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Risk assessment for cardiovascular adverse drug events in the ICU: Case study on COVID-19 patients

Natalia L Freitas1, Raiane Diniz Oliveira2, Ana Katarina da Silva Santos2

  • 1School of Health Sciences, University of Brasilia (UnB), Brasília, DF, Brazil.

Plos One
|March 24, 2026
PubMed

Insights

This study reduced cardiovascular drug risks in COVID-19 ICU patients by simulating prescription changes. Hypothetical interventions significantly decreased high-risk patients and adverse cardiovascular events, improving patient safety.

Area of Science:

  • Pharmacology
  • Critical Care Medicine
  • Infectious Diseases

Background:

  • The COVID-19 pandemic led to increased ICU admissions and polypharmacy.
  • Polypharmacy in COVID-19 patients elevates the risk of serious adverse drug reactions (ADEs), particularly cardiovascular ones.
  • Effective medication management is crucial for ICU patient survival during health emergencies.

Purpose of the Study:

  • To identify cardiovascular ADEs in COVID-19 patients admitted to an ICU in Brazil.
  • To evaluate the potential of simulated drug substitutions in reducing cardiovascular risk.
  • To assess the impact of optimized prescriptions on patient risk stratification.

Main Methods:

  • Analysis of 141 medical records of COVID-19 patients admitted in 2020.
  • Determination of cardiovascular risk using the Tisdale score.
  • Simulation of hypothetical drug substitutions using MedUTI software to mitigate cardiovascular risk.

Main Results:

  • Simulated prescription interventions led to a 53% decrease in high-risk patients (from 96.0% to 43.0%).
  • Optimized prescriptions shifted 56% of patients to medium or low cardiovascular risk.
  • A reduction in medications associated with serious cardiovascular ADEs was observed, including QT interval prolongation and Torsades de Pointes.

Conclusions:

  • The COVID-19 pandemic underscores the need for rapid medication management in ICUs.
  • Technology-assisted interventions, like MedUTI software, can significantly reduce cardiovascular ADEs in critically ill patients.
  • Optimizing polypharmacy through technological support is vital for improving patient outcomes in overcrowded ICUs.

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