Effect of Pre-admission Hydroxychloroquine Treatment on COVID-19-related Intensive Care Follow-up in Geriatric Patients
SBÜ Fulya Çiyiltepe, Ayten Saracoglu, Yeliz Bilir, Elif Bombacı, Kemal Saracoglu, Dr İstanbul Kartal, Lütfi Kırdar, Şehir Hastanesi, Anesteziyoloji Ve
Southern Clinics of Istanbul Eurasia, doi:10.14744/scie.2021.89847
Objective: The admission rates to intensive care units and mortalities in geriatric patients are higher than the rest of the population with COVID-19 infection. Although the efficacy of hydroxychloroquine sulfate has been recognized, especially when started early during infection, its effectiveness at these early time points in geriatric patients has not been investigated. In this study, our primary aim was to investigate the effects of early treatment of hydroxychloroquine sulfate on COVID-19 positive geriatric patients, according to their clinical symptoms, situation before the intensive care, and patient survival. Methods: A total of 147 geriatric patients diagnosed with COVID-19 in the intensive care unit were divided into three groups: Patients who were admitted to the intensive care unit from the emergency department but did not receive treatment (Group 1); from the service for whose a 5-day treatment was initiated but not completed (Group 2); and those who completed 5-days of drug therapy (Group 3). Results: Although demographic data were similar between the three groups, the age parameters were significantly differed between them. Furthermore, there was no difference between the groups regarding mortality rate, discharge time, or extubation. The time to mortality and the duration of mechanical ventilation were found to be significantly shorter in Group 1 (p=0.001).
Conclusion: No significant effect was observed on patient survival and outcome due to early administration of hydroxychloroquine sulfate.According to our main findings, this study cannot recommend pre-admission hydroxychloroquine treatment for critically ill geriatric patients with COVID-19.
Conflict of Interest None declared.
References
Amaç, Gereç ve Yöntem: Yoğun bakım ünitesinde COVID-19 tanısı alan toplam 147 geriatrik hasta üç gruba ayrıldı: Acil servisten yoğun bakım ünitesine kabul edilen ancak tedavi almayan hastalar (Grup 1); beş günlük tedavi başlatılan ancak tamamlanmayan klinikten kabul edilen hastalar (Grup 2); ve beş günlük ilaç tedavisini tamamlamış olanlar
Andreani, Bideau, Duflot, Jardot, Rolland et al., In vitro testing of combined hydroxychloroquine and azithromycin on SARS-CoV-2 shows synergistic effect, Microb Pathog,
doi:10.1016/j.micpath.2020.104228
Astuti, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2): An overview of viral structure and host response, Diabetes Metab Syndr,
doi:10.1016/j.dsx.2020.04.020
Bulgular, Üç grup arasında demografik veriler benzer olmasına rağmen, yaş parametreleri aralarında önemli ölçüde farklıydı. Ayrıca ölüm oranı, taburculuk veya ekstübasyon zamanı açısından gruplar arasında fark yoktu
Celotto, Veronese, Barbagallo, Ometto, Smith et al., An umbrella review of systematic reviews with meta-analyses evaluating positive and negative outcomes of Hydroxychloroquine and chloroquine therapy, Int J Infect Dis,
doi:10.1016/j.ijid.2020.12.018
El Mershati, Thouvenin, Secretan, Lonlay, Tuchmann-Durand et al., Formulation and stability study of hydroxychloroquine sulfate oral suspensions, Pharm Dev Technol,
doi:10.1080/10837450.2021.1871918
Fda, against use of hydroxychloroquine or chloroquine for COVID-19 outside of the hospital setting or a clinical trial due to risk of heart rhythm problems
Grasselli, Zangrillo, Zanella, Antonelli, Cabrini et al., Baseline characteristics and outcomes of 1591 patients infected with SARS-CoV-2 admitted to ICUs of the Lombardy Region, Italy, JAMA,
doi:10.1001/jama.2020.5394
Guan, Ni, Hu, Zhou, Wang et al., China medical treatment expert group for covid-19. Clinical characteristics of coronavirus disease 2019 in China, N Engl J Med
Koenig, Beÿ, Mcdonald, 2019-nCoV: The identify-isolate-inform (3I) tool applied to a novel emerging coronavirus, West J Emerg Med,
doi:10.5811/westjem.2020.1.46760
Lara, Nguyen, Macias-Verde, Burgos-Burgos, Arenas et al., Whole-lung low dose irradiation for SARS-Cov2 induced pneumonia in the geriatric population: An old effective treatment for a new disease? Recommendation of the International Geriatric Radiotherapy Group, Aging Dis,
doi:10.14336/AD.2020.0506
Liu, Cao, Xu, Wang, Zhang et al., Hydroxychloroquine, a less toxic derivative of chloroquine, is effective in inhibiting SARS-CoV-2 infection in vitro, Cell Discov,
doi:10.1038/s41421-020-0156-0
Liu, Chen, Lin, Han, Clinical features of COVID-19 in elderly patients: A comparison with young and middle-aged patients, J Infect,
doi:10.1016/j.jinf.2020.03.005
Liu, Chen, Liu, Nie, Lu, Comorbid chronic diseases are strongly correlated with disease severity among COVID-19 patients: A systematic review and meta-analysis, Aging Dis,
doi:10.14336/AD.2020.0502
Magrone, Magrone, Russo, Jirillo, Peripheral immunosenescence and central neuroinflammation: a dangerous liaison. A dietary approach, Endocr Metab Immune Disord Drug Targets,
doi:10.2174/1871530320666200406123734
Mertz, Kim, Johnstone, Lam, Science et al., Populations at risk for severe or complicated influenza illness: systematic review and meta-analysis, BMJ,
doi:10.1136/bmj.f5061
Million, Lagier, Gautret, Colson, Fournier et al., Early treatment of COVID-19 patients with hydroxychloroquine and azithromycin: A retrospective analysis of 1061 cases in Marseille, France, Travel Med Infect Dis,
doi:10.1016/j.tmaid.2020.101738
Porcheddu, Serra, Kelvin, Rubino, Similarity in case fatality rates (CFR) of COVID-19/SARS-COV-2 in Italy and China, J Infect Dev Ctries,
doi:10.3855/jidc.12600
Schrezenmeier, Dörner, Mechanisms of action of hydroxychloroquine and chloroquine: implications for rheumatology, Nat Rev Rheumatol,
doi:10.1038/s41584-020-0372-x
Sonuç, Ana bulgularımıza göre, bu çalışma COVID-19'u olan geriatrik kritik hastalarda başvuru öncesi hidroksiklorokin tedavisi önermemektedir
Van Den Brand, Smits, Haagmans, Pathogenesis of Middle East respiratory syndrome coronavirus, J Pathol,
doi:10.1002/path.4458
Who, Definition of an older or elderly person
Wong, Lai, Wong, Comparison of initial high resolution computed tomography features in viral pneumonia between metapneumovirus infection and severe acute respiratory syndrome, Eur J Radiol2012,
doi:10.1016/j.ejrad.2011.02.050
Yao, Ye, Zhang, Cui, Huang et al., In Vitro antiviral activity and projection of optimized dosing design of hydroxychloroquine for the treatment of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), Clin Infect Dis,
doi:10.1093/cid/ciaa237
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