Serveur d'exploration COVID et hydrochloroquine

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Safety of hydroxychloroquine and darunavir or lopinavir in COVID-19 infection.

Identifieur interne : 000791 ( Main/Corpus ); précédent : 000790; suivant : 000792

Safety of hydroxychloroquine and darunavir or lopinavir in COVID-19 infection.

Auteurs : Etienne Meriglier ; Claire Rivoisy ; Mojgan Hessamfar ; Noelle Bernard ; Ines Aureau ; Joelle Lapoirie ; Anne Contis ; Frédéric Sacher ; Benjamin Sacristan ; Marin Lahouati ; Stéphane Pedeboscq ; Marie-Anne Vandenhende ; Stéphane Bouchet ; Fabrice Bonnet

Source :

RBID : pubmed:33221868

English descriptors

Abstract

BACKGROUND

Combination therapy with hydroxychloroquine and darunavir/ritonavir or lopinavir/ritonavir has been suggested as an approach to improve the outcome of patients with moderate/severe COVID-19 infection.

OBJECTIVES

To examine the safety of combination therapy with hydroxychloroquine and darunavir/ritonavir or lopinavir/ritonavir.

METHODS

This was an observational cohort study of patients hospitalized for COVID-19 pneumonia treated with hydroxychloroquine and darunavir/ritonavir or lopinavir/ritonavir. Clinical evaluations, electrocardiograms and the pharmacokinetics of hydroxychloroquine, darunavir and lopinavir were examined according to clinical practice and guidelines.

RESULTS

Twenty-one patients received hydroxychloroquine with lopinavir/ritonavir (median age 68 years; 10 males) and 25 received hydroxychloroquine with darunavir/ritonavir (median age 71 years; 15 males). During treatment, eight patients (17.4%) developed ECG abnormalities. Ten patients discontinued treatment, including seven for ECG abnormalities a median of 5 (range 2-6) days after starting treatment. All ECG abnormalities reversed 1-2 days after interrupting treatment. Four patients died within 14 days. ECG abnormalities were significantly associated with age over 70 years, coexisting conditions (such as hypertension, chronic cardiovascular disease and kidney failure) and initial potential drug interactions, but not with the hydroxychloroquine concentration.

CONCLUSIONS

Of the patients with COVID-19 who received hydroxychloroquine with lopinavir or darunavir, 17% had ECG abnormalities, mainly related to age or in those with a history of cardiovascular disease.


DOI: 10.1093/jac/dkaa441
PubMed: 33221868
PubMed Central: PMC7717306

Links to Exploration step

pubmed:33221868

Le document en format XML

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<term>Antiviral Agents (therapeutic use)</term>
<term>COVID-19 (drug therapy)</term>
<term>COVID-19 (epidemiology)</term>
<term>Cohort Studies (MeSH)</term>
<term>Darunavir (administration & dosage)</term>
<term>Darunavir (adverse effects)</term>
<term>Darunavir (blood)</term>
<term>Darunavir (therapeutic use)</term>
<term>Drug Therapy, Combination (MeSH)</term>
<term>Electrocardiography (MeSH)</term>
<term>France (MeSH)</term>
<term>Humans (MeSH)</term>
<term>Hydroxychloroquine (administration & dosage)</term>
<term>Hydroxychloroquine (adverse effects)</term>
<term>Hydroxychloroquine (blood)</term>
<term>Hydroxychloroquine (therapeutic use)</term>
<term>Long QT Syndrome (chemically induced)</term>
<term>Long QT Syndrome (epidemiology)</term>
<term>Lopinavir (administration & dosage)</term>
<term>Lopinavir (adverse effects)</term>
<term>Lopinavir (blood)</term>
<term>Lopinavir (therapeutic use)</term>
<term>SARS-CoV-2 (MeSH)</term>
<term>Severity of Illness Index (MeSH)</term>
<term>Treatment Outcome (MeSH)</term>
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<term>Antiviral Agents</term>
<term>Darunavir</term>
<term>Hydroxychloroquine</term>
<term>Lopinavir</term>
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<term>Antiviral Agents</term>
<term>Darunavir</term>
<term>Hydroxychloroquine</term>
<term>Lopinavir</term>
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<term>Antiviral Agents</term>
<term>Darunavir</term>
<term>Hydroxychloroquine</term>
<term>Lopinavir</term>
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<term>Antiviral Agents</term>
<term>Darunavir</term>
<term>Hydroxychloroquine</term>
<term>Lopinavir</term>
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<term>Drug Therapy, Combination</term>
<term>Electrocardiography</term>
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<front>
<div type="abstract" xml:lang="en">
<p>
<b>BACKGROUND</b>
</p>
<p>Combination therapy with hydroxychloroquine and darunavir/ritonavir or lopinavir/ritonavir has been suggested as an approach to improve the outcome of patients with moderate/severe COVID-19 infection.</p>
</div>
<div type="abstract" xml:lang="en">
<p>
<b>OBJECTIVES</b>
</p>
<p>To examine the safety of combination therapy with hydroxychloroquine and darunavir/ritonavir or lopinavir/ritonavir.</p>
</div>
<div type="abstract" xml:lang="en">
<p>
<b>METHODS</b>
</p>
<p>This was an observational cohort study of patients hospitalized for COVID-19 pneumonia treated with hydroxychloroquine and darunavir/ritonavir or lopinavir/ritonavir. Clinical evaluations, electrocardiograms and the pharmacokinetics of hydroxychloroquine, darunavir and lopinavir were examined according to clinical practice and guidelines.</p>
</div>
<div type="abstract" xml:lang="en">
<p>
<b>RESULTS</b>
</p>
<p>Twenty-one patients received hydroxychloroquine with lopinavir/ritonavir (median age 68 years; 10 males) and 25 received hydroxychloroquine with darunavir/ritonavir (median age 71 years; 15 males). During treatment, eight patients (17.4%) developed ECG abnormalities. Ten patients discontinued treatment, including seven for ECG abnormalities a median of 5 (range 2-6) days after starting treatment. All ECG abnormalities reversed 1-2 days after interrupting treatment. Four patients died within 14 days. ECG abnormalities were significantly associated with age over 70 years, coexisting conditions (such as hypertension, chronic cardiovascular disease and kidney failure) and initial potential drug interactions, but not with the hydroxychloroquine concentration.</p>
</div>
<div type="abstract" xml:lang="en">
<p>
<b>CONCLUSIONS</b>
</p>
<p>Of the patients with COVID-19 who received hydroxychloroquine with lopinavir or darunavir, 17% had ECG abnormalities, mainly related to age or in those with a history of cardiovascular disease.</p>
</div>
</front>
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<AbstractText Label="BACKGROUND">Combination therapy with hydroxychloroquine and darunavir/ritonavir or lopinavir/ritonavir has been suggested as an approach to improve the outcome of patients with moderate/severe COVID-19 infection.</AbstractText>
<AbstractText Label="OBJECTIVES">To examine the safety of combination therapy with hydroxychloroquine and darunavir/ritonavir or lopinavir/ritonavir.</AbstractText>
<AbstractText Label="METHODS">This was an observational cohort study of patients hospitalized for COVID-19 pneumonia treated with hydroxychloroquine and darunavir/ritonavir or lopinavir/ritonavir. Clinical evaluations, electrocardiograms and the pharmacokinetics of hydroxychloroquine, darunavir and lopinavir were examined according to clinical practice and guidelines.</AbstractText>
<AbstractText Label="RESULTS">Twenty-one patients received hydroxychloroquine with lopinavir/ritonavir (median age 68 years; 10 males) and 25 received hydroxychloroquine with darunavir/ritonavir (median age 71 years; 15 males). During treatment, eight patients (17.4%) developed ECG abnormalities. Ten patients discontinued treatment, including seven for ECG abnormalities a median of 5 (range 2-6) days after starting treatment. All ECG abnormalities reversed 1-2 days after interrupting treatment. Four patients died within 14 days. ECG abnormalities were significantly associated with age over 70 years, coexisting conditions (such as hypertension, chronic cardiovascular disease and kidney failure) and initial potential drug interactions, but not with the hydroxychloroquine concentration.</AbstractText>
<AbstractText Label="CONCLUSIONS">Of the patients with COVID-19 who received hydroxychloroquine with lopinavir or darunavir, 17% had ECG abnormalities, mainly related to age or in those with a history of cardiovascular disease.</AbstractText>
<CopyrightInformation>© The Author(s) 2020. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For permissions, please email: journals.permissions@oup.com.</CopyrightInformation>
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<Affiliation>Univ. Bordeaux, F-33000 Bordeaux, France.</Affiliation>
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<AffiliationInfo>
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<ISSNLinking>0305-7453</ISSNLinking>
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<DescriptorName UI="D005602" MajorTopicYN="N" Type="Geographic">France</DescriptorName>
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<MeshHeading>
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<MeshHeading>
<DescriptorName UI="D006886" MajorTopicYN="N">Hydroxychloroquine</DescriptorName>
<QualifierName UI="Q000008" MajorTopicYN="N">administration & dosage</QualifierName>
<QualifierName UI="Q000009" MajorTopicYN="Y">adverse effects</QualifierName>
<QualifierName UI="Q000097" MajorTopicYN="N">blood</QualifierName>
<QualifierName UI="Q000627" MajorTopicYN="N">therapeutic use</QualifierName>
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<MeshHeading>
<DescriptorName UI="D008133" MajorTopicYN="N">Long QT Syndrome</DescriptorName>
<QualifierName UI="Q000139" MajorTopicYN="N">chemically induced</QualifierName>
<QualifierName UI="Q000453" MajorTopicYN="N">epidemiology</QualifierName>
</MeshHeading>
<MeshHeading>
<DescriptorName UI="D061466" MajorTopicYN="N">Lopinavir</DescriptorName>
<QualifierName UI="Q000008" MajorTopicYN="N">administration & dosage</QualifierName>
<QualifierName UI="Q000009" MajorTopicYN="Y">adverse effects</QualifierName>
<QualifierName UI="Q000097" MajorTopicYN="N">blood</QualifierName>
<QualifierName UI="Q000627" MajorTopicYN="N">therapeutic use</QualifierName>
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<MeshHeading>
<DescriptorName UI="D000086402" MajorTopicYN="N">SARS-CoV-2</DescriptorName>
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<MeshHeading>
<DescriptorName UI="D012720" MajorTopicYN="N">Severity of Illness Index</DescriptorName>
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<MeshHeading>
<DescriptorName UI="D016896" MajorTopicYN="N">Treatment Outcome</DescriptorName>
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<PubMedPubDate PubStatus="received">
<Year>2020</Year>
<Month>06</Month>
<Day>11</Day>
</PubMedPubDate>
<PubMedPubDate PubStatus="accepted">
<Year>2020</Year>
<Month>09</Month>
<Day>29</Day>
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<PubMedPubDate PubStatus="pubmed">
<Year>2020</Year>
<Month>11</Month>
<Day>23</Day>
<Hour>6</Hour>
<Minute>0</Minute>
</PubMedPubDate>
<PubMedPubDate PubStatus="medline">
<Year>2021</Year>
<Month>2</Month>
<Day>3</Day>
<Hour>6</Hour>
<Minute>0</Minute>
</PubMedPubDate>
<PubMedPubDate PubStatus="entrez">
<Year>2020</Year>
<Month>11</Month>
<Day>22</Day>
<Hour>20</Hour>
<Minute>42</Minute>
</PubMedPubDate>
</History>
<PublicationStatus>ppublish</PublicationStatus>
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<ArticleId IdType="pubmed">33221868</ArticleId>
<ArticleId IdType="pii">5998282</ArticleId>
<ArticleId IdType="doi">10.1093/jac/dkaa441</ArticleId>
<ArticleId IdType="pmc">PMC7717306</ArticleId>
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