Evaluation of the Potential Drug-Drug Interactions among Hospitalized Patients with COVID-19: A Cross-Sectional Study

Abstract

Objective: COVID-19 related drugs and concomitantly used drugs of the patients for their co-morbid diseases may enhance the risk for having potential drug-drug interactions (pDDIs) during hospitalization. The aim of the present study was to identify the frequency and severity of pDDIs between the COVID-19 treatment options and concomitantly used drugs at COVID-19 inpatient clinics of a public hospital.

Methods:  A total of 321 files of the patients with COVID-19 who were hospitalized at inpatient clinics of a public hospital were assessed retrospectively. The frequency, risk category and severity of the pDDIs were assessed according to the Lexi-comp® online drug interaction database.

Results: A vast majority of the patients (99.1%) had at least one pDDI with a maximum of 25 pDDIs. The most commonly detected pDDIs were between Favipiravir and Paracetamol (B risk category), (24.4%), followed by the pDDIs between Enoxaparin-Acetylsalicylic acid (D risk category), (10.1%) drug pairs. Hyper-polypharmacy (≥10 drugs) was significantly and positively associated with male gender (p=0.023), adult age group (p=0.002) and co-morbid diabetes mellitus (p<0.001) and essential hypertension (p<0.001). The presence of moderate to major pDDIs was significantly and positively associated with male gender (p=0.012) and adult age group (p=0.019).

Conclusion: The present study revealed that the frequency of pDDIs among hospitalized patients with COVID-19 are quite high. Although the severity of pDDIs at COVID-19 inpatient clinics in general, are moderate and preventable, physicians should pay a particular attention regarding the pDDIs which may have life-threatening consequences such as the risk of bleeding.