Adverse drug reactions and drug interactions in the treatment of hospitalized patients with coronavirus disease 2019 (COVID-19)

Abstract

Objectives: To identify drugs that were administered off label to hospitalized patients with suspected coronavirus disease 2019 (COVID-19) and to identify adverse drug reactions (ADRs) and drug–drug interactions associated with these therapies. Methods: This case–control study was conducted in a Brazilian hospital from March to April 2020 among patients with suspected COVID-19, comparing those with positive severe acute respiratory coronavirus virus 2 (SARS-CoV-2) reverse-transcriptase polymerase chain reaction (RT-PCR) results and those with negative results. Results: The most commonly used medications in both groups were azithromycin and hydroxychloroquine. There was a significantly higher prevalence of reactions among patients with positive RT-PCR for SARS-CoV-2 (48.5% vs 28.8%; P = .008) in the propensity score–matched cohort, and the most commonly reported ADRs among these patients were diarrhea (43.8%), elevated liver enzymes (31.3%), and nausea and vomiting (29.7%). Conclusions: Our data demonstrate that ADRs and drug–drug interactions are common with off-label treatments for COVID-19.

Comparison of Computerized Prescription Support Systems in COVID-19 Patients: INTERCheck and Drug-PIN

“…A high prevalence of ADRs among patients (n.188) with COVID-19 (48.5% versus 28.8% in controls n.66, p = 0.008) was recently described in a Brazilian study [ 8 ]. They also evaluated the ADRs and drug-drug interactions by the means of IBM Micromedex ®, Up To Date electronic databases, and the Credible Meds website ( http://www.crediblemeds.org , for the potential risk for QT interval prolongation) [ 8 ].…”

“…Recent experimental therapies for the treatment of COVID-19 need a careful evaluation, to reduce the risk of potentially adverse drug reactions (ADRs) [ 5 – 7 ]. In a case–control study conducted in a Brazilian hospital from March to April 2020, the presence of any adverse drugs reaction involved about half group of the hospitalized patients with COVID-19 [ 8 ]. Adherence to the local/national/international guidelines and training programs to enhance the skill of healthcare professionals has been suggested, in order to reduce the risk of ADRs [ 9 , 10 ].…”