COVID-19 treatment in the older people: a brief clinical review

Cenderello, Giovanni; Dini, Simone; Ziliani, S.; Casuccio, Crocefissa Fiorella; Ubaldini, Francesca Mori

doi:10.4081/gc.2020.9330

Cited by 2 publications

(1 citation statement)

References 30 publications

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“…Moreover, the large majority of trials with HCQ have been conducted in Europe or USA in young people which did not show relevant comorbidities and drug interactions. 11 In some studies, drug combinations that prolong the cQT interval did not result in a greater degree of prolongation of the cQT interval than single drug administration. 12 It is not uncommon for patients with a prolonged cQT interval to be routinely prescribed drugs that prolong the cQT interval, despite the increased risk.…”

Section: Discussionmentioning

confidence: 97%

Proarrhythmia assessment in treatment with hydroxychloroquine and azithromycin hospitalized elderly COVID-19 patients - our experience

Costa

Castagna²,

Torchia

et al. 2021

Geriatr Care

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The aim of our study was to characterize the repolarization disorders propensity induced by drug-drug interaction. In this observational retrospective study, we report our experience on all elderly patients with ascertained diagnosis of coronavirus disease 2019 through nasopharyngeal swab with real time-polymerase chain reaction at our Pugliese-Ciaccio hospital in Catanzaro, who received hydroxychloroquine (HCQ), with or without azithromycin (AZY). 33 hospitalized patients were examined. We calculated QT value, cQT, QT dispersion, and cQT dispersion and examined possible progression on the basal electrocardiogram (T0) and after the insertion of the drug (T1). The QT value is increased by T0 vs T1 (370±40.74 vs 420±36.91 ms; P=0.000), as well as the cQT value (408±25.40 vs 451.54±58.81; P=0.003), the QT dispersion (QTd: 36.36±14.53 vs 50.90±13.12 ms; P=0.000); the dispersion of cQTc (cQTd 46.27±18.72 vs 63.18±21.93 ms; P=0.001). The ΔQT was 37.44±44.09 while the ΔcQT was 32.01±56.47). The main determinant of QTc prolongation is the number of drug at risk of prolongation of the QT that could influence the ventricular repolarization phase. The use of HCQ in combination with AZY, in patients suffering from severe acute respiratory syndrome-related coronavirus-2, can favor the onset of serious side effects, even potentially fatal. Finally, the measures of QTd and cQTd confirmed additional electrocardiographic parameters useful in identifying patients being treated with drugs at risk of potential adverse arrhythmic events following drug interaction.

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Section: Discussionmentioning

confidence: 97%

Proarrhythmia assessment in treatment with hydroxychloroquine and azithromycin hospitalized elderly COVID-19 patients - our experience

Costa

Castagna²,

Torchia

et al. 2021

Geriatr Care

View full text Add to dashboard Cite

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Frailty and risk of mortality and hospitalization in nursing home residents affected by COVID-19

Veronese¹,

Stangherlin²,

Mantoan³

et al. 2021

Geriatr Care

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Coronavirus disease 2019 (COVID-19) is a widespread condition in nursing homes (NHs). However, no research was made regarding frailty in NH residents during COVID-19 pandemic. The aim of this study was to assess whether frailty, assessed by the multidimensional prognostic index (MPI), can predict mortality/hospitalization in COVID-19 NH residents. A Cox’s regression analysis was used, reporting the results as hazard ratios (HRs) with 95% confidence intervals (CIs). 1146 NH residents affected by COVID-19 were included (mean age: 86 years; 75.4% females). During the followup period, we observed 286 deaths and 239 hospitalizations. Taking those with MPI <0.41 as reference, an MPI ≥0.50 was associated with a higher risk of death (HR=1.41; 95%CI: 1.07-1.85). Similar results were obtained using the MPI score increase in 0.10 points (HR=1.12; 95%CI: 1.03-1.23). Using hospitalization as outcome, only MPI score as continuous variable was associated with this outcome (HR=1.08; 95%CI: 1.002-1.17). In conclusion, frailty, as assessed by the MPI, was associated with a significant higher risk of mortality and hospitalization in NH residents affected by COVID-19 further indicating the necessity of assessing frailty in NH.

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COVID-19 treatment in the older people: a brief clinical review

Cited by 2 publications

References 30 publications

Proarrhythmia assessment in treatment with hydroxychloroquine and azithromycin hospitalized elderly COVID-19 patients - our experience

Proarrhythmia assessment in treatment with hydroxychloroquine and azithromycin hospitalized elderly COVID-19 patients - our experience

Frailty and risk of mortality and hospitalization in nursing home residents affected by COVID-19

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