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. 2022 Jul 1;12(7):1612.
doi: 10.3390/diagnostics12071612.

Safety of Drugs Used during the First Wave of COVID-19: A Hospital-Registry-Based Study

Cristina Aguilera  1   2   3 , Immaculada Danés  1   2   3 , Elena Guillén  1   2 , Alba Vimes  1 , Montserrat Bosch  1   2   3 , Gloria Cereza  2   3   4 , Adrián Sánchez-Montalvá  5 , Isabel Campos-Varela  6   7 , Marta Miarons  8 , Jaume Mestre-Torres  9 , Antònia Agustí  1   2   3
Affiliations

Safety of Drugs Used during the First Wave of COVID-19: A Hospital-Registry-Based Study

Cristina Aguilera et al. Diagnostics (Basel). .

Abstract

The emergency of the coronavirus disease 2019 (COVID-19) pandemic led to the off-label use of drugs without data on their toxicity profiles in patients with COVID-19, or on their concomitant use. Patients included in the COVID-19 Patient Registry of a tertiary hospital during the first wave were analyzed to evaluate the adverse drug reactions (ADRs) with the selected treatments. Twenty-one percent of patients (197 out of 933) had at least one ADR, with a total of 240 ADRs. Patients with ADRs were more commonly treated with multiple drugs for COVID-19 infection than patients without ADRs (p < 0.001). They were younger (median 62 years vs. 70.1 years; p < 0.001) and took less medication regularly (69.5% vs. 75.7%; p = 0.031). The most frequent ADRs were gastrointestinal (67.1%), hepatobiliary (10.8%), and cardiac disorders (3.3%). Drugs more frequently involved included lopinavir/ritonavir (82.2%), hydroxychloroquine (72.1%), and azithromycin (66.5%). Although most ADRs recovered without sequelae, fatal cases were described, even though the role of the disease could not be completely ruled out. In similar situations, efforts should be made to use the drugs in the context of clinical trials, and to limit off-label use to those drugs with a better benefit/risk profile in specific situations and for patients at high risk of poor disease prognosis.

Keywords: COVID-19; adverse drug reactions; hydroxychloroquine; lopinavir/ritonavir; off-label use; registries.

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Conflict of interest statement

The authors declare that this research was conducted in the absence of any commercial or financial relationships that could be construed as potential conflicts of interest.

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