience with the use of the drug in other countries such as China, which outlined a benefit with the use of the drug considering its potential in reducing viral replication and therefore reducing the severity of the infection.”

CCSS has said that in Costa Rica, all coronavirus patients — including those with minor symptoms or who are asymptomatic — were offered the option to take hydroxychloroquine upon their diagnosis, as long as they didn’t have contraindications to the drug.

Costa Rica has used hydroxychloroquine in the past as a treatment for malaria, rheumatoid arthritis, and systemic lupus erythematosus. In those cases, the institution indicated that no serious side effects were generated.

The suspension agreement was communicated this Thursday to the regional directors, medical directors and heads of health centers.

The CCSS clarified that the use of hydroxychloroquine will continue in patients who have already started treatment, until they finish the recommended dosage.

Costa Rica’s low case fatality rate

Costa Rica has a low case fatality rate (1.0%), and fewer than 5% of known active coronavirus cases are currently hospitalized.

“We can’t say that’s a result of this medication (hydroxychloroquine), but we can’t discard it either,” Román Macaya, executive president of the CCSS, said earlier this week. 

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

It has used the drug for treatment since conferencing with Chinese experts in April, according to Ruíz.

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A version of this story was originally published by Semanario Universidad on May 28, 2020. It was translated and republished with permission by The Tico Times. Read the original report at Semanario Universidad here.

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