Adverse drug reactions in SARS-CoV-2 inpatients: a case-series with a
focus on drug-drug interactions
Abstract
Background and aim: The search for early and emergency effective
treatments for COVID-19 infection may have led to loss of sight of
treatments safety. In addition, characteristics of drug-drug
interactions (DDIs)-related adverse drug reactions (ADRs) in COVID-19
patients have not yet been studied in depth. The aim of the present
case-series study is to describe clinical and pharmacological
characteristics of SARS-CoV-2 inpatients, focusing on ADRs, particularly
those related to DDIs. Methods: We evaluated all reports of COVID-19
medications-related ADRs collected within the COVID-19 Units of Careggi
University Hospital, Florence (Italy), between January 1st and 31st May
2020. Information regarding COVID-19 medications, patients’ demographic
and clinical characteristics, concomitant drugs, ADRs description and
outcome, were collected. Each case was evaluated for the causality
assessment and to identify the presence of DDIs. Results: During the
study period, 23 Caucasian patients (56.5% males, mean age 76.1 years)
experienced one or more ADRs. The majority of them were exposed to
polypharmacy and 17.4% presented concomitant conditions. ADRs were
referred to cardiovascular, psychiatric and gastrointestinal disorders.
The most frequently reported preferred term was QT prolongation (mean QT
interval 496.1 msec). ADRs improved or resolved completely in 60.8% of
cases. For all patients, a case-by-case evaluation revealed the presence
of one or more DDIs, especially those related to pharmacokinetic
interactions. Conclusions: Despite the small number of patients, our
evidence underline the clinical burden of DDIs in SARS-CoV-2 inpatients
and the risk of unexpected and uncommon psychiatric ADRs.