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A call to caution when hydroxychloroquine is given to elderly patients with COVID-19

INTRODUCTION: Use of hydroxychloroquine in patients with coronavirus disease 2019 (COVID-19) was widespread and uncontrolled until recently. Patients vulnerable to severe COVID-19 are at risk of hydroxychloroquine interactions with co-morbidities and co-medications contributing to detrimental, inclu...

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Autores principales: Gabor, Julian J., Kreidenweiss, Andrea, Weber, Stefan, Salama, Moaaz, Sulyok, Mihaly, Sulyok, Zita, Koehne, Erik, Esen, Meral, Kreuels, Benno, Shamsrizi, Parichehr, Biecker, Erwin, Mordmüller, Benjamin, Berg, Christoph P., Fusco, Stefano, Köhler, Carsten, Kubicka, Stefan, Leitlein, Jens, Addo, Marylyn, Ramharter, Michael, Schwab, Matthias, Bissinger, Alfred Lennart, Velavan, Thirumalaisamy P., Krishna, Sanjeev, Kremsner, Peter G.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Authors. Published by Elsevier Ltd on behalf of International Society for Infectious Diseases. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8035801/
https://www.ncbi.nlm.nih.gov/pubmed/33848675
http://dx.doi.org/10.1016/j.ijid.2021.04.009
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author Gabor, Julian J.
Kreidenweiss, Andrea
Weber, Stefan
Salama, Moaaz
Sulyok, Mihaly
Sulyok, Zita
Koehne, Erik
Esen, Meral
Kreuels, Benno
Shamsrizi, Parichehr
Biecker, Erwin
Mordmüller, Benjamin
Berg, Christoph P.
Fusco, Stefano
Köhler, Carsten
Kubicka, Stefan
Leitlein, Jens
Addo, Marylyn
Ramharter, Michael
Schwab, Matthias
Bissinger, Alfred Lennart
Velavan, Thirumalaisamy P.
Krishna, Sanjeev
Kremsner, Peter G.
author_facet Gabor, Julian J.
Kreidenweiss, Andrea
Weber, Stefan
Salama, Moaaz
Sulyok, Mihaly
Sulyok, Zita
Koehne, Erik
Esen, Meral
Kreuels, Benno
Shamsrizi, Parichehr
Biecker, Erwin
Mordmüller, Benjamin
Berg, Christoph P.
Fusco, Stefano
Köhler, Carsten
Kubicka, Stefan
Leitlein, Jens
Addo, Marylyn
Ramharter, Michael
Schwab, Matthias
Bissinger, Alfred Lennart
Velavan, Thirumalaisamy P.
Krishna, Sanjeev
Kremsner, Peter G.
author_sort Gabor, Julian J.
collection PubMed
description INTRODUCTION: Use of hydroxychloroquine in patients with coronavirus disease 2019 (COVID-19) was widespread and uncontrolled until recently. Patients vulnerable to severe COVID-19 are at risk of hydroxychloroquine interactions with co-morbidities and co-medications contributing to detrimental, including fatal, adverse treatment effects. METHODS: A retrospective survey was undertaken of health conditions and co-medications of patients with COVID-19 who were pre-screened for enrolment in a randomized, double-blind, placebo-controlled hydroxychloroquine multi-centre trial. RESULTS: The survey involved 305 patients [median age 71 (interquartile range 59–81) years]. The majority of patients (n = 279, 92%) considered for inclusion in the clinical trial were not eligible, mainly due to safety concerns caused by health conditions or co-medications. The most common were QT-prolonging drugs (n = 188, 62%) and haematologic/haemato-oncologic diseases (n = 39, 13%) which prohibited the administration of hydroxychloroquine. In addition, 165 (54%) patients had health conditions and 167 (55%) patients were on co-medications that did not prohibit the use of hydroxychloroquine but had a risk of adverse interactions with hydroxychloroquine. The most common were diabetes (n = 86, 28%), renal insufficiency (n = 69, 23%) and heart failure (n = 58, 19%). CONCLUSION: The majority of hospitalized patients with COVID-19 had health conditions or took co-medications precluding safe treatment with hydroxychloroquine. Therefore, hydroxychloroquine should be administered with extreme caution in elderly patients with COVID-19, and only in clinical trials.
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spelling pubmed-80358012021-04-12 A call to caution when hydroxychloroquine is given to elderly patients with COVID-19 Gabor, Julian J. Kreidenweiss, Andrea Weber, Stefan Salama, Moaaz Sulyok, Mihaly Sulyok, Zita Koehne, Erik Esen, Meral Kreuels, Benno Shamsrizi, Parichehr Biecker, Erwin Mordmüller, Benjamin Berg, Christoph P. Fusco, Stefano Köhler, Carsten Kubicka, Stefan Leitlein, Jens Addo, Marylyn Ramharter, Michael Schwab, Matthias Bissinger, Alfred Lennart Velavan, Thirumalaisamy P. Krishna, Sanjeev Kremsner, Peter G. Int J Infect Dis Article INTRODUCTION: Use of hydroxychloroquine in patients with coronavirus disease 2019 (COVID-19) was widespread and uncontrolled until recently. Patients vulnerable to severe COVID-19 are at risk of hydroxychloroquine interactions with co-morbidities and co-medications contributing to detrimental, including fatal, adverse treatment effects. METHODS: A retrospective survey was undertaken of health conditions and co-medications of patients with COVID-19 who were pre-screened for enrolment in a randomized, double-blind, placebo-controlled hydroxychloroquine multi-centre trial. RESULTS: The survey involved 305 patients [median age 71 (interquartile range 59–81) years]. The majority of patients (n = 279, 92%) considered for inclusion in the clinical trial were not eligible, mainly due to safety concerns caused by health conditions or co-medications. The most common were QT-prolonging drugs (n = 188, 62%) and haematologic/haemato-oncologic diseases (n = 39, 13%) which prohibited the administration of hydroxychloroquine. In addition, 165 (54%) patients had health conditions and 167 (55%) patients were on co-medications that did not prohibit the use of hydroxychloroquine but had a risk of adverse interactions with hydroxychloroquine. The most common were diabetes (n = 86, 28%), renal insufficiency (n = 69, 23%) and heart failure (n = 58, 19%). CONCLUSION: The majority of hospitalized patients with COVID-19 had health conditions or took co-medications precluding safe treatment with hydroxychloroquine. Therefore, hydroxychloroquine should be administered with extreme caution in elderly patients with COVID-19, and only in clinical trials. The Authors. Published by Elsevier Ltd on behalf of International Society for Infectious Diseases. 2021-05 2021-04-10 /pmc/articles/PMC8035801/ /pubmed/33848675 http://dx.doi.org/10.1016/j.ijid.2021.04.009 Text en © 2021 The Authors 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
Gabor, Julian J.
Kreidenweiss, Andrea
Weber, Stefan
Salama, Moaaz
Sulyok, Mihaly
Sulyok, Zita
Koehne, Erik
Esen, Meral
Kreuels, Benno
Shamsrizi, Parichehr
Biecker, Erwin
Mordmüller, Benjamin
Berg, Christoph P.
Fusco, Stefano
Köhler, Carsten
Kubicka, Stefan
Leitlein, Jens
Addo, Marylyn
Ramharter, Michael
Schwab, Matthias
Bissinger, Alfred Lennart
Velavan, Thirumalaisamy P.
Krishna, Sanjeev
Kremsner, Peter G.
A call to caution when hydroxychloroquine is given to elderly patients with COVID-19
title A call to caution when hydroxychloroquine is given to elderly patients with COVID-19
title_full A call to caution when hydroxychloroquine is given to elderly patients with COVID-19
title_fullStr A call to caution when hydroxychloroquine is given to elderly patients with COVID-19
title_full_unstemmed A call to caution when hydroxychloroquine is given to elderly patients with COVID-19
title_short A call to caution when hydroxychloroquine is given to elderly patients with COVID-19
title_sort call to caution when hydroxychloroquine is given to elderly patients with covid-19
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8035801/
https://www.ncbi.nlm.nih.gov/pubmed/33848675
http://dx.doi.org/10.1016/j.ijid.2021.04.009
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