Hydroxychloroquine Efficacy and Safety Concerns in the Tre, Lecture notes of Accounting

Download Hydroxychloroquine Efficacy and Safety Concerns in the Tre and more Lecture notes Accounting in PDF only on Docsity! HYDROXYCHLOROQUINE SAFETY, EFFECTIVENESS AND CONCERNS Hydroxychloroquine Efficacy and Safety Concerns in the Treatment of COVID-19 Grand Canyon University: BIO-317V 1 HYDROXYCHLOROQUINE VS COVID-19: FRIEND OR FOE Abstract Since the World Health Organization (WHO) declared the SARS-C0-V2, otherwise known as COVID-19, a pandemic, a fervent search for a therapeutic treatment was initiated. Countries outside the United States where incidences of the virus were prevalent initiated limited studies on the use of Hydroxychloroquine (HCG) to shorten the duration of the virus and to decrease mortality. Based on the results of those studies,HCQ was approved by the FDA to be utilized as an emergent treatment for COVID. Being a novel virus, the course of action the virus takes on the body is unknown but seemed to be like other SARS. Previous and ongoing studies involving the effects of the virus on patients in relation to age, gender, comorbidities and other factors are being reviewed to see if HCQ can be used safely in all patients despite it's proven adverse cardiovascular complication including prolonged QT intervals which is one of many serious adverse cardiovascular effects identified with use of this therapeutic in the fight against COVID- 19. This review details the outcomes of multiple studies put forward to determine if the known risks of HCQ outweigh any benefits in becoming an approved therapeutic against that can be prescribed to all patients who are diagnosed with the COVID-19 virus . 2 HYDROXYCHLOROQUINE VS COVID-19: FRIEND OR FOE significant correlation to prolong QT intervals and other potential seriouslife-threatening cardiovascular events. Variables The studies selected included groups of patients with and without significant comorbidities. Also, treatment regiments that included HCQ when being given alone or in conjunction with other therapeutic agents. Results HCQ has been used effectively worldwide to treat malaria and other autoimmune illnesses without severe adverse reactions. Its potential to act as an antagonist against coronaviruses deemed it a recommended treatment for SARS-CoV-2. Dosages were scrutinized as some prescribers were not following recommended guidelines. Cardiac arrest has been listed as a serious complication that can occur in some studies resulting in recommendations for routine ECG monitoring and restricting use in patients with a known cardiac issue. HCQ has a long half- life putting patients with known renal impairments at higher risk for serious complications as well.2 Prolonged QT intervals are closely examined as this is a proven side effect of HCQ. Normal QT intervals differ from male to female and patients. Otherfactors that can contribute to this adverse effect such as age, sex, use of diuretics, potassium levels, sepsis, and other heart related issues are considered a risk for developing prolonged QT intervals.5 Prior to any treatment with therapeutics, patients with severe COVID-19 have experienced cardiovascular complications as a result of the hyper inflammatory state the virus jolts the body into. In the absence of HCQ in these patients, QT intervals can be associated with the progression of the virus instead of an effect of the drug.6 However, other studies reveal that other patients fitting the same criteria who were given high dosages of HCQ in an unmonitored environment experienced 5 HYDROXYCHLOROQUINE VS COVID-19: FRIEND OR FOE GI issues and a general malaise which was attributed to a prolonged QT interval which was resolved by administering supplemental electrolyte infusions and the discontinuation of HCQ.1 Larger case studies of hospitalized patients with COVID-19 revealed that with close monitoring of baseline ECG's and following recommended dosage guidelines of HCQ, the therapeutic can be administered alone or in conjunction with other drugs even in the presence of a prolonged QT interval without the need to discontinue treatment due to severe cardiac events.7 Discussion This review of the data that has been collected regarding the safe and effective use of HCQ as a therapeutic agent to fight the COVID-19 virus contains many variables that warrant consideration. Initially the use of HCQ in China led to a decrease in the length of the illness. HCQ is a widely used medication that has been successful in treating other conditions with minimal serious effects. Its ability to interfere with the virus’s replication cycle tagged it as an emergency treatment against COVID-19 in the beginning of the pandemic.2 As clinical trials of the drug were initiated; other factors began to become relevant. A large portion of patients who were experiencing adverse cardiovascular effects were found to have underlying issues that contributed to that, such as renal impairment, electrolyte imbalances and other heart related problems. It was also noted that COVID-19 alone could cause a strain on multiple organ systems which increased the risk for severe cardiovascular issues when treated with HCQ.8 Once a link was established between HCQ and the specific cardiac effect of prolonged QT intervals, all of the forementioned factors were then examined further and it was determined the drug should only be given to patients who are hospitalized or had access to some kind of an ongoing monitoring system.1 As other drug therapies were given in combination with HCQ, questions arose on whether or not these drugs increase the cardiovascular adverse reactions. Drugs such as 6 HYDROXYCHLOROQUINE VS COVID-19: FRIEND OR FOE Remdisivir and Azithromycin were commonly used together to treat COVID-19. While studies regarding Remdisivir andHCQ revealed no increase in the adverse reaction of prolonged QT interval's, they did reveal an increase in the prevalence of this potential severe adverse effect with Azithromycin andHCQ.1,6,7,9 While there are many documented cases of patients who were treated with HCQ for COVID-19 experiencing serious cardiac side effects, with close monitoring these effects were able to be corrected without serious harm to the patient.6 The use of HCQ has decreased among patients who are diagnosed with COVID-19 because of the multiple studies revealing these potentially serious cardiac effects but still remains a controversial topic because if it's early documented success in China. Conclusion As health care providers continue to try to navigate their way through the pandemic caused by the COVID-19 virus, they must consider any and all factors that could contribute to an adverse effect of a medication that is being used. HCQ may be able to be administered to a certain population as a safe and effective therapeutic agent, but not to all. At this time, HCQ should continue to be utilized as a clinical trial until further studies can be conducted.10Consideration to the effects of the COVID-19 viruses effect on the body without the use of any therapeutic agent must be further understood in order to separate effects from an agent from that of the virus itself. As of this writing, there has not been a definite therapeutic identified to treat COVID-19 but scientists continue to make progress through continuous research and trials. Whether or not HCQ will be reconsidered as a safe and effective treatment in lieu of its cardiovascular effects are yet to be determined and will require further research. 7