Vigilance for patients with Covid-19 treated with hydroxychloroquine. Indeed, the Medicines Agency (ANSM) warns of undesirable effects reported because patients with coronavirus seeming to present a "particular fragility" on the cardiac level.
"Covid patients are more fragile on the cardiovascular level and therefore more likely than ordinary people to have problems with drugs that are harmful to the heart" such as hydroxychloroquine, explained to AFP Dominique Martin, Director General of the National Medicines Safety Agency.
This is what emerges from a pharmacovigilance survey launched at the end of March, which identified in just under two weeks "a hundred cases of adverse reactions linked to drugs used in patients infected with Covid-19 , including 79 serious cases including 4 cases of death ”, details the ANSM.
Seven cardiac arrests reported
"The majority of cases of adverse reactions are divided by half between lopinavir / ritonavir", a treatment for HIV marketed in particular under the name of Kaletra, "and hydroxychloroquine", a derivative of the antimalarial chloroquine used in normal times against lupus and rheumatoid arthritis. For “a large part” of them, the investigation was able to conclude that there was a “plausible” link between the observed effect and the medication taken by the patient.
Cardiac adverse events, half of the total, were the subject of a specific analysis. It appears that "almost all" (43 out of 53) have been reported in patients treated "with hydroxychloroquine, alone or in combination (in particular with azithromycin)", an antibiotic.
These are "conduction disorders", an electrical abnormality visible on the EKG that can lead to heart rhythm disturbances or even death. Seven cardiac arrests of this nature have been reported, four of which led to death.
Need to limit the use of these drugs "in the hospital"
These are "known" side effects of hydroxychloroquine, "but it seems that they are increased in Covid patients", who often have a potassium deficiency, an essential element in the contraction of muscles, especially the heart, while the available data suggest that the new coronavirus also has its own toxicity on the heart. The side effects linked to Kaletra are mainly liver and kidney damage.
Our file on the coronavirus
"This information [...] constitutes an important signal" and reinforces the need to limit the use of these drugs "in the hospital, under close medical supervision", insists the ANSM, while several voices in the medical and political world claim the possibility of being able to prescribe hydroxychloroquia more broadly.
Pending the results of the ongoing trials on the efficacy of this drug, "the benefit-risk ratio seems acceptable to us in the hospital in the context" of the lack of recognized treatment, however it is "not acceptable in the city, ”where a patient cannot be immediately rescued in the event of a heart attack at home, summarizes Dominique Martin.
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