COVİD-19 tanısıyla evde takip edilen hastaların hidroksiklorokin tedavisine uyumları ve geri bildirimleri

Yıl 2022, Cilt: 9 Sayı: 2, 194 - 201, 30.06.2022

Ayşe Didem Esen , Seçil Gunher Arıca , Funda Şimşek

https://doi.org/10.34087/cbusbed.984714

Öz

Giriş ve Amaç: Bu çalışmada Eğitim Aile Sağlığı Merkezlerine (EASM) kayıtlı ve COVID-19 nedeniyle evde hidroksiklorokin (HCQ) tedavisi alan hastaların ilaç uyumlarını ve geri bildirimlerinin değerlendirilmesi amaçlandı.
Gereç ve Yöntemler: Hastanemize bağlı Eğitim Aile Sağlığı Merkezlerinde kayıtlı COVID-19 nedeniyle evde tedavi gören ve HCQ tedavisi gören hastalar dahil edildi. Evde takip edilen bu hastalara ev takiplerinin 6. ve 14. günleri arasında bir kez ulaşıldı. Hastalara HCQ tedavisine uyumları, ilaç yan etkileri, geri bildirimler, ateş ve öksürük gibi semptomların süreleri, hastaneye yeniden sevklerle ilgili bilgileri içeren 31 maddeden oluşan anket soruları yöneltildi. Anket yoluyla toplanan veriler istatistiksel analiz ile değerlendirildi. İstatistiksel analizler SPSS 17.0 programı ile yapıldı.
Bulgular: Çalışmaya 37'si erkek 30'u kadın toplam 67 hasta katıldı. Ortalama yaş 45.34 ± 19.01 yıldır. Orta derecede semptomları olan 7 hasta ve hafif semptomları olan 60 hasta vardı. Bir hasta ilaca bağlı cilt döküntüsü nedeniyle tedaviyi bıraktı. 63 hastanın semptomlarında azalma oldu. Hastaneye yatan 23 hastanın ortalama yatış süresi 12.96 ± 5.92 gündü. Tekrar hastaneye sevk edilen 5 hasta vardı. Azitromisin kullanımı olanlarda tekrar hastaneye sevk oranı daha düşük bulundu.
Sonuç: HCQ kullanan evdeki takip edilen COVİD-19 hastalarının çoğunluğunun semptomlarında hafifleme olmuştur. HCQ ile kombine azitromisin tedavisi alanlarda tekrar hastaneye yatma oranları daha düşük gözlenmiştir.

Anahtar Kelimeler

COVİD-19, Hidroksiklorokin, Azitromisin

Compliance and feedback of hydroxychloroquine treatments in home follow-up patients with diagnosis of COVID-19

Öz

Objective: In this study we aimed to evaluate the medication compliance and feedback of the patients who were registered in Education Family Health Centers (EASM) and who received hydroxychloroquine (HCQ) treatment at home due to COVID-19.
Materials and Methods: Patients who were being treated at home and being treated for hydroxychloroquine due to COVID-19 registered in Education Family Health Centers affiliated to our hospital were included. These patients who were followed at home were contacted once between the 6th and 14th days of home follow-up. The patients were asked questionnaire questions including 31 items including information on their compliance with hydroxychloroquine treatment, drug side effects, feedback, duration of symptoms such as fever and cough, re-referrals to the hospital. The data collected through questionnaires were evaluated by statistical analysis.
Results: Statistical analysis was done with SPSS version 17.0 program. A total of 67 patients, 37 men and 30 women, participated in the study. The average age is 45.34 ± 19.01 years. There are 7 patients with moderate symptoms and 60 people who have mild symptoms. One patient had skin rush and stopped the treatment because of adverse effect. 63 patients had a reduction in their symptoms. There were 23 patients hospitalized and the average duration is 12.96 ± 5.92 days. There were 5 patients who are referred to the hospital again. Among patients 33 were receiving azithromycin combined with HCQ and their re-hospitalization rates were lower.
Conclusion: HCQ was observed efficient in relieving the COVİD-19 symptoms in most of the home follow-up patients Azithromycin combined with HCQ reduced re-hospitalization rates.

Anahtar Kelimeler

COVİD-19, Hydroxychloroquine, Azithromycin

Kaynakça

• Shukla, A.M, Wagle Shukla, A, Expanding horizons for clinical applications of chloroquine, hydroxychloroquine, and related structural analogues, Drugs Context, 2019, 8, 2019-9-1.
• Sinha, N, Balayla, G, Hydroxychloroquine and COVID-19, Postgraduate Medical Journal, 2020, 96, 550–5.
• Savarino, A, Boelaert, J.R, Cassone, A, Majori, G, Cauda R, Effects of chloroquine on viral infections: an old drug against today’s diseases? Lancet Infect Disease, 2003, 3(11), 722–7.
• Dowall, S.D, Bosworth, A, Watson, R, et al., Chloroquine inhibited Ebola virus replication in vitro but failed to protect against infection and disease in the in vivo guinea pig model, Journal of Genetic Virology, 2015, 96(12), 3484–92.
• de Wilde, A.H, Jochmans, D, Posthuma, C.C, et al., Screening of an FDA-approved compound library identifies four small-molecule inhibitors of Middle East respirator syndrome coronavirus replication in cell culture, Antimicrobial Agents Chemotheraphy, 647, 2014,58(8),4875–84.
• Zhonghua, J, He, H, Hu, X, Za, Z, Multicenter collaboration group of Department of Science and Technology of Guangdong Province and Health Commission of Guangdong Province for chloroquine in the treatment of novel coronavirus pneumonia Expert consensus on chloroquine phosphate for the treatment of novel coronavirus pneumonia], 2020, 12, 43(3), 185–8.
• Biot, C, Daher, W, Chavain, N, Fandeur, T, Khalife, J, Dive, D, et al. Design and synthesis of hydroxyferroquine derivatives with antimalarial and antiviral activities, Journal of Medical Chemistry 2006,49, 2845–9.
• Marmor, M.F, Kellner, U, Lai, T.Y, Melles, R.B, Mieler, WF, American Academy of Ophthalmology. Recommendations on Screening for Chloroquine and Hydroxychloroquine Retinopathy (2016 Revision), Ophthalmology, 2016, 123(6), 1386–94.
• Gordon, C, Amissah-Arthu, M.B, Gayed, M, Brown, S, Bruce, I.N, D'Cruz, D, et al., British Society for Rheumatology Standards, Audit and Guidelines Working Group. The British Society for Rheumatology guideline for the management of systemic lupus erythematosus in adults: Executive Summary, Rheumatology (Oxford), 2018, 1, 57(1), 14-18.
• Rainsford, K.D, Parke, A.L, Clifford-Rashotte, M, Kean, W.F., Therapy and pharmacological properties of hydroxychloroquine and chloroquine in treatment of systemic lupus erythematosus, rheumatoid arthritis and related diseases. Inflammopharmacology, 2015, 23(5), 231-269.
• Schrezenmeier, E, Dorner, T, Mechanisms of action of hydroxychloroquine and chloroquine: implications for rheumatology, Nature Reviews Rheumatology, 2020, DOI: 10.1038/s41584-020-0372-x.
• Akpovwa, H, Chloroquine could be used for the treatment of filoviral infections and other viral infections that emerge or emerged from viruses requiring an acidic pH for infectivity, Cell Biochemistry Function, 2016, 34(4), 191–196.
• Keyaerts, E, Vijgen, L, Maes, P, Neyts, J, Ranst, M.V, In vitro inhibition of severe acute respiratory syndrome coronavirus by chloroquine, Biochemistry Biophysiology Research Communication, 2004, 323, 264-268. 14. Vincent, M.J, Bergeron, E, Benjannet, S, et al., Chloroquine is a potent inhibitor of SARS coronavirus infection and spread, Virol Journal, 2005, 2, 69. doi:10.1186/1743-422X-2-69.
• Al-Bari, M.A, Chloroquine analogues in drug discovery: new directions of uses, mechanisms of actions and toxic manifestations from malaria to multifarious diseases, Journal of Antimicrobial Chemotheraphy, 2015,70(6),1608–1621.
• J. Gao, Z. Tian, X. Yang. Breakthrough: chloroquine phosphate has shown apparent efficacy in treatment of COVID-19 associated pneumonia in clinical studies. Biosci Trends (2020 Feb 19), 10.5582/bst.2020.01047. DOI: 10.5582/bst.2020.01047.
• Colson, P, Rolain, J.M, Lagier, J.C, Brouqui, P, Raoult, D, Chloroquine and hydroxychloroquine as available weapons to fight COVID-19 [published online ahead of print, 2020 Mar 4], International Journal of Antimicrobial Agents, 2020, 105932.
• Xu, H, Huang, S, Liu, S, et al., Evaluation of the clinical characteristics of suspected or confirmed cases of COVID-19 during home care with isolation: A new retrospective analysis, medRxiv 2020, 02, 26, 20028084; doi: https://doi.org/10.1101/2020.02.26.20028084.
• Wu,, Z, McGoogan, J.M, Characteristics of and Important Lessons From the Coronavirus Disease 2019 (COVID-19) Outbreak in China: Summary of a Report of 72 314 Cases From the Chinese Center for Disease Control and Prevention, JAMA, 2020, 323(13),1239–1242. doi:10.1001/jama.2020.2648.based on O2O, medRxiv preprint doi: https://doi.org/10.1101/2020.02.26.20028084.
• Arashiro, T, Furukawa, K, and Nakamura, A. COVID-19 in 2 Persons with Mild Upper Respiratory Symptoms on a Cruise Ship, Japan. Emergency Infectious Disease, 2020, 26(6).
• Wang, C, Horby, P.W, Hayden, F.G, Gao, G.F, A novel coronavirus outbreak of global health concern, The Lancet, 2020,395(10223), 470-473.
• Huang, C, Wang, Y, Li, X, et al., Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China, Lancet, 2020, published online, https://doi.org/10.1016/S0140-6736(20)30183-5.
• Chen, N, Zhou, M, Dong, X, et al., Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study, Lancet, 2020, 395(10223):507-513.
• Chen, Z, Hu, J, Zhang, Z, Jiang, S, Han, S, Yan, D, Zhuang, R, Hu, B, Zhang, Z, Efficacy of hydroxychloroquine in patients with COVID-19: results of a randomized clinical trial, medRxiv 2020.03.22.20040758, doi: https://doi.org/10.1101/2020.03.22.20040758.
• Geleris, J, Sun, Y, Platt, J, Zucker, J, Baldwin, M, Hripcsak, G, et al., Observational Study of Hydroxychloroquine in Hospitalized Patients with Covid-19, New England Journal of Medicine, 2020, 18, 382(25), 2411-8.
• Gautret, P, Lagier, J.C, Parola, P, et al., Hydroxychloroquine and azithromycin as a treatment of COVID-19: results of an open-label non-randomized clinical trial, International Journal of Antimicrobial Agents, 2020, 56(1), 105949.
• Gautret, P, Lagier, J.C, Parola, P, Hoang, V.T, Meddeb, L, Sevestre, J, et al., Clinical and microbiological effect of a combination of hydroxychloroquine and azithromycin in 80 COVID-19 patients with at least a six-day follow up: A pilot observational study, Travel Medicine Infectious Disease, 2020, 34, 101663.
• Cortegiani, A, Ingoglia, G, Ippolito, M, Giarratano, A, Einav, S, A systematic review on the efficacy and safety of chloroquine for the treatment of COVID-19, Journal of Critical Care, 2020, 57, 279-283.
• Rosenberg, E.S, Dufort, E.M, Udo, T, Wilberschied, L.A, Kumar, J, Tesoriero, J, et. al., Association of Treatment With Hydroxychloroquine or Azithromycin With In-Hospital Mortality in Patients With COVID-19 in New York State, JAMA, 2020, 323(24), 2493–2502.
• Arshad, S, Kilgore, P, Chaudhry, Z.S, Jacobsen, G, Wang, D.D, Huitsing, K, et. al., COVID-19 Task Force, Treatment with hydroxychloroquine, azithromycin, and combination in patients hospitalized with COVID-19, International Journal of Infectious Disease, 2020, 97, 396-403.