Institute of Tropical Medicine, Travel Medicine and Human Parasitology, University Hospital Tübingen, Tübingen, Germany; Zollernalb Hospital Balingen, Balingen, Germany.
Institute of Tropical Medicine, Travel Medicine and Human Parasitology, University Hospital Tübingen, Tübingen, Germany; German Centre for Infection Research, Tübingen / Hamburg, Germany.
Int J Infect Dis. 2021 May;106:265-268. doi: 10.1016/j.ijid.2021.04.009. Epub 2021 Apr 10.
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.
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.
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%).
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.
直到最近，羟氯喹在 2019 年冠状病毒病（COVID-19）患者中的使用还广泛且不受控制。易患严重 COVID-19 的患者有与合并症和合并用药相互作用的风险，导致有害的，包括致命的，不良治疗效果。
对 COVID-19 患者进行了一项回顾性调查，这些患者在参加一项随机、双盲、安慰剂对照羟氯喹多中心试验前进行了预筛选，以评估他们的健康状况和合并用药情况。
该调查涉及 305 名患者[中位数年龄 71（四分位距 59-81）岁]。大多数（n = 279，92%）被认为符合纳入临床试验标准的患者由于健康状况或合并用药引起的安全性问题而不合格。最常见的是延长 QT 间期的药物（n = 188，62%）和血液学/血液肿瘤学疾病（n = 39，13%），这些疾病禁止使用羟氯喹。此外，165（54%）名患者有健康状况，167（55%）名患者正在服用不会禁止使用羟氯喹但与羟氯喹有不良反应相互作用风险的合并用药。最常见的是糖尿病（n = 86，28%）、肾功能不全（n = 69，23%）和心力衰竭（n = 58，19%）。
大多数住院 COVID-19 患者有健康状况或服用合并用药，这使得他们无法安全使用羟氯喹进行治疗。因此，老年 COVID-19 患者应谨慎使用羟氯喹，且仅在临床试验中使用。
