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The American Journal of Medicine Responds

Published:February 17, 2021DOI:https://doi.org/10.1016/j.amjmed.2021.02.001
      The Editors of The American Journal of Medicine (AJM) are grateful to Dr. Heslley Machado Silva for calling our attention to the Brazilian government's misinterpretation and misuse of an article published in The American Journal of Medicine.
      • Silva HM
      The Brazilian scientific denialism through The American Journal of Medicine.
      As noted in Dr. Silva's commentary, the Brazilian government continues to tout hydroxychloroquine (HCQ) as a cure-all and preventive for Coronavirus disease 2019 (COVID-19) infections. The government quotes an article printed in the AJM in January 2021 but written and accepted more than 6 months earlier and posted on the PubMed website
      • McCullough PA
      • Kelly RJ
      • Ruocco G
      • et al.
      Pathophysiological basis and rationale for early outpatient treatment of SARS-CoV-2 (COVID-19) infection.
      at that time. This article was accepted for publication at a time when scientific information concerning prevention and management of COVID-19 was rapidly evolving. The article begins by emphasizing the importance of preventive measures including facial coverings, sanitization, and quarantining. The authors then discuss 8 agents or groups of agents that have shown in vitro or possible clinical activity against various coronaviruses, including severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Subsequently, a number of these agents, including HCQ, have been shown to be ineffective or harmful in preventing or treating infection with SARS-CoV-2. The AJM is one of many publications to call attention to this evolving scientific information.
      • Shih RD
      • Johnson HM
      • Maki DG
      • Hennekens CH
      Hydroxychloroquine for Coronavirus: the urgent need for a moratorium on prescriptions.
      Despite these new data, the government of Brazil continues to cite “the prestigious American Journal of Medicine” as proof that hydroxychloroquine can prevent or treat COVID-19. In other words, the Brazilian government claims that the AJM had given a seal of approval to the use of HCQ. Nothing could be further from the truth.
      The AJM is neither a regulatory agency nor an arbiter of political and scientific disputes. The AJM is a vehicle of communication employed by scientists and clinicians to report information that is potentially useful to physicians throughout the world. It is completely inaccurate to claim that the AJM has endorsed a therapeutic intervention. The article that the Brazilian government quotes as “proof” of the efficacy of HCQ was posted in PubMed before studies demonstrated that HCQ does more harm than good. The results of scientific studies are always open to review and revision by later investigation. This was the case with some of the hopeful speculations in the article by McCullough et al.
      • McCullough PA
      • Kelly RJ
      • Ruocco G
      • et al.
      Pathophysiological basis and rationale for early outpatient treatment of SARS-CoV-2 (COVID-19) infection.
      What seemed reasonable last summer based on laboratory experiments has subsequently been shown to be untrue, but the Brazilian government does not seem to have taken account of this widely available new information, as well as the crucial role of face covering, social distancing, and sanitization that are the first recommendations of McCullough et al.
      • McCullough PA
      • Kelly RJ
      • Ruocco G
      • et al.
      Pathophysiological basis and rationale for early outpatient treatment of SARS-CoV-2 (COVID-19) infection.
      Based on the US experience in 2020, this politicization of science should not be surprising.

      References

        • Silva HM
        The Brazilian scientific denialism through The American Journal of Medicine.
        Am J Med. 2021; ([e-pub ahead of print]) (Feb 6)https://doi.org/10.1016/j.amjmed.2021.01.003
        • McCullough PA
        • Kelly RJ
        • Ruocco G
        • et al.
        Pathophysiological basis and rationale for early outpatient treatment of SARS-CoV-2 (COVID-19) infection.
        Am J Med. 2021; 134: 16-22
        • Shih RD
        • Johnson HM
        • Maki DG
        • Hennekens CH
        Hydroxychloroquine for Coronavirus: the urgent need for a moratorium on prescriptions.
        Am J Med. 2021; 133: 1007-1008