Incidence of COVID-19 in patients exposed to chloroquine and hydroxychloroquine: results from a population-based prospective cohort in Catalonia, Spain, 2020.

BackgroundSeveral clinical trials have assessed the protective potential of chloroquine and hydroxychloroquine. Chronic exposure to such drugs might lower the risk of infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) or severe coronavirus disease (COVID-19).AimTo assess COVID-19 incidence and risk of hospitalisation in a cohort of patients chronically taking chloroquine/hydroxychloroquine.MethodsWe used linked health administration databases to follow a cohort of patients with chronic prescription of hydroxychloroquine/chloroquine and a control cohort matched by age, sex and primary care service area, between 1 January and 30 April 2020. COVID-19 cases were identified using International Classification of Diseases 10 codes.ResultsWe analysed a cohort of 6,746 patients (80% female) with active prescriptions for hydroxychloroquine/chloroquine, and 13,492 controls. During follow-up, there were 97 (1.4%) COVID-19 cases in the exposed cohort and 183 (1.4%) among controls. The incidence rate was very similar between the two groups (12.05 vs 11.35 cases/100,000 person-days). The exposed cohort was not at lower risk of infection compared with controls (hazard ratio (HR): 1.08; 95% confidence interval (CI): 0.83-1.44; p = 0.50). Forty cases (0.6%) were admitted to hospital in the exposed cohort and 50 (0.4%) in the control cohort, suggesting a higher hospitalisation rate in the former, though differences were not confirmed after adjustment (HR: 1·46; 95% CI: 0.91-2.34; p = 0.10).ConclusionsPatients chronically exposed to chloroquine/hydroxychloroquine did not differ in risk of COVID-19 nor hospitalisation, compared with controls. As controls were mainly female, findings might not be generalisable to a male population.

[Factors of success in the implementation of the technologies of the information and the communication in the health systems. The human factor]. / Factores de éxito en la implementación de las tecnologías de la información y la comunicación en los sistemas de salud. El factor humano.

In this work some of the fundamentals of change management techniques to ensure the introduction of information and communication technologies in health organizations are analized. Managing change is aimed at redirecting the impact of any transformation process in the organizations towards a positive attitude and enthusiasm of those involved. That is, this paper analyzes the most important of all factors that must be managed in any project for change: the human factor. If a proper change management is a critical success factor in implementing new processes and systems of information and communication technologies (ICT) in an organization, when we faced with the introduction of new processes and interoperability systems between different organizations, cooperation, leadership and motivation of individuals focused on a common goal is absolutely imperative. This is the case of the new ICT systems being introduced in the Catalan Health System. Indeed, by definition of the model itself, in Catalonia, continuity of care, increased efficiency and effectiveness and quality improvement of projects as the clinical history shared, electronic prescriptions, or scanning medical imaging, require necessarily the definition of processes in which a large number of different health organizations, different in their law status, and whose own interests should converge towards the ICT systems and processes of health care so that the contribution of all parties can make a whole. The success of these projects, a reality nowadays, is due largely to the management of the human factor conducted continuously since its inception.