Meta-analysis on outcome-worsening comorbidities of COVID-19 and related potential drug-drug interactions

dc.contributor.authorAwortwe, Charlesen_ZA
dc.contributor.authorCascorbi, Ingolfen_ZA
dc.date.accessioned2021-02-02T11:49:05Z
dc.date.available2021-02-02T11:49:05Z
dc.date.issued2020-11
dc.descriptionCITATION: 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.
dc.descriptionThe original publication is available at https://www.sciencedirect.com
dc.description.abstractENGLISH 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.en_ZA
dc.description.sponsorshipAlexander von Humboldt Foundation
dc.description.urihttps://www.sciencedirect.com/science/article/pii/S1043661820315589#!
dc.description.versionPublisher's version
dc.format.extent10 pagesen_ZA
dc.identifier.citationAwortwe, 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.
dc.identifier.issn1043-6618 (online)
dc.identifier.otherdoi:10.1016/j.phrs.2020.105250
dc.identifier.urihttp://hdl.handle.net/10019.1/109497
dc.language.isoen_ZAen_ZA
dc.publisherElsevier
dc.rights.holderAuthors retain copyright
dc.subjectCOVID-19 (Disease)en_ZA
dc.subjectMeta-analysisen_ZA
dc.subjectComorbidityen_ZA
dc.subjectEpidemiologyen_ZA
dc.titleMeta-analysis on outcome-worsening comorbidities of COVID-19 and related potential drug-drug interactionsen_ZA
dc.typeArticleen_ZA
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