The effects of COVID-19 on pharmacotherapy in patients with chronic diseases
DOI:
https://doi.org/10.33448/rsd-v10i16.23479Keywords:
COVID-19; Hypertension; Diabetes; Pharmacotherapy.Abstract
The COVID-19 pandemic, caused by a new strain of coronavirus, has created great challenges throughout the world. This disease has the power to develop complications, higher morbidity and mortality when compared to other diseases, and a higher prevalence of hospitalizations in patients with Systemic Arterial Hypertension (SAH) and Diabetes Mellitus (DM). This study aimed to evaluate the effects of COVID-19 on pharmacotherapy in patients with chronic diseases. This is a descriptive, exploratory research with a qualitative and quantitative approach, carried out at FAINOR's Health Clinic. The sample for this study consisted of 20 patients, with the inclusion criteria being patients with chronic diseases, exclusively SAH or DM who had COVID-19 disease. As exclusion criteria, patients who did not have the disease. The data were collected through a questionnaire applied in an electronic format. Of the patients diagnosed, about 50% had isolated DM, 20% had isolated hypertension, 30% had associated DM and hypertension, and 30% were obese/overweight. About 70% of these people developed sequelae from the coronavirus, such as dehydration, body aches, dry cough, forgetfulness, and Acute Renal Failure. Approximately 40% of these patients had serious drug interactions in their treatments for SAH and DM, as well as concomitant SARS-CoV-2 treatment. It was concluded from the data collected in the survey that for SAH and DM the questionnaire elicited responses that indicated that the pandemic COVID-19 did not generate noticeable changes in the pharmacotherapy of the participants. However, the virus reflected negatively on the general health condition of the patients, causing sequelae in many of them.
References
Abajo, F. J., Rodriguez-Martin, S. Lerma, V., Mejía-Abril, G., Aguilar, M., García-Luque, A., Laredo, L., Laosa, O., Centeno-Soto, G. A., Ángeles, Gálvez. M., Puerro, M., González-Rojano, E., Pedraza, L., de Pablo, I., Abad-Santos, F., Rodríguez-Mañas, L., Gil. M.; Tobías, A., Rodríguez-Miguel, A., & Rodríguez-Puyol, (2020). D. MED-ACE2-COVID19 study group. Use of renin-angiotensin-aldosterone system inhibitors and risk of COVID-19 requiring admission to hospital: a case-population study. Lancet, 30(395) (10238), 1705-1714.
Arnett, D. K., Blumenthal, R. S., Albert, M. A., Buroker, A. B., Goldberger, Z. D., & Hahn, E. J. (2019). ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease. JACC, 74(10): e 177-232.
Aronson, J. K., & Ferner, R. E. (2020). Inibidores da enzima de conversão da angiotensina (ECA) e bloqueadores do receptor da angiotensina no COVID-19 - CEBM.
Bardin, L. (2011). Análise de conteúdo. Edições 70.
Barroso, W. K. S., Rodrigues, C. I. S., Bortolotto, L. A., Mota-Gomes, M. A., Brandão, A. A., & Feitosa, ADM. (2020). Diretrizes Brasileiras de Hipertensão Arterial. Arq Bras Cardiol, PP.0-0.
Bhutani, S., & Cooper, J. A. (2020). COVID-19 related home confinement in adults: weight gain risks and opportunities. Obesity (Silver Spring). https://doi.org/10.1002/oby.22904. https://doi.org/10.1002/oby.22904.
Bouadma, L., Lescure, F. X., Lucet, J. C., Yazdanpanah, Y., & Timsit, J, F. (2020). Severe SARS-CoV-2 infections: practical considerations and management strategy for intensivists. Intensive Care Med.
Brasil. (2021). Ministério da Saúde. Doença pelo coronavírus. Boletim Epidemiológico Especial. Brasília.
Brasil. (2013). Ministério da Saúde. Estratégias para o cuidado da pessoa com doença crônica: hipertensão arterial sistêmica. Brasília: Ministério da Saúde, Cadernos de Atenção Básica, 37.
Brasil. (2021). Ministério da Saúde. Secretaria da Saúde. Estilo de vida saudável. Número de hipertensos cresce no mundo. Brasília: Ministério da Saúde; 2019b. http://www.saude.br/index.php/articles/123-artigos-antigos/444-numero-de hipertensos-cresce-no-mundo.
Brasil. (2017). Ministério da Saúde. Vigilância de fatores de risco e proteção para doenças crônicas por inquérito telefônico. Brasília: Ministério da Saúde, Agência Nacional de Saúde Suplementar.
Brasil. (2020). Protocolo de manejo clínico do coronavírus (COVID19) na atenção primária à saúde. Secr Atenção Primária à Saúde.
CDC. (2020). Interim Clinical Guidance for Management of Patients with Confirmed Coronavirus Disease (COVID-19).
Chaolin, H., Yeming, W. & Xingwang, L. (2020). Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. The Lancet, 395: 497-506.
Costa, C. L. A., Costa, T. M. & Barbosa Filho, V. C. (2020). Influência do distanciamento social no nível de atividade física durante a pandemia do COVID-19. Revista Brasileira de Atividade Física e Saúde, 25, e0123.
Dasgupta, A. (2016). Therapeutic Drug Monitoring of Mycophenolic Acid, 76. 10.1016/bs.acc.2016.04.001.
Daskalopoulou, S. S., Rabi, D. M., Zarnke, K. B., Dasgupta, K., Nerenberg, K., & Cloutier, L. (2015). The 2015 Canadian Hypertension Education Program recommendations for blood pressure measurement, diagnosis, and assessment of risk, prevention, and treatment of hypertension. Can J Cardiol, 31(5): 549-68.
Davies, M. J., D’Alessio, D. A., Fradkin, J., Kernan, W. N., Mathieu, C., & Mingrone, G. (2020). Management of Hyperglycemia in Type 2 Diabetes. A Consensus Report by the American Diabetes Association (ADA) and the European Association the Study of Diabetes (EASD). Diabetes Care, 41(12). https://care.diabetesjournals.org/content/early/2018/09/27/dci18-0033.full-text.pdf.
Deng, L., Li, C., Zeng, Q., Liu, X., Li, X., & Zhang, H. (2020). Arbidol combined with LPV/r versus LPV/r alone against Corona Virus Disease 2019: A retrospective cohort study. J Infect.
Faludi, A. Izar, M., Saraiva, J., Chacra, A., Bianco, H., & Afiune Neto, (2017). A. Atualização da diretriz brasileira de dislipidemias e prevenção da aterosclerose - 2017. Arquivos Brasileiros de Cardiologia [Internet], 109(1). http://www.gnresearch.org/doi/10.5935/abc.20170121
Fang, L., Karakiulakis, G., & Roth, M. (2020). Are patients with hypertension and diabetes mellitus at increased risk for COVID-19 infection? The Lancet. Respiratory medicine. England, 116.
Ferreira, C., & Santos, G. A. C. (2020). Métodos Laboratoriais para Diagnóstico da Infecção pelo SARS-CoV-2 [Internet], 105. Sociedade Brasileira de Patologia Clínica.
Flacco, M. E., Acuti Martellucci, C., & Bravi, F. (2020). Tratamento com inibidores da ECA ou ARBs e risco de COVID-19 grave / letal: uma meta-análise. Heart, pmid: 32611676.
Fox, C. S., Golden, S. H., & Anderson, C. (2017). AHA/ADA Scientific Statement: Update on prevention of cardiovascular disease in adults with type 2 diabetes mellitus in light of recent evidence. Circulation 132: 691–718.
Gabarre, P. (2020). Acute kidney injury in critically ill patients with COVID-19. Intensive Care Med, 46, 7, 1339-1348. DOI: 10.1007/s00134-020-06153-9. https://pubmed.ncbi.nlm.nih.gov/32533197/.
Gao, C., Cai, Y., Zhang, K., Zhou, L., Zhang, Y., & Zhang, X. (2020). Association of hypertension and antihypertensive treatment with COVID-19 mortality: a retrospective observational study. Eur. heart. j. [Internet], 06];41:2058-66. https://academic.oup.com/eurheartj/article/41/22/2058/5851436.
García-Álvarez, L., Fuente-Tomás, L., Sáiz, P. A., García-Portilla, M. P., & Bobes, J. (2020). Will changes in alcohol and tobacco use be seen during the COVID-19lockdown? 32(2):85-9. https://doi.org/10.20882/adicciones.1546» https://doi.org/10.20882/adicciones.1546.
Gautret et al. (2020). Hydroxychloroquine and azithromycin as a treatment of COVID-19: results of an open-label non-randomized clinical trial. Int J Antimicrob Agents.
Gérard, A., Romani, S., Fresse, A., Viard, D., Parassol, N., & Granvuillemin, A. (2020). "Off-label" use of hydroxychloroquine, azithromycin, lopinavir-ritonavir and chloroquine in COVID-19: a survey of cardiac adverse drug reactions by the French Network of Pharmacovigilance Centers. Therapie; 75:371-9.
Gil, A. C. (2008). Métodos e Técnicas de Pesquisa Social. Atlas.
Grasselli, G., Greco, M., Zanella, A., Albano, G., Antonelli, A., & Bellani, G. (2020). Risk factors associated with mortality among patients with COVID-19 in intensive care units in Lombardy, Italy. JAMA Intern Med, 180(10):e203539.
Greenwood, B. (2014). A contribuição da vacinação para a saúde global: passado, presente e futuro. Philos Trans R Soc Lond B Biol Sei, 369: 20130433.
Guan, W., Ni, Z., & Hu, Y. (2020). Clinical Characteristics of coronavirus disease 2019 in China. N Engl J Med. doi: 10.1056 / NEJMoa2002032.
Guo, T., Fan, Y., Chen, M., Wu, X., Zhang, L., & He, T. (2020). Cardiovascular implications of fatal outcomes of patients with coronavirus disease 2019 (COVID-19). JAMA Cardiol.
Hollstein, T., Schulte, D., Schulz, J., Glück, A., Ziegler, A., & Bonifacio, E. (2020). Autoantibody-negative insulin-dependent diabetes mellitus after SARS-CoV-2 infection: a case report. Nature Metabolism, 2(10), 1021-1024. doi: 10.1038/s42255-020-00281-8.
Huang, C. (2020). Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet.
Hussain, A., Bhowmik, B., & do Vale Moreira, N.C. (2020). COVID-19 and diabetes: Knowledge in progress. Diabetes Res Clin Pract, 162:108142. doi:10.1016/j.diabres.2020.108142.
Instituto de Comunicação e Informação Científica e Tecnológica em Saúde, Fundação Oswaldo Cruz. (2020). MonitoraCovid-19. https://bigdata-covid19.icict.fiocruz.br/.
International Diabetes Federation. (2015). IDF Diabetes Atlas [Internet]. 7th ed. Brussels, Belgium: International Diabetes Federation.
Jin, Y. H., Cai, L., Cheng, Z. S., Cheng, H., Deng, T., & Fan, Y, P. (2020). A rapid advice guideline for the diagnosis and treatment of 2019 novel coronavirus (2019-nCoV) infected pneumonia (standard version). Mil Med Res, 7(1):4.
Kenneth McIntosh, M. D. (2020). Novel Coronavirus (2019-nCov). UpToDate.
Lana, R. M., Coelho, F. C., Gomes, M. F. C., Cruz, O. G., Bastos, L. S., & Villela, D. A. M. (2020). Emergência do novo coronavírus (SARS-CoV-2) e o papel de uma vigilância nacional em saúde oportuna e efetiva. Cad Saúde Pública, 2020;36(3):1-5.
Lefèvre, F., & Lefèvre, A. M. C. (2005). O discurso do sujeito coletivo: um novo enfoque em pesquisa qualitativa (desdobramentos). EDUSC.
Lefèvre, F., Lefèvre, A. M. C., & Marques, M. C. C. (2009). Discurso do sujeito coletivo, complexidade e auto-organização. Ciência e saúde coletiva, Rio de Janeiro, 14, 4, 1193-1204.
Lima, C. M. O. Radiologia Brasileira. Informações sobre o novo coronavirus (COVID-19), 53.
Lopes, R. D., Macedo, A. V. S., de Barros, E., Silva, P. G. M., Moll-Bernardes, R. J., Feldman, A., & D’Andréa Saba Arruda, G. (2020). Continuing versus suspending angiotensin-converting enzyme inhibitors and angiotensin receptorblockers: Impact on adverse outcomes in hospitalized patients withsevere acute respiratory syndrome coronavirus 2 (SARS-CoV-2)--TheBRACE CORONA Trial. Am Heart J, 226:49-59. doi: 10.1016/j.ahj.2020.05.002.
Lopez, M., Bell, K., Annaswamy. T., Juengst, S., & Ifejika, N. (2020). COVID-19 Guia para o clínico de reabilitação: Uma revisão das manifestações e complicações não pulmonares. Am J Phys Med Rehabil, 99: 669–673.
Maddaloni, E., & Buzzetti R. (2020). Covid-19 and diabetes mellitus: unveiling the interaction of two pandemics. Diabetes Metab Res Rev, e33213321. doi:10.1002/dmrr.3321.
Malhotra, N. (2001). Pesquisa de marketing. (3a ed.), Bookman.
Malik, M., Tahir, M, J., Jabbar, R., Ahmed, A., & Hussain R. (2020). Self-medication during Covid-19 pandemic: challenges and opportunities. Drugs Ther Perspect, 36:565-7.
Milken Institute. (2020). COVID-19 tratamento e rastreador de vacinas, Milken Institute (2020) COVID-19 tratamento e rastreador de vacinas. https://covid-19tracker.milkeninstitute.org/.
New-Onset Diabetes in Covid-19 NEJM. (2021). New England Journal Of Medicine. https://www.nejm.org/doi/full/10.1056/NEJMc2018688.
Onder, G., Rezza, G., & Brusaferro, S. (2020). Taxa de letalidade e características de pacientes que morrem em relação ao COVID-19 na Itália. JAMA 323 (18): 1775–1776.
OPAS - Organização Pan-Americana da Saúde. (2020). Folha informativa COVID-19 - Escritório da OPAS e da OMS no Brasil. 2021.
Organização Mundial da Saúde (OMS). (2020). Teste de diagnóstico para SARS-CoV-2. WHO/2019-nCoV/laboratory/2020.6. Genebra: OMS.
Póvoa, R., Barroso, W. S., Brandão, A. A., Jardim, P. C., Barroso, O. & Passarelli, O. Jr. et al. (2014). I Brazilian position paper on antihypertensive drug combination. Arq Bras Cardiol, 102(3):203-10.
Précoma, D. B., Oliveira, G. M. M., Simão, A. F., Dutra, O. P., Coelho, O. R., & Izar, M. C. O. (2019). Atualização da Diretriz de Prevenção Cardiovascular da Sociedade Brasileira de Cardiologia – 2019. Arq Bras Cardiol, 113(4):787-891.
Ramanathan, K., Antognini, D., Combes, A., Paden, M., Zakhary, B., & Ogino, M. (2020). Planning and provision of ECMO services for severe ARDS during the COVID-19 pandemic and other outbreaks of emerging infectious diseases. Lancet Respir Med.
Romero, D.E., & Silva, D. R. P. (2021). Scielo. Idosos no Contexto da Pandemia da Covid-19 no Brasil: Efeitos nas Condições de Saúde, Renda e Trabalho. Cad. Saúde Pública 37. https://scielosp.org/article/csp/2021.v37n3/e00216620/.
Roncon, L., Zuin, M., Rigatelli, G., & Zuliani, G. (2020). Pacientes diabéticos com infecção por COVID-19 apresentam maior risco de admissão na UTI e desfecho desfavorável em curto prazo.
Rosenberg et al. (2020). Association of treatment with hydroxychloroquine or azithromycin with in-hospital mortality in patients with COVID-19 in New York State. JAMA.
Rubino, F., Amiel, S. A., Zimmet, P., Alberti, G., Bornstein, S., & Eckel, R. H. (2020). New-Onset Diabetes in Covid-19. N Engl J Med, 383(8):789-790. doi:10.1056/nejmc2018688.
SBI - Sociedade Brasileira de Imunologia. (2020). Parecer Científico da Sociedade Brasileira de Imunologia sobre a utilização da Cloroquina/Hidroxicloroquina para o tratamento da COVID-19.
Skyler, J. S., Bakris, G. L., Bonifacio, E., Darsow, T., Eckel, R. H., & Groop, L. (2017). Differentiation of diabetes by pathophysiology, natural history, and prognosis. Diabetes, 66(2):241-55.
Sociedade brasileira de infectologia atualizações e recomendações sobre a COVID-19. (2020). https://infectologia.org.br/wp-content/uploads/2020/12/atualizacoes-e-recomendacoes-covid-19.pdf.
Sociedade Brasileira de Patologia Clínica e Medicina Laboratorial - SBPC/ML. (2020). Métodos laboratoriais para diagnóstico da infecção pelo SARS-CoV-2. Recomendações da Sociedade Brasileira de Patologia Clínica/Medicina Laboratorial.
Solon Júnior, L. J. F., Fortes, L. S., & Barbosa, B. T. et al. (2020). Home-based exercise during confinement in COVID-19 pandemic and mental health in adults: a cross-sectional comparative study. Revista Brasileira de Atividade Física e Saúde, 25, e0120.
Task Force of the Latin American Society of Hypertension. (2017). Guidelines on the management of arterial hypertension and related comorbidities in Latin America. Journal of Hypertension, 35(8):1529–45.
Vaduganathan, M., Vardeny, O., Michel, T., McMurray, J. J., Pfeffer, M. A., & Solomon, S. D. (2020). Renin-angiotensin-aldosterone system inhibitors in patients with Covid-19. N Engl J Med, 382:1653-59. doi: 10.1056/NEJMsr2005760.
Van Zyl-Smit, R. N., Richards, G., & Leone, F. T. (2020). Tobacco smoking and COVID-19 infection. Lancet Respir Med,. 8(7): 664-5. https://doi.org/10.1016/S2213-2600(20)30239-3.
Wald, D. S., Law, M., Morris, J. K., Bestwick, J. P., & Wald, N. J. (2014). Combination therapy versus monotherapy in reducing blood pressure: metaanalysis on 11,000 participants from 42 trials. J Med, 122(3):290–300.
Wang, D., Hu, B., Hu, C., Zhu, F., Liu, X., & Zhang J. (2020). Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China. JAMA.
Wang, W., Xu, Y., Gao, R., Lu, R., Han, K., & Wu, G. (2020). Detection of SARS-CoV-2 in Different Types of Clinical Specimens. JAMA, 323(18):1843-1844.
WHO. (2020). Clinical management of severe acute respiratory infection (SARI) when COVID-19 disease is suspected.
WHO. (2020). Coronavirus disease 2019 (COVID-19) Situation Report– 51. Geneva. https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200311-sitrep-51-covid-19.pdf?sfvrsn=1ba62e57_10.
WHO. (2021). Draft landscape of COVID-19 candidate vaccines. World Health Organization. https://www. who.int/docs/default-source/coronaviruse/novel-coronavirus-landscape-covid-.
Williams, B., Mancia, G., Spiering, W., Agabiti, R. E., Azizi, M., & Burnier, M. (2018). ESC/ESH Guidelines for the management of arterial hypertension: The Task Force for the management of arterial hypertension of the European Society of Cardiology and the European Society of Hypertension: The Task Force for the management of arterial hypertension of the European Society of Cardiology and the European Society of Hypertension. J Hypertens. 36(10):1953-2041.
World Health Organization (WHO). (2020). Laboratory testing for coronavirus disease 2019 (COVID-19) in suspected human cases. Interim guidance. Reference: WHO/COVID-19/laboratory/2020.5.
World Health Organization. (2020). Clinical management of severe acute respiratory infection when novel coronavirus (nCoV) infection is suspected.
World Health Organization. (2016). Global report on diabetes. Geneva.
World Health Organization. (2020). Statement on the second meeting of the international health regulations (2005) emergency committee regarding the outbreak of novel coronavirus (2019-nCoV). Geneva: World Health Organization. https://www.who.int/news-room/ detail/30-01-2020-statement-on-the-second-meetingof-the-international-health-regulations-(2005) emergency-committee-regarding-the-outbreak-ofnovel-coronavirus-(2019-ncov).
Xiao, S. Y., Wu, Y., & Liu, H. (2020). Evolving status of the 2019 novel coronavirus infection: Proposal of conventional serologic assays for disease diagnosis and infection monitoring. J Med Virol, 92(5):464–7.
Zheng, Z., Peng, F., Xu, B., Zhao, J., Liu, H., & Peng, J. (2020). Fatores de risco de casos críticos e mortais de COVID-19: uma revisão sistemática da literatura e meta-análise. J Infect.
Zhou, F., Yu, T., Du, R., Fan, G., Liu, Y., & Liu, Z. et al. (2020). Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet, 395(10229):1054-62.
Zhu, J., Ji, P., Pang, J., Zhong, Z., Li, H., & He, C. (2020). Características clínicas de 3.062 pacientes com COVID-19: uma meta-análise. J Med Virol.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2021 Danielle Portugal Vieira; Nicolly Luz Pita; Tayanne Andrade dos Santos; Daianne Arruda Luz
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with this journal agree to the following terms:
1) Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
2) Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
3) Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.
