Meta-analysis on outcome-worsening comorbidities of COVID-19 and related potential drug-drug interactions
Date
2020-11
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
Elsevier
Abstract
ENGLISH ABSTRACT: Drug-drug interactions (DDI) potentially occurring between medications used in the course of COVID-19 infection and medications prescribed for the management of underlying comorbidities may cause adverse drug reactions (ADRs) contributing to worsening of the clinical outcome in affected patients. First, we conducted a meta-analysis to determine comorbidities observed in the course of COVID-19 disease associated with an increased risk of worsened clinical outcome from 24 published studies. In addition, the potential risk of DDI between medications used in the course of COVID-19 treatment in these studies and those for the management of observed comorbidities was evaluated for possible worsening of the clinical outcome. Our meta-analysis revealed an implication cardiometabolic syndrome (e.g. cardiovascular disease, cerebrovascular disease, hypertension, and diabetes), chronic kidney disease and chronic obstructive pulmonary disease as main co-morbidities associated with worsen the clinical outcomes including mortality (risk difference RD 0.12, 95 %-CI 0.05−0.19, p = 0.001), admission to ICU (RD 0.10, 95 %-CI 0.04−0.16, p = 0.001) and severe infection (RD 0.05, 95 %-CI 0.01−0.09, p = 0.01) in COVID-19 patients. Potential DDI on pharmacokinetic level were identified between the antiviral agents atazanavir and lopinavir/ritonavir and some drugs, used in the treatment of cardiovascular diseases such as antiarrhythmics and anti-coagulants possibly affecting the clinical outcome including cardiac injury or arrest because of QTc-time prolongation or bleeding. Concluding, DDI occurring in the course of anti-Covid-19 treatment and co-morbidities could lead to ADRs, increasing the risk of hospitalization, prolonged time to recovery or death on extreme cases. COVID-19 patients with cardiometabolic diseases, chronic kidney disease and chronic obstructive pulmonary disease should be subjected to particular carefully clinical monitoring of adverse events with a possibility of dose adjustment when necessary.
Description
CITATION: Awortwe, C. & Cascorbi, I. 2020. Meta-analysis on outcome-worsening comorbidities of COVID-19 and related potential drug-drug interactions. Pharmacological Research, 161:105250, doi:10.1016/j.phrs.2020.105250.
The original publication is available at https://www.sciencedirect.com
The original publication is available at https://www.sciencedirect.com
Keywords
COVID-19 (Disease), Meta-analysis, Comorbidity, Epidemiology
Citation
Awortwe, C. & Cascorbi, I. 2020. Meta-analysis on outcome-worsening comorbidities of COVID-19 and related potential drug-drug interactions. Pharmacological Research, 161:105250, doi:10.1016/j.phrs.2020.105250.