Adverse drug reactions in SARS-CoV-2 hospitalised patients: a case-series with a focus on drug–drug interactions

Crescioli, Giada; Brilli, Valentina; Lanzi, Cecilia; Burgalassi, Andrea; Ieri, Alessandra; Bonaiuti, Roberto; Romano, Elias; Innocenti, Rinaldo; Mannaioni, Guido; Vannacci, Alfredo; Lombardi, Niccolò

doi:10.1007/s11739-020-02586-8

Cited by 27 publications

(33 citation statements)

References 40 publications

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“…Nevertheless, for a better general understanding and a wide comparability between settings, Naranjo scale still plays a role, although, as stated in several pharmacovigilance studies, the scale presents numerous well-known application limits [5]. Finally, as reported in Table 2 [2], none of adverse drug reactions described in our study were assessed as "certainly" associated with the suspected drugs.…”

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confidence: 67%

Adverse drug reactions in SARS-CoV-2 hospitalised patients: a case-series with a focus on drug–drug interactions-reply

et al. 2021

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We read with great interest the comment written by Pardo-Cabello and colleagues [1], replying to our original article entitled "Adverse drug reactions in SARS-COV-2 hospitalised patients: a case series with a focus on drug-drug interactions" [2] and we would like to make some comments regarding their considerations. As the authors correctly point out, data on the overall number of patients hospitalised for COVID-19 during the study period were not available at the time of writing. For this reason, only those patients for whom a pharmacological and toxicological counselling was requested by clinicians working in COVID-19 Units were considered. Of course, knowing the overall number of patients treated, and consequently, the prevalence rate of adverse drug reactions, could improve the assessment of burden due to pharmacological treatments in COVID-19 inpatients. Currently, we are able to retrieve the total number of patients hospitalised in the COVID-19 Units during the different phases of the SARS-CoV-2 pandemic, from the last Smart Consensus Conference organised by Careggi University Hospital, Florence (Italy) available online [3]. In particular, during the first wave (I semester 2020), a total of 472 patients were hospitalised, with a mean age of 72 years and an average hospital stay of 14.2 days. Of them, 27% (n = 127) were managed in the intensive care units, with an overall mortality of 25.6% (mean age of 77 years) [3]. Considering that all

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confidence: 67%

Adverse drug reactions in SARS-CoV-2 hospitalised patients: a case-series with a focus on drug–drug interactions-reply

et al. 2021

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“…A study done by Sun et al reported hepatobiliary and gastrointestinal symptoms as the main manifestations of ADRs [9]. However, in the case series by Crescioli et al, 2020, it was concluded that the ADRs related to cardiovascular, psychiatric and gastrointestinal disorders were the most frequent [15].…”

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confidence: 99%

Adverse Drug Reactions in COVID-19 patients admitted to Intensive care unit: Analysis of individual case study reports

Nazir

Chopra

Sidhu

et al. 2021

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Background Occurrence of adverse drug reactions in COVID-19 patients has not been extensively studied. Thus the present study was conducted to analyze the pattern of suspected Adverse Drug Reactions in COVID-19 patients admitted in Intensive Care Unit. Methods In this observational study, all the individual case study reports of patients admitted to the COVID ICU from August to October 2020 were analyzed. The type of ADR, the system involved, drug history, the suspected drug, reaction time and time to revert and management of ADR were recorded. ADRs were classified as serious and non-serious and causality was assessed using the WHO-UMC scale. The severity of ADRs was determined using Hartwig Scale. Results From 395 patients admitted to the COVID ICU during the study period, 44 individual case reports were received of 36 patients. Dermatological manifestations were the most frequent ADRs reported in this study, followed by gastrointestinal. Remedesivir was the most common drug associated with ADRs. The female gender, use of more than 5 drugs and presence of comorbidities were the independent risk factors for the occurrence of ADRs in patients with COVID-19. Conclusion The use of many of these drugs in this pandemic is experimental and so far the data available in the literature does not guarantee the safety and efficacy for COVID-19 treatment. Therefore, during these times of uncertainty, the results from present study reinforce the importance of monitoring patients. Early diagnosis and management of ADRs is warranted.

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“…Most of the published papers on drug interactions in COVID patients consist of presenting potential interactions to which patients have been exposed after reviewing medical records [30][31][32] (no specific outcome). We have found 2 papers [33,34] with individual descriptions of the clinical cases presented in eTable 31 (use suppInfo).…”

Section: Literature Researchmentioning

confidence: 99%

Drug-drug Interactions between COVID-19 Treatments and Antidepressants, Mood Stabilizers/Anticonvulsants, and Benzodiazepines: Integrated Evidence from 3 Databases

et al. 2021

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Introduction The SARS-CoV-2 pandemic with psychiatric comorbidities leads to a scenario in which the use of psychotropic drugs may be required. This requires the support of evidence-based medicine to take into account possible interactions between antidepressants, mood stabilizers, benzodiazepines, and coronavirus infection treatments. Methods Three databases were consulted: (a) Lexicomp Drug Interactions, (b) Micromedex Solutions Drugs Interactions, (c)Liverpool Drug Interaction Group for COVID-19 therapies. The CredibleMeds QTDrugs List was also queried. Hydroxychloroquine, chloroquine, azithromycin, lopinavir-ritonavir, remdesivir, favipiravir, tocilizumab, baricitinib, anakinra, and dexamethasone – drugs used for SARS-CoV-2 – were analyzed, and consensus recommendations are made. Results The potential interactions of agomelatine, desvenlafaxine, duloxetine, milnacipran, and vortioxetine with COVID-19 treatments shall be considered less risky. Antidepressant interactions with hydroxychloroquine, chloroquine, and azithromycin enhance the risk of QT prolongation, and ECG monitoring is advised for most antidepressants. Antidepressants with lopinavir/ritonavir involve multiple CYP enzyme interactions (except with milnacipran). Gabapentin, oxcarbazepine, pregabalin, topiramate, and zonisamide are safe treatment options that have no significant interactions with COVID-19 treatments. Lithium is contraindicated with hydroxychloroquine, chloroquine, and azithromycin. Precaution should be taken in using valproic acid with lopinavir-ritonavir. The use of benzodiazepines does not present a risk of drug interaction with COVID-19 treatments, except lopinavir/ritonavir. Conclusions Clinicians prescribing antidepressants, mood stabilizers/anticonvulsants, and benzodiazepines, should be aware of the probable risk of drug-drug interaction with COVID-19 medications and may benefit from heeding these recommendations for use to ensure patient safety.

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Adverse drug reactions in SARS-CoV-2 hospitalised patients: a case-series with a focus on drug–drug interactions

Cited by 27 publications

References 40 publications

Adverse drug reactions in SARS-CoV-2 hospitalised patients: a case-series with a focus on drug–drug interactions-reply

Adverse drug reactions in SARS-CoV-2 hospitalised patients: a case-series with a focus on drug–drug interactions-reply

Adverse Drug Reactions in COVID-19 patients admitted to Intensive care unit: Analysis of individual case study reports

Drug-drug Interactions between COVID-19 Treatments and Antidepressants, Mood Stabilizers/Anticonvulsants, and Benzodiazepines: Integrated Evidence from 3 Databases

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