A call to caution when hydroxychloroquine is given to elderly patients with COVID-19.
Identifieur interne : 000113 ( Main/Corpus ); précédent : 000112; suivant : 000114A call to caution when hydroxychloroquine is given to elderly patients with COVID-19.
Auteurs : Julian J. Gabor ; Andrea Kreidenweiss ; Stefan Weber ; Moaaz Salama ; Mihaly Sulyok ; Zita Sulyok ; Erik Koehne ; Meral Esen ; Benno Kreuels ; Parichehr Shamsrizi ; Erwin Biecker ; Benjamin Mordmüller ; Christoph P. Berg ; Stefano Fusco ; Carsten Köhler ; Stefan Kubicka ; Jens Leitlein ; Marylyn Addo ; Michael Ramharter ; Matthias Schwab ; Alfred Lennart Bissinger ; Thirumalaisamy P. Velavan ; Sanjeev Krishna ; Peter G. KremsnerSource :
- International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases [ 1878-3511 ] ; 2021.
Abstract
INTRODUCTION
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.
METHODS
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.
RESULTS
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%).
CONCLUSION
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.
DOI: 10.1016/j.ijid.2021.04.009
PubMed: 33848675
PubMed Central: PMC8035801
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">A call to caution when hydroxychloroquine is given to elderly patients with COVID-19.</title><author><name sortKey="Gabor, Julian J" sort="Gabor, Julian J" uniqKey="Gabor J" first="Julian J" last="Gabor">Julian J. Gabor</name><affiliation><nlm:affiliation>Institute of Tropical Medicine, Travel Medicine and Human Parasitology, University Hospital Tübingen, Tübingen, Germany; Zollernalb Hospital Balingen, Balingen, Germany. Electronic address: Julian.Gabor@uni-tuebingen.de.</nlm:affiliation></affiliation></author><author><name sortKey="Kreidenweiss, Andrea" sort="Kreidenweiss, Andrea" uniqKey="Kreidenweiss A" first="Andrea" last="Kreidenweiss">Andrea Kreidenweiss</name><affiliation><nlm:affiliation>Institute of Tropical Medicine, Travel Medicine and Human Parasitology, University Hospital Tübingen, Tübingen, Germany; German Centre for Infection Research, Tübingen / Hamburg, Germany.</nlm:affiliation></affiliation></author><author><name sortKey="Weber, Stefan" sort="Weber, Stefan" uniqKey="Weber S" first="Stefan" last="Weber">Stefan Weber</name><affiliation><nlm:affiliation>Institute of Tropical Medicine, Travel Medicine and Human Parasitology, University Hospital Tübingen, Tübingen, Germany.</nlm:affiliation></affiliation></author><author><name sortKey="Salama, Moaaz" sort="Salama, Moaaz" uniqKey="Salama M" first="Moaaz" last="Salama">Moaaz Salama</name><affiliation><nlm:affiliation>Zollernalb Hospital Balingen, Balingen, Germany.</nlm:affiliation></affiliation></author><author><name sortKey="Sulyok, Mihaly" sort="Sulyok, Mihaly" uniqKey="Sulyok M" first="Mihaly" last="Sulyok">Mihaly Sulyok</name><affiliation><nlm:affiliation>Institute of Tropical Medicine, Travel Medicine and Human Parasitology, University Hospital Tübingen, Tübingen, Germany; Zollernalb Hospital Balingen, Balingen, Germany; Department of Pathology and Neuropathology, University Hospital Tübingen, Tübingen, Germany.</nlm:affiliation></affiliation></author><author><name sortKey="Sulyok, Zita" sort="Sulyok, Zita" uniqKey="Sulyok Z" first="Zita" last="Sulyok">Zita Sulyok</name><affiliation><nlm:affiliation>Institute of Tropical Medicine, Travel Medicine and Human Parasitology, University Hospital Tübingen, Tübingen, Germany; Neonatology, University Hospital Tübingen, Tübingen, Germany.</nlm:affiliation></affiliation></author><author><name sortKey="Koehne, Erik" sort="Koehne, Erik" uniqKey="Koehne E" first="Erik" last="Koehne">Erik Koehne</name><affiliation><nlm:affiliation>Institute of Tropical Medicine, Travel Medicine and Human Parasitology, University Hospital Tübingen, Tübingen, Germany; Zollernalb Hospital Balingen, Balingen, Germany.</nlm:affiliation></affiliation></author><author><name sortKey="Esen, Meral" sort="Esen, Meral" uniqKey="Esen M" first="Meral" last="Esen">Meral Esen</name><affiliation><nlm:affiliation>Institute of Tropical Medicine, Travel Medicine and Human Parasitology, University Hospital Tübingen, Tübingen, Germany; German Centre for Infection Research, Tübingen / Hamburg, Germany.</nlm:affiliation></affiliation></author><author><name sortKey="Kreuels, Benno" sort="Kreuels, Benno" uniqKey="Kreuels B" first="Benno" last="Kreuels">Benno Kreuels</name><affiliation><nlm:affiliation>Department of Tropical Medicine Bernhard Nocht Institute for Tropical Medicine and I. Department of Medicine, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany.</nlm:affiliation></affiliation></author><author><name sortKey="Shamsrizi, Parichehr" sort="Shamsrizi, Parichehr" uniqKey="Shamsrizi P" first="Parichehr" last="Shamsrizi">Parichehr Shamsrizi</name><affiliation><nlm:affiliation>Department of Tropical Medicine Bernhard Nocht Institute for Tropical Medicine and I. Department of Medicine, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany.</nlm:affiliation></affiliation></author><author><name sortKey="Biecker, Erwin" sort="Biecker, Erwin" uniqKey="Biecker E" first="Erwin" last="Biecker">Erwin Biecker</name><affiliation><nlm:affiliation>Zollernalb Hospital Balingen, Balingen, Germany.</nlm:affiliation></affiliation></author><author><name sortKey="Mordmuller, Benjamin" sort="Mordmuller, Benjamin" uniqKey="Mordmuller B" first="Benjamin" last="Mordmüller">Benjamin Mordmüller</name><affiliation><nlm:affiliation>Institute of Tropical Medicine, Travel Medicine and Human Parasitology, University Hospital Tübingen, Tübingen, Germany; Department of Medical Microbiology, Radboud University Medical Centre, Nijmegen, The Netherlands.</nlm:affiliation></affiliation></author><author><name sortKey="Berg, Christoph P" sort="Berg, Christoph P" uniqKey="Berg C" first="Christoph P" last="Berg">Christoph P. Berg</name><affiliation><nlm:affiliation>Department of Internal Medicine I, University Hospital Tübingen, Tübingen, Germany.</nlm:affiliation></affiliation></author><author><name sortKey="Fusco, Stefano" sort="Fusco, Stefano" uniqKey="Fusco S" first="Stefano" last="Fusco">Stefano Fusco</name><affiliation><nlm:affiliation>Department of Internal Medicine I, University Hospital Tübingen, Tübingen, Germany.</nlm:affiliation></affiliation></author><author><name sortKey="Kohler, Carsten" sort="Kohler, Carsten" uniqKey="Kohler C" first="Carsten" last="Köhler">Carsten Köhler</name><affiliation><nlm:affiliation>Institute of Tropical Medicine, Travel Medicine and Human Parasitology, University Hospital Tübingen, Tübingen, Germany; German Centre for Infection Research, Tübingen / Hamburg, Germany.</nlm:affiliation></affiliation></author><author><name sortKey="Kubicka, Stefan" sort="Kubicka, Stefan" uniqKey="Kubicka S" first="Stefan" last="Kubicka">Stefan Kubicka</name><affiliation><nlm:affiliation>Hospital Steinenberg, Reutlingen, Germany.</nlm:affiliation></affiliation></author><author><name sortKey="Leitlein, Jens" sort="Leitlein, Jens" uniqKey="Leitlein J" first="Jens" last="Leitlein">Jens Leitlein</name><affiliation><nlm:affiliation>Hospital Steinenberg, Reutlingen, Germany.</nlm:affiliation></affiliation></author><author><name sortKey="Addo, Marylyn" sort="Addo, Marylyn" uniqKey="Addo M" first="Marylyn" last="Addo">Marylyn Addo</name><affiliation><nlm:affiliation>Department of Tropical Medicine Bernhard Nocht Institute for Tropical Medicine and I. Department of Medicine, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany; German Centre for Infection Research, Tübingen / Hamburg, Germany.</nlm:affiliation></affiliation></author><author><name sortKey="Ramharter, Michael" sort="Ramharter, Michael" uniqKey="Ramharter M" first="Michael" last="Ramharter">Michael Ramharter</name><affiliation><nlm:affiliation>Centre de Recherches Médicale de Lambaréné, Lambaréné, Gabon; Department of Tropical Medicine Bernhard Nocht Institute for Tropical Medicine and I. Department of Medicine, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany; German Centre for Infection Research, Tübingen / Hamburg, Germany.</nlm:affiliation></affiliation></author><author><name sortKey="Schwab, Matthias" sort="Schwab, Matthias" uniqKey="Schwab M" first="Matthias" last="Schwab">Matthias Schwab</name><affiliation><nlm:affiliation>Dr. Margarete Fischer-Bosch-Institute of Clinical Pharmacology, Stuttgart, Germany; Departments of Clinical Pharmacology, and Pharmacy and Biochemistry, University Tübingen, Tübingen, Germany.</nlm:affiliation></affiliation></author><author><name sortKey="Bissinger, Alfred Lennart" sort="Bissinger, Alfred Lennart" uniqKey="Bissinger A" first="Alfred Lennart" last="Bissinger">Alfred Lennart Bissinger</name><affiliation><nlm:affiliation>Institute of Tropical Medicine, Travel Medicine and Human Parasitology, University Hospital Tübingen, Tübingen, Germany.</nlm:affiliation></affiliation></author><author><name sortKey="Velavan, Thirumalaisamy P" sort="Velavan, Thirumalaisamy P" uniqKey="Velavan T" first="Thirumalaisamy P" last="Velavan">Thirumalaisamy P. Velavan</name><affiliation><nlm:affiliation>Institute of Tropical Medicine, Travel Medicine and Human Parasitology, University Hospital Tübingen, Tübingen, Germany; Vietnamese-German Centre for Medical Research, Hanoi, Viet Nam.</nlm:affiliation></affiliation></author><author><name sortKey="Krishna, Sanjeev" sort="Krishna, Sanjeev" uniqKey="Krishna S" first="Sanjeev" last="Krishna">Sanjeev Krishna</name><affiliation><nlm:affiliation>Institute of Infection and Immunity, London, UK.</nlm:affiliation></affiliation></author><author><name sortKey="Kremsner, Peter G" sort="Kremsner, Peter G" uniqKey="Kremsner P" first="Peter G" last="Kremsner">Peter G. Kremsner</name><affiliation><nlm:affiliation>Institute of Tropical Medicine, Travel Medicine and Human Parasitology, University Hospital Tübingen, Tübingen, Germany; Centre de Recherches Médicale de Lambaréné, Lambaréné, Gabon; German Centre for Infection Research, Tübingen / Hamburg, Germany.</nlm:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2021">2021</date><idno type="RBID">pubmed:33848675</idno><idno type="pmid">33848675</idno><idno type="doi">10.1016/j.ijid.2021.04.009</idno><idno type="pmc">PMC8035801</idno><idno type="wicri:Area/Main/Corpus">000113</idno><idno type="wicri:explorRef" wicri:stream="Main" wicri:step="Corpus" wicri:corpus="PubMed">000113</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">A call to caution when hydroxychloroquine is given to elderly patients with COVID-19.</title><author><name sortKey="Gabor, Julian J" sort="Gabor, Julian J" uniqKey="Gabor J" first="Julian J" last="Gabor">Julian J. Gabor</name><affiliation><nlm:affiliation>Institute of Tropical Medicine, Travel Medicine and Human Parasitology, University Hospital Tübingen, Tübingen, Germany; Zollernalb Hospital Balingen, Balingen, Germany. Electronic address: Julian.Gabor@uni-tuebingen.de.</nlm:affiliation></affiliation></author><author><name sortKey="Kreidenweiss, Andrea" sort="Kreidenweiss, Andrea" uniqKey="Kreidenweiss A" first="Andrea" last="Kreidenweiss">Andrea Kreidenweiss</name><affiliation><nlm:affiliation>Institute of Tropical Medicine, Travel Medicine and Human Parasitology, University Hospital Tübingen, Tübingen, Germany; German Centre for Infection Research, Tübingen / Hamburg, Germany.</nlm:affiliation></affiliation></author><author><name sortKey="Weber, Stefan" sort="Weber, Stefan" uniqKey="Weber S" first="Stefan" last="Weber">Stefan Weber</name><affiliation><nlm:affiliation>Institute of Tropical Medicine, Travel Medicine and Human Parasitology, University Hospital Tübingen, Tübingen, Germany.</nlm:affiliation></affiliation></author><author><name sortKey="Salama, Moaaz" sort="Salama, Moaaz" uniqKey="Salama M" first="Moaaz" last="Salama">Moaaz Salama</name><affiliation><nlm:affiliation>Zollernalb Hospital Balingen, Balingen, Germany.</nlm:affiliation></affiliation></author><author><name sortKey="Sulyok, Mihaly" sort="Sulyok, Mihaly" uniqKey="Sulyok M" first="Mihaly" last="Sulyok">Mihaly Sulyok</name><affiliation><nlm:affiliation>Institute of Tropical Medicine, Travel Medicine and Human Parasitology, University Hospital Tübingen, Tübingen, Germany; Zollernalb Hospital Balingen, Balingen, Germany; Department of Pathology and Neuropathology, University Hospital Tübingen, Tübingen, Germany.</nlm:affiliation></affiliation></author><author><name sortKey="Sulyok, Zita" sort="Sulyok, Zita" uniqKey="Sulyok Z" first="Zita" last="Sulyok">Zita Sulyok</name><affiliation><nlm:affiliation>Institute of Tropical Medicine, Travel Medicine and Human Parasitology, University Hospital Tübingen, Tübingen, Germany; Neonatology, University Hospital Tübingen, Tübingen, Germany.</nlm:affiliation></affiliation></author><author><name sortKey="Koehne, Erik" sort="Koehne, Erik" uniqKey="Koehne E" first="Erik" last="Koehne">Erik Koehne</name><affiliation><nlm:affiliation>Institute of Tropical Medicine, Travel Medicine and Human Parasitology, University Hospital Tübingen, Tübingen, Germany; Zollernalb Hospital Balingen, Balingen, Germany.</nlm:affiliation></affiliation></author><author><name sortKey="Esen, Meral" sort="Esen, Meral" uniqKey="Esen M" first="Meral" last="Esen">Meral Esen</name><affiliation><nlm:affiliation>Institute of Tropical Medicine, Travel Medicine and Human Parasitology, University Hospital Tübingen, Tübingen, Germany; German Centre for Infection Research, Tübingen / Hamburg, Germany.</nlm:affiliation></affiliation></author><author><name sortKey="Kreuels, Benno" sort="Kreuels, Benno" uniqKey="Kreuels B" first="Benno" last="Kreuels">Benno Kreuels</name><affiliation><nlm:affiliation>Department of Tropical Medicine Bernhard Nocht Institute for Tropical Medicine and I. Department of Medicine, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany.</nlm:affiliation></affiliation></author><author><name sortKey="Shamsrizi, Parichehr" sort="Shamsrizi, Parichehr" uniqKey="Shamsrizi P" first="Parichehr" last="Shamsrizi">Parichehr Shamsrizi</name><affiliation><nlm:affiliation>Department of Tropical Medicine Bernhard Nocht Institute for Tropical Medicine and I. Department of Medicine, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany.</nlm:affiliation></affiliation></author><author><name sortKey="Biecker, Erwin" sort="Biecker, Erwin" uniqKey="Biecker E" first="Erwin" last="Biecker">Erwin Biecker</name><affiliation><nlm:affiliation>Zollernalb Hospital Balingen, Balingen, Germany.</nlm:affiliation></affiliation></author><author><name sortKey="Mordmuller, Benjamin" sort="Mordmuller, Benjamin" uniqKey="Mordmuller B" first="Benjamin" last="Mordmüller">Benjamin Mordmüller</name><affiliation><nlm:affiliation>Institute of Tropical Medicine, Travel Medicine and Human Parasitology, University Hospital Tübingen, Tübingen, Germany; Department of Medical Microbiology, Radboud University Medical Centre, Nijmegen, The Netherlands.</nlm:affiliation></affiliation></author><author><name sortKey="Berg, Christoph P" sort="Berg, Christoph P" uniqKey="Berg C" first="Christoph P" last="Berg">Christoph P. Berg</name><affiliation><nlm:affiliation>Department of Internal Medicine I, University Hospital Tübingen, Tübingen, Germany.</nlm:affiliation></affiliation></author><author><name sortKey="Fusco, Stefano" sort="Fusco, Stefano" uniqKey="Fusco S" first="Stefano" last="Fusco">Stefano Fusco</name><affiliation><nlm:affiliation>Department of Internal Medicine I, University Hospital Tübingen, Tübingen, Germany.</nlm:affiliation></affiliation></author><author><name sortKey="Kohler, Carsten" sort="Kohler, Carsten" uniqKey="Kohler C" first="Carsten" last="Köhler">Carsten Köhler</name><affiliation><nlm:affiliation>Institute of Tropical Medicine, Travel Medicine and Human Parasitology, University Hospital Tübingen, Tübingen, Germany; German Centre for Infection Research, Tübingen / Hamburg, Germany.</nlm:affiliation></affiliation></author><author><name sortKey="Kubicka, Stefan" sort="Kubicka, Stefan" uniqKey="Kubicka S" first="Stefan" last="Kubicka">Stefan Kubicka</name><affiliation><nlm:affiliation>Hospital Steinenberg, Reutlingen, Germany.</nlm:affiliation></affiliation></author><author><name sortKey="Leitlein, Jens" sort="Leitlein, Jens" uniqKey="Leitlein J" first="Jens" last="Leitlein">Jens Leitlein</name><affiliation><nlm:affiliation>Hospital Steinenberg, Reutlingen, Germany.</nlm:affiliation></affiliation></author><author><name sortKey="Addo, Marylyn" sort="Addo, Marylyn" uniqKey="Addo M" first="Marylyn" last="Addo">Marylyn Addo</name><affiliation><nlm:affiliation>Department of Tropical Medicine Bernhard Nocht Institute for Tropical Medicine and I. Department of Medicine, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany; German Centre for Infection Research, Tübingen / Hamburg, Germany.</nlm:affiliation></affiliation></author><author><name sortKey="Ramharter, Michael" sort="Ramharter, Michael" uniqKey="Ramharter M" first="Michael" last="Ramharter">Michael Ramharter</name><affiliation><nlm:affiliation>Centre de Recherches Médicale de Lambaréné, Lambaréné, Gabon; Department of Tropical Medicine Bernhard Nocht Institute for Tropical Medicine and I. Department of Medicine, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany; German Centre for Infection Research, Tübingen / Hamburg, Germany.</nlm:affiliation></affiliation></author><author><name sortKey="Schwab, Matthias" sort="Schwab, Matthias" uniqKey="Schwab M" first="Matthias" last="Schwab">Matthias Schwab</name><affiliation><nlm:affiliation>Dr. Margarete Fischer-Bosch-Institute of Clinical Pharmacology, Stuttgart, Germany; Departments of Clinical Pharmacology, and Pharmacy and Biochemistry, University Tübingen, Tübingen, Germany.</nlm:affiliation></affiliation></author><author><name sortKey="Bissinger, Alfred Lennart" sort="Bissinger, Alfred Lennart" uniqKey="Bissinger A" first="Alfred Lennart" last="Bissinger">Alfred Lennart Bissinger</name><affiliation><nlm:affiliation>Institute of Tropical Medicine, Travel Medicine and Human Parasitology, University Hospital Tübingen, Tübingen, Germany.</nlm:affiliation></affiliation></author><author><name sortKey="Velavan, Thirumalaisamy P" sort="Velavan, Thirumalaisamy P" uniqKey="Velavan T" first="Thirumalaisamy P" last="Velavan">Thirumalaisamy P. Velavan</name><affiliation><nlm:affiliation>Institute of Tropical Medicine, Travel Medicine and Human Parasitology, University Hospital Tübingen, Tübingen, Germany; Vietnamese-German Centre for Medical Research, Hanoi, Viet Nam.</nlm:affiliation></affiliation></author><author><name sortKey="Krishna, Sanjeev" sort="Krishna, Sanjeev" uniqKey="Krishna S" first="Sanjeev" last="Krishna">Sanjeev Krishna</name><affiliation><nlm:affiliation>Institute of Infection and Immunity, London, UK.</nlm:affiliation></affiliation></author><author><name sortKey="Kremsner, Peter G" sort="Kremsner, Peter G" uniqKey="Kremsner P" first="Peter G" last="Kremsner">Peter G. Kremsner</name><affiliation><nlm:affiliation>Institute of Tropical Medicine, Travel Medicine and Human Parasitology, University Hospital Tübingen, Tübingen, Germany; Centre de Recherches Médicale de Lambaréné, Lambaréné, Gabon; German Centre for Infection Research, Tübingen / Hamburg, Germany.</nlm:affiliation></affiliation></author></analytic><series><title level="j">International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases</title><idno type="eISSN">1878-3511</idno><imprint><date when="2021" type="published">2021</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><b>INTRODUCTION</b></p><p>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.</p></div><div type="abstract" xml:lang="en"><p><b>METHODS</b></p><p>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.</p></div><div type="abstract" xml:lang="en"><p><b>RESULTS</b></p><p>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%).</p></div><div type="abstract" xml:lang="en"><p><b>CONCLUSION</b></p><p>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.</p></div></front></TEI><pubmed><MedlineCitation Status="Publisher" Owner="NLM"><PMID Version="1">33848675</PMID><DateRevised><Year>2021</Year><Month>04</Month><Day>30</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1878-3511</ISSN><JournalIssue CitedMedium="Internet"><Volume>106</Volume><PubDate><Year>2021</Year><Month>Apr</Month><Day>10</Day></PubDate></JournalIssue><Title>International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases</Title><ISOAbbreviation>Int J Infect Dis</ISOAbbreviation></Journal><ArticleTitle>A call to caution when hydroxychloroquine is given to elderly patients with COVID-19.</ArticleTitle><Pagination><MedlinePgn>265-268</MedlinePgn></Pagination><ELocationID EIdType="pii" ValidYN="Y">S1201-9712(21)00320-9</ELocationID><ELocationID EIdType="doi" ValidYN="Y">10.1016/j.ijid.2021.04.009</ELocationID><Abstract><AbstractText Label="INTRODUCTION" NlmCategory="BACKGROUND">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.</AbstractText><AbstractText Label="METHODS" NlmCategory="METHODS">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.</AbstractText><AbstractText Label="RESULTS" NlmCategory="RESULTS">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%).</AbstractText><AbstractText Label="CONCLUSION" NlmCategory="CONCLUSIONS">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.</AbstractText><CopyrightInformation>Copyright © 2021 The Authors. Published by Elsevier Ltd.. All rights reserved.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Gabor</LastName><ForeName>Julian J</ForeName><Initials>JJ</Initials><AffiliationInfo><Affiliation>Institute of Tropical Medicine, Travel Medicine and Human Parasitology, University Hospital Tübingen, Tübingen, Germany; Zollernalb Hospital Balingen, Balingen, Germany. Electronic address: Julian.Gabor@uni-tuebingen.de.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Kreidenweiss</LastName><ForeName>Andrea</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>Institute of Tropical Medicine, Travel Medicine and Human Parasitology, University Hospital Tübingen, Tübingen, Germany; German Centre for Infection Research, Tübingen / Hamburg, Germany.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Weber</LastName><ForeName>Stefan</ForeName><Initials>S</Initials><AffiliationInfo><Affiliation>Institute of Tropical Medicine, Travel Medicine and Human Parasitology, University Hospital Tübingen, Tübingen, Germany.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Salama</LastName><ForeName>Moaaz</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Zollernalb Hospital Balingen, Balingen, Germany.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Sulyok</LastName><ForeName>Mihaly</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Institute of Tropical Medicine, Travel Medicine and Human Parasitology, University Hospital Tübingen, Tübingen, Germany; Zollernalb Hospital Balingen, Balingen, Germany; Department of Pathology and Neuropathology, University Hospital Tübingen, Tübingen, Germany.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Sulyok</LastName><ForeName>Zita</ForeName><Initials>Z</Initials><AffiliationInfo><Affiliation>Institute of Tropical Medicine, Travel Medicine and Human Parasitology, University Hospital Tübingen, Tübingen, Germany; Neonatology, University Hospital Tübingen, Tübingen, Germany.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Koehne</LastName><ForeName>Erik</ForeName><Initials>E</Initials><AffiliationInfo><Affiliation>Institute of Tropical Medicine, Travel Medicine and Human Parasitology, University Hospital Tübingen, Tübingen, Germany; Zollernalb Hospital Balingen, Balingen, Germany.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Esen</LastName><ForeName>Meral</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Institute of Tropical Medicine, Travel Medicine and Human Parasitology, University Hospital Tübingen, Tübingen, Germany; German Centre for Infection Research, Tübingen / Hamburg, Germany.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Kreuels</LastName><ForeName>Benno</ForeName><Initials>B</Initials><AffiliationInfo><Affiliation>Department of Tropical Medicine Bernhard Nocht Institute for Tropical Medicine and I. Department of Medicine, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Shamsrizi</LastName><ForeName>Parichehr</ForeName><Initials>P</Initials><AffiliationInfo><Affiliation>Department of Tropical Medicine Bernhard Nocht Institute for Tropical Medicine and I. Department of Medicine, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Biecker</LastName><ForeName>Erwin</ForeName><Initials>E</Initials><AffiliationInfo><Affiliation>Zollernalb Hospital Balingen, Balingen, Germany.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Mordmüller</LastName><ForeName>Benjamin</ForeName><Initials>B</Initials><AffiliationInfo><Affiliation>Institute of Tropical Medicine, Travel Medicine and Human Parasitology, University Hospital Tübingen, Tübingen, Germany; Department of Medical Microbiology, Radboud University Medical Centre, Nijmegen, The Netherlands.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Berg</LastName><ForeName>Christoph P</ForeName><Initials>CP</Initials><AffiliationInfo><Affiliation>Department of Internal Medicine I, University Hospital Tübingen, Tübingen, Germany.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Fusco</LastName><ForeName>Stefano</ForeName><Initials>S</Initials><AffiliationInfo><Affiliation>Department of Internal Medicine I, University Hospital Tübingen, Tübingen, Germany.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Köhler</LastName><ForeName>Carsten</ForeName><Initials>C</Initials><AffiliationInfo><Affiliation>Institute of Tropical Medicine, Travel Medicine and Human Parasitology, University Hospital Tübingen, Tübingen, Germany; German Centre for Infection Research, Tübingen / Hamburg, Germany.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Kubicka</LastName><ForeName>Stefan</ForeName><Initials>S</Initials><AffiliationInfo><Affiliation>Hospital Steinenberg, Reutlingen, Germany.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Leitlein</LastName><ForeName>Jens</ForeName><Initials>J</Initials><AffiliationInfo><Affiliation>Hospital Steinenberg, Reutlingen, Germany.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Addo</LastName><ForeName>Marylyn</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Department of Tropical Medicine Bernhard Nocht Institute for Tropical Medicine and I. Department of Medicine, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany; German Centre for Infection Research, Tübingen / Hamburg, Germany.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Ramharter</LastName><ForeName>Michael</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Centre de Recherches Médicale de Lambaréné, Lambaréné, Gabon; Department of Tropical Medicine Bernhard Nocht Institute for Tropical Medicine and I. Department of Medicine, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany; German Centre for Infection Research, Tübingen / Hamburg, Germany.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Schwab</LastName><ForeName>Matthias</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Dr. Margarete Fischer-Bosch-Institute of Clinical Pharmacology, Stuttgart, Germany; Departments of Clinical Pharmacology, and Pharmacy and Biochemistry, University Tübingen, Tübingen, Germany.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Bissinger</LastName><ForeName>Alfred Lennart</ForeName><Initials>AL</Initials><AffiliationInfo><Affiliation>Institute of Tropical Medicine, Travel Medicine and Human Parasitology, University Hospital Tübingen, Tübingen, Germany.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Velavan</LastName><ForeName>Thirumalaisamy P</ForeName><Initials>TP</Initials><AffiliationInfo><Affiliation>Institute of Tropical Medicine, Travel Medicine and Human Parasitology, University Hospital Tübingen, Tübingen, Germany; Vietnamese-German Centre for Medical Research, Hanoi, Viet Nam.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Krishna</LastName><ForeName>Sanjeev</ForeName><Initials>S</Initials><AffiliationInfo><Affiliation>Institute of Infection and Immunity, London, UK.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Kremsner</LastName><ForeName>Peter G</ForeName><Initials>PG</Initials><AffiliationInfo><Affiliation>Institute of Tropical Medicine, Travel Medicine and Human Parasitology, University Hospital Tübingen, Tübingen, Germany; Centre de Recherches Médicale de Lambaréné, Lambaréné, Gabon; German Centre for Infection Research, Tübingen / Hamburg, Germany.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2021</Year><Month>04</Month><Day>10</Day></ArticleDate></Article><MedlineJournalInfo><Country>Canada</Country><MedlineTA>Int J Infect Dis</MedlineTA><NlmUniqueID>9610933</NlmUniqueID><ISSNLinking>1201-9712</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">Adverse effects</Keyword><Keyword MajorTopicYN="N">COVID-19</Keyword><Keyword MajorTopicYN="N">Contraindications</Keyword><Keyword MajorTopicYN="N">Hydroxychloroquine</Keyword><Keyword MajorTopicYN="N">SARS-CoV-2</Keyword></KeywordList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2021</Year><Month>01</Month><Day>10</Day></PubMedPubDate><PubMedPubDate PubStatus="revised"><Year>2021</Year><Month>03</Month><Day>31</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2021</Year><Month>04</Month><Day>04</Day></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2021</Year><Month>4</Month><Day>14</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2021</Year><Month>4</Month><Day>14</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2021</Year><Month>4</Month><Day>13</Day><Hour>20</Hour><Minute>14</Minute></PubMedPubDate></History><PublicationStatus>aheadofprint</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">33848675</ArticleId><ArticleId IdType="pii">S1201-9712(21)00320-9</ArticleId><ArticleId IdType="doi">10.1016/j.ijid.2021.04.009</ArticleId><ArticleId IdType="pmc">PMC8035801</ArticleId></ArticleIdList></PubmedData></pubmed></record>Pour manipuler ce document sous Unix (Dilib)
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