Antiviral Use in Mild-to-Moderate SARS-CoV-2 Infections during the Omicron Wave in Geriatric Patients

Article Article scientifique Article Antiviral Use in Mild-to-Moderate SARS-CoV-2 Infections during the Omicron Wave in Geriatric Patients eng 2024-05-28 2024-05-28 author Exquis Nadia 724701 author Dionisi Benjamin Bruno 933872 author Samer Caroline Flora 0000-0001-8178-0616 105661 Département d'anesthésiologie, pharmacologie et soins intensifs (APSIC) author Rollason Victoria 40955 Département d'anesthésiologie, pharmacologie et soins intensifs (APSIC) author Curtin François 22848 Département d'anesthésiologie, pharmacologie et soins intensifs (APSIC) author Zekry Berger Dina Selma 134897 dept de réadaptation et gériatrie (MIGRG) author Graf Christophe 0000-0002-0235-5046 105946 dept de réadaptation et gériatrie (MIGRG) author Prendki Virginie 0000-0003-1315-2938 811987 dept de réadaptation et gériatrie (MIGRG) author Ing Lorenzini Kuntheavy 0000-0001-8472-7714 510277 Département d'anesthésiologie, pharmacologie et soins intensifs (APSIC) 864 10.3390/v16060864 1999-4915 https://www.mdpi.com/1999-4915/16/6/864 <p>(1) Background: Geriatric patients are at high risk of complications of Coronavirus disease-2019 (COVID-19) and are good candidates for antiviral drugs. (2) Methods: A retrospective study of electronic health records (EHRs) aiming to describe antiviral (nirmatrelvir and ritonavir (nirmatrelvir/r) or remdesivir) use, drug–drug interactions (DDIs) and adverse drug reactions (ADRs) in elderly patients (75 and over), hospitalized with mild-to-moderate COVID-19 between July 2022 and June 2023. (3) Results: Out of 491 patients (mean age: 86.9 years), 180 (36.7%) received nirmatrelvir/r, 78 (15.9%) received remdesivir, and 233 (47.4%) received no antiviral therapy. No association was found between the choice of antiviral and the demographic or medical data. No serious ADR was observed. Nirmatrelvir/r dosage adjustment was inadequate in 65% of patients with renal impairment. In total, 128 patients (71%) on nirmatrelvir/r had potential pharmacokinetic DDIs, with 43 resulting in a possibly related ADR. In the remdesivir group, pharmacodynamic DDIs were more frequent, with QTc prolongation risk in 56 patients (72%). Only 20 patients underwent follow-up ECG, revealing QTc prolongation in 4. (4) Conclusions: There is an underutilization of antivirals despite their justified indications. Nirmatrelvir/r dosage was rarely adjusted to renal function. Dose adjustments and closer monitoring are needed due to the high risk of drug interactions.</p> COVID-19 Remdesivir Nirmatrelvir Ritonavir Geriatrics Dewey 616 Dewey 617 Dewey 618.97 63 Département d'anesthésiologie, pharmacologie, soins intensifs et urgences 229 65 Département de réadaptation et gériatrie 22B 56 Département de médecine 221 false 1280 Pharmaco-omiques et médecine de précision 1003 Viruses 16 6 4f8f7d81-05d6-45c9-b7ef-52f9bcbf9db0 Article (Published version) Public Article_scientifique_from_crossref.pdf 599873 application/pdf CC BY-4.0 285944685c55471c4297a4824e493b68713944375501fbb14a3877add4694d15 399c48c2-d96c-48a4-bae2-6a62ead0d221 Supplemental data Public viruses-3022120-Supplementary_mater.pdf 99353 application/pdf d37d91a2c7838372f183162ffb2f7c16e593f0a0514e204fe908485deec1cb1b openAccess Faculté de médecine / Section de médecine clinique / Département d'anesthésiologie, pharmacologie, soins intensifs et urgences Faculté de médecine / Section de médecine clinique / Département de réadaptation et gériatrie Faculté de médecine / Section de médecine clinique / Département de médecine

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