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First experience of using favipiravir in the first healthcare worker patient with moderate case of Coronavirus Disease 2019 (COVID-19) at Sulianti Saroso Infectious Disease Hospital, Jakarta, Indonesia: a case report Pompini Agustina Sitompul; Nina Mariana; Adria Rusli
Health Science Journal of Indonesia Vol 12 No 1 (2021)
Publisher : Sekretariat Badan Penelitian dan Pengembangan Kesehatan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22435/hsji.v12i1.4879

Abstract

Background: During the early period of the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) pandemic, there was no approved and definitive drug available for the treatment of COVID-19. Favipiravir, chloroquine, hydroxychloroquine was used for re-purposing drugs while their efficacy and safety remained a major concern for healthcare workers. Clinical trial to assess efficacy and safety were ongoing. Case presentation: We present here the case of a 38-year-old woman, the first case of a healthcare worker diagnosed with COVID-19 who had moderate type, including first experience treatment with favipiravir in Sulianti Saroso Infectious Disease Hospital, Jakarta, Indonesia. We present the clinical characteristics, chest X-ray, clinical laboratory profiles, the treatment process with favipiravir and hydroxychloroquine as well as the clinical outcome of moderate type COVID-19 patient. Conclusion: This case highlights that considering the use of emergency intervention outside of clinical trial in the COVID-19 population, the informed patient consent has been given and the use of emergency intervention was monitored. Keywords: COVID-19, favipiravir, medical worker, case report, Jakarta Abstrak Latar belakang: Periode awal pandemi Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), belum terdapat obat yang disetujui dan pasti tersedia untuk pengobatan COVID-19. Favipiravir, chloroquine, hydroxychloroquine digunakan sebagai obat dengan indikasi baru yang sementara efektifitas dan keamanannya menjadi perhatian para petugas medis. Penyajian kasus: Disini kami melaporkan kasus wanita umur 38 tahun, merupakan kasus pertama seorang tenaga kesehatan Rumah Sakit terdiagnosis Coronavirus Disease 2019 (COVID-19) dengan penggunaan terapi favipiravir untuk pertama kalinya di Rumah Sakit Pusat Infeksi Sulianti Saroso, Jakarta, Indonesia. Berikut ini kami gambarkan karakteristik klinis, hasil foto thorak, profil laboratorium dan proses terapi menggunakan favipiravir and hidroxychloroquine serta hasil akhir pada kasus COVID-19 derajat sedang. Kesimpulan: Kasus ini menggaribawahi bahwa pertimbangan penggunaan kegawatdaruratan obat antivirus diluar uji klinis pada populasi pasien COVID-19, pasien telah memberikan persetujuan dan penggunaan obat-obat tersebut dimonitor. Kata kunci: Covid-19, favipiravir, tenaga kesehatan, laporan kasus, Jakarta
Safety monitoring of chloroquine and hydroxychloroquine in COVID-19 patients in Indonesia on QT prolongation: hospital based monitoring study Jarir At Thobari; Togi Junice Hutadjulu; Tri Asti Isnariani; Umi Sa'adatun Nikmah; Lukman Ade Chandra; Pompini Agustina Sitompul; Anggoro Budi Hartopo; Rizki Amalia Gumilang; Luhur Pribadi; Deva Bachtiar; Anwar Santoso
Indonesian Journal of Pharmacology and Therapy Vol 4 No 1 (2023)
Publisher : Faculty of Medicine, Public Health, and Nursing Universitas Gadjah Mada and Indonesian Pharmacologist Association or Ikatan Farmakologi Indonesia (IKAFARI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/ijpther.7148

Abstract

Chloroquine (CQ) and Hydroxychloroquine (HCQ) are the challenging drugs used for COVID-19. Several studies show its beneficial, however, both medications can prolong the QTc interval and increase the risk of patients for torsades de pointes and death. The Tisdale score is identified to have successfully predicted the at-risk population of side effects of these drugs. This study aim to evaluate the QT prolongation caused by the administration of chloroquine and hydroxychloroquine in COVID-19 patients and the association with the treatment outcomes based on their Tisdale score. We conducted an observational study on 213 hospitalized patients with confirmed or suspect COVID-19 in 6 referral hospitals in Indonesia. All baseline demographic such as age and gender, RT-PCR test result, severity of disease, history of cardiovascular disease (myocardial infarction, heart failure, hypertension), serum kalium level at baseline, and the use of medication associated with risk QTc interval prolongation were collected. The Tisdale risk score was used for predicting high-risk patients for QT corrected (QTc) interval prolongation. Out of 213 patients who were treated with CQ/HCQ, there were 60 (28.2%) patients had QTc interval prolongation, included 43 patients (20.2%) who had normal QTc interval at baseline and at the end of treatment had prolong interval; or 17 patients (8.0%) who had QTc interval more than 470 msec at baseline and QTc interval prolongation was worsen at the end of treatment. Several factors, including age more than 50 years, COVID-19 confirm PCR, and had comorbidity heart failure, were statistically significant associated with QTc interval prolongation. The high-risk score of Tisdale score have increased risk significantly on QTc interval prolongation (RR: 2.15, 95%CI 1.07-4.32) and associated with risk of death (RR: 3.50, 95%CI 1.34-9.13) compared to low-risk score. Our findings showed that the treatment of CQ/HCQ in COVID-19 patients is associated with QTc prolongation. The Tisdale score can be used as a valuable tool to predict the COVID-19 patients’ outcome after treatment of these QTc-prolonging drugs.