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Chloroquine dosage regimens in patients with COVID-19: Safety risks and optimization using simulations
Currently no specific medicinal treatment exists against the new SARS-CoV2 and chloroquine is widely used, since it can decrease the length of hospital stay and improve the evolution of the associated COVID-19 pneumonia. However, several safety concerns have been raised from chloroquine use due to t...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier Ltd.
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7241328/ https://www.ncbi.nlm.nih.gov/pubmed/32501367 http://dx.doi.org/10.1016/j.ssci.2020.104842 |
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author | Karalis, Vangelis Ismailos, George Karatza, Eleni |
author_facet | Karalis, Vangelis Ismailos, George Karatza, Eleni |
author_sort | Karalis, Vangelis |
collection | PubMed |
description | Currently no specific medicinal treatment exists against the new SARS-CoV2 and chloroquine is widely used, since it can decrease the length of hospital stay and improve the evolution of the associated COVID-19 pneumonia. However, several safety concerns have been raised from chloroquine use due to the lack of essential information regarding its dosing. The aim of this study is to provide a critical appraisal of the safety information regarding chloroquine treatment and to apply simulation techniques to unveil relationships between the observed serious adverse events and overdosing, as well as to propose optimized dosage regimens. The dose related adverse events of chloroquine are unveiled and maximum tolerated doses and concentration levels are quoted. Among others, treatment with chloroquine can lead to severe adverse effects like prolongation of the QT interval and cardiomyopathy. In case of chloroquine overdosing, conditions similar to those produced by SARS-CoV2, such as pulmonary oedema with respiratory insufficiency and circulatory collapse, can be observed. Co-administration of chloroquine with other drugs for the treatment of COVID-19 patients, like azithromycin, can further increase the risk of QT prolongation and cardiomyopathy. For elder patients there is a high risk for toxicity and dose reduction should be made. This study unveils the risks of some widely used dosing regimens and binds the observed serious adverse events with dosing. Based on simulations, safer alternative dosage regimens are proposed and recommendations regarding chloroquine dosing are made. |
format | Online Article Text |
id | pubmed-7241328 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Elsevier Ltd. |
record_format | MEDLINE/PubMed |
spelling | pubmed-72413282020-05-21 Chloroquine dosage regimens in patients with COVID-19: Safety risks and optimization using simulations Karalis, Vangelis Ismailos, George Karatza, Eleni Saf Sci Article Currently no specific medicinal treatment exists against the new SARS-CoV2 and chloroquine is widely used, since it can decrease the length of hospital stay and improve the evolution of the associated COVID-19 pneumonia. However, several safety concerns have been raised from chloroquine use due to the lack of essential information regarding its dosing. The aim of this study is to provide a critical appraisal of the safety information regarding chloroquine treatment and to apply simulation techniques to unveil relationships between the observed serious adverse events and overdosing, as well as to propose optimized dosage regimens. The dose related adverse events of chloroquine are unveiled and maximum tolerated doses and concentration levels are quoted. Among others, treatment with chloroquine can lead to severe adverse effects like prolongation of the QT interval and cardiomyopathy. In case of chloroquine overdosing, conditions similar to those produced by SARS-CoV2, such as pulmonary oedema with respiratory insufficiency and circulatory collapse, can be observed. Co-administration of chloroquine with other drugs for the treatment of COVID-19 patients, like azithromycin, can further increase the risk of QT prolongation and cardiomyopathy. For elder patients there is a high risk for toxicity and dose reduction should be made. This study unveils the risks of some widely used dosing regimens and binds the observed serious adverse events with dosing. Based on simulations, safer alternative dosage regimens are proposed and recommendations regarding chloroquine dosing are made. Elsevier Ltd. 2020-09 2020-05-21 /pmc/articles/PMC7241328/ /pubmed/32501367 http://dx.doi.org/10.1016/j.ssci.2020.104842 Text en © 2020 Elsevier Ltd. All rights reserved. Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active. |
spellingShingle | Article Karalis, Vangelis Ismailos, George Karatza, Eleni Chloroquine dosage regimens in patients with COVID-19: Safety risks and optimization using simulations |
title | Chloroquine dosage regimens in patients with COVID-19: Safety risks and optimization using simulations |
title_full | Chloroquine dosage regimens in patients with COVID-19: Safety risks and optimization using simulations |
title_fullStr | Chloroquine dosage regimens in patients with COVID-19: Safety risks and optimization using simulations |
title_full_unstemmed | Chloroquine dosage regimens in patients with COVID-19: Safety risks and optimization using simulations |
title_short | Chloroquine dosage regimens in patients with COVID-19: Safety risks and optimization using simulations |
title_sort | chloroquine dosage regimens in patients with covid-19: safety risks and optimization using simulations |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7241328/ https://www.ncbi.nlm.nih.gov/pubmed/32501367 http://dx.doi.org/10.1016/j.ssci.2020.104842 |
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