that highlights efforts in the USA but fails to acknowledge cutting-edge research collaborations from low-income countries such as Brazil.
“What are the [Brazilian] health and science community and civil society doing?” Brazilian research provided evidence that hydroxychloroquine, with or without azithromycin, did not benefit mild-to-moderate COVID-19 cases (Coalition COVID-19 Brazil I),
that azithromycin also did not benefit patients with severe disease (Coalition COVID-19 Brazil II),
and confirmed that dexamethasone helps patients with severe cases of COVID-19 (Coalition COVID-19 Brazil III).
In the BRACE CORONA trial,
Brazilian researchers also demonstrated, for the first time in a randomised trial, that suspending angiotensin-converting enzyme inhibitors or angiotensin receptor blockers was not beneficial for mild-to-moderate COVID-19. Several additional multicentre randomised studies testing different interventions such as hydroxychloroquine in the pre-hospital setting, direct oral anticoagulants for in-hospital patients, tociluzumab and antivirals for severe COVID-19, pre-hospital anticoagulation, and long-term outcomes are ongoing and are expected to yield results in the next 3–6 months.
Amid political turmoil, controversial quotes, and plain widespread confusion, Brazilian researchers, through resilience, discretion, and outstanding science, have managed to answer relevant questions related to COVID-19 and continue to do so. And this is a story that also deserves to be told.
RDL reports personal fees from Bayer, Boehringer Ingleheim, and Daiichi Sankyo; grants and personal fees from Bristol-Myers Squibb, Glaxo Smith Kline, Medtronic, Pfizer, and Sanofi; and personal fees from Merck and Portola, unrelated to this Correspondence. All other authors declare no competing interests.
COVID-19 in Brazil: “So what?”.
Lancet. 2020; 3951461
Completion of clinical trials in light of COVID-19.
Lancet Respir Med. 2020; ()
Hydroxychloroquine with or without azithromycin in mild-to-moderate Covid-19.
New Engl J Med. 2020; ()
Azithromycin in addition to standard of care versus standard of care alone in the treatment of patients admitted to the hospital with severe COVID-19 in Brazil: a randomised clinical trial.
Lancet. 2020; 396: 959-967
Effect of dexamethasone on days alive and ventilator-free in patients with moderate or severe acute respiratory distress syndrome and COVID-19: The CoDEX randomized clinical trial.
JAMA. 2020; 324: 1307-1316
Continuing versus suspending angiotensin-converting enzyme inhibitors and angiotensin receptor blockers: impact on adverse outcomes in hospitalized patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).
Am Heart J. 2020; 226: 49-59
Published: November 10, 2020
© 2020 Published by Elsevier Ltd.