COVID-19感染和药物不良反应的风险:队列研究
Paul-Benoît Fargier1, Marlène Damin-Pernik1, Manon Launay1
1Centre régional de pharmacovigilance, hôpital Nord, CHU de Saint-Étienne, 42055 Saint-Étienne cedex, France.
概括
冠状病毒疾病2019 (COVID-19) 患者没有比其他感染患者出现更多的不良药物反应 (ADR). 高C反应蛋白和低估计的淋巴膜过率是ADR的主要风险因素.
科学领域:
- 药物监督 药物监督 药物监督
- 传染性疾病 传染性疾病
- 内部医学 内部医学
背景情况:
- 药物不良反应 (ADR) 的发生率似乎在COVID-19大流行期间增加.
- 严重急性呼吸道综合征冠状病毒2 (SARS-CoV-2) 感染诱导的炎症被假设为ADRs增加的原因.
- 需要进行比较分析来评估COVID-19与其他感染的ADR风险.
研究的目的:
- 为了调查COVID-19感染是否与其他传染病相比,与药物不良反应 (ADR) 的风险更高有关.
- 在COVID-19大流行期间,在住院患者中识别ADRs的危险因素.
主要方法:
- 一个单心的历史队列研究比较了住院COVID-19患者与非COVID-19患者.
- 药物不良反应 (ADRs) 被追溯评估,使用Begaud等人. 这是一个算法.
- 使用多变量考克斯回归分析来确定ADRs的危险比率 (HR).
主要成果:
- 在COVID-19 (4.64) 和非COVID-19 (3.52) 组之间,每人/月的ADR发生率没有显著差异 (调整HR1.29,P=0.1436).
- COVID-19患者患有更多的肝胆道疾病,而非COVID-19患者患有更多的脏和尿路疾病.
- 抗生素和抗血栓剂是两组中与ADR相关的最常见的药物类别. 较高的C-反应蛋白 (CRP) 和较低的估计球膜过率 (eGFR) 与ADR发生有关.
结论:
- 与其他感染患者相比,住院COVID-19患者的药物不良反应 (ADR) 发病率没有呈现出统计学上显著的较高发病率.
- 升高的C-反应蛋白 (CRP) 水平和降低估计的淋巴膜过率 (eGFR) 成为ADR的主要危险因素.
- 这些发现强调了在为住院患者制定ADR预防策略时考虑CRP和eGFR的重要性.
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