Observational studyBMC infectious diseases2025
Baseline medication profile and risk of CYP3A4 mediated drug-drug interactions among COVID-19 hospitalized patients in Spain.
Observational study in BMC infectious diseases, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundCOVID-19 remains a significant cause of hospitalizations and deaths. Some COVID-19 treatments interact with a key liver enzyme complex, CYP450. Detecting potential drug interactions with these antivirals is crucial as they are usually indicated for patients with chronic treatments.
objectivesDescribe the baseline co-medication profile in hospitalized COVID-19 patients in Spain and analyze potential CYP3A4 mediated drug-drug interactions (DDI) and contraindications.
methodsObservational, retrospective, multi-center study, based on hospital electronic medical records. Patients were adults hospitalized for respiratory COVID-19 between January 1, 2022, and March 31, 2022. Descriptive analyses were performed for all outcomes.
resultsThe mean age was 73.9 years old; 57% were male, 58% non-smokers, and 99.45% of patients had multiple comorbidities associated with an increased risk of COVID-19. 76% of patients were vaccinated against SARS-CoV-2, but only 30% with a full schedule including a booster dose. 90.32% of patients had co-medications upon admission, and 84.1% took three or more medications. 98.7% had medications with potential CYP3A4 mediated DDI, 40% had contraindicated drugs, and 37% had major DDI risk. 71.33% of all drugs administered had potential interactions. 25.33% of the patients had renal impairment, 88.81% moderate or severe, and 2.83% exhibited hepatic impairment.
conclusionsThe study reveals high prevalence of co-medications and potential DDI among high-risk COVID-19 patients, with a high prevalence of polypharmacy, particularly the elderly, and a substantial number of contraindicated drugs. It emphasizes the need for careful medication management, close monitoring, and vigilance in prescribing treatments to mitigate DDI risks.
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