Abstract
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.
Keywords: Adverse effects; COVID-19; Contraindications; Hydroxychloroquine; SARS-CoV-2.
【저자키워드】 COVID-19, SARS-CoV-2, Hydroxychloroquine, adverse effects, contraindications, 【초록키워드】 Treatment, coronavirus disease, clinical trial, Trial, severe COVID-19, clinical trials, risk, drug, heart failure, Randomized, Patient, co-morbidity, age, disease, placebo-controlled, retrospective, Interaction, detrimental, Elderly patient, Safe, double-blind, interquartile range, Adverse, enrolment, treatment effects, renal, health condition, Administered, widespread, extreme, caused, involved, addition, majority, hospitalized patient, contributing to, diabete, administration of hydroxychloroquine, co-medication, eligible, for inclusion, patients with COVID-19, use of hydroxychloroquine, with COVID-19, 【제목키워드】 Elderly patient, with COVID-19,