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

Gabor, JJ; Kreidenweiss, A; Weber, S; Salama, M; Sulyok, M; Sulyok, Z; Koehne, E; Esen, M; Kreuels, B; Shamsrizi, P; et al. Gabor, JJ; Kreidenweiss, A; Weber, S; Salama, M; Sulyok, M; Sulyok, Z; Koehne, E; Esen, M; Kreuels, B; Shamsrizi, P; Biecker, E; Mordmüller, B; Berg, CP; Fusco, S; Köhler, C; Kubicka, S; Leitlein, J; Addo, M; Ramharter, M; Schwab, M; Bissinger, AL; Velavan, TP; Krishna, S; Kremsner, PG (2021) A call to caution when hydroxychloroquine is given to elderly COVID-19 patients. Int J Infect Dis, 106. pp. 265-268. ISSN 1878-3511 https://doi.org/10.1016/j.ijid.2021.04.009
SGUL Authors: Krishna, Sanjeev

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Abstract

INTRODUCTION: Hydroxychloroquine use in COVID-19 patients was widespread and uncontrolled until recently. Patients vulnerable to severe COVID-19 are at risk for hydroxychloroquine interactions with comorbidities and co-medications contributing to detrimental, including fatal adverse treatment effects. METHODS: This is a retrospective survey of health conditions and co-medications of COVID-19 patients who were pre-screened for enrolment into a randomized, double-blind, placebo-controlled hydroxychloroquine multicenter trial. RESULTS: Our survey involved 305 patients (median age 71 (IQR: 59-81) years). The majority of patients (N = 279, 92%) considered for inclusion into the clinical trial were not eligible mainly due to safety concerns caused by health conditions or co-medications. Most common were QT prolonging drugs (N = 188, 62%) and hematologic/hemato-oncologic diseases (N = 39, 13%) which prohibited the administration of hydroxychloroquine in our clinical trial. Additionally, 165 (54%) patients had health conditions and 167 (55%) were on co-medications that did not prohibit hydroxychloroquine treatment but had a risk of adverse interactions with hydroxychloroquine. Most common were diabetes (N = 86, 28%), renal insufficiency (N = 69, 23%) and heart failure (N = 58, 19%). CONCLUSION: The majority of hospitalized COVID-19 patients had health conditions or took co-medications precluding safe treatment with hydroxychloroquine. Therefore, especially in elderly, hydroxychloroquine should be administered with extreme caution and only in clinical trials.

Item Type: Article
Additional Information: © 2021 The Authors. Published by Elsevier Ltd on behalf of International Society for Infectious Diseases. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
Keywords: Adverse Effects, COVID-19, Contraindications, Hydroxychloroquine, SARS-Cov2, 0605 Microbiology, 1108 Medical Microbiology, Microbiology
SGUL Research Institute / Research Centre: Academic Structure > Infection and Immunity Research Institute (INII)
Journal or Publication Title: Int J Infect Dis
ISSN: 1878-3511
Language: eng
Dates:
DateEvent
May 2021Published
10 April 2021Published Online
4 April 2021Accepted
Publisher License: Creative Commons: Attribution 4.0
Projects:
Project IDFunderFunder ID
01KI2052German Federal Ministry of Education and ResearchUNSPECIFIED
PubMed ID: 33848675
Go to PubMed abstract
URI: https://openaccess.sgul.ac.uk/id/eprint/113192
Publisher's version: https://doi.org/10.1016/j.ijid.2021.04.009

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