Traveling for heart transplantation and returning with COVID-19: a logistical, clinical, and pharmacotherapeutic challenge from the Middle East.

Autor: Atallah B; Department of Pharmacy Services, Cleveland Clinic Abu Dhabi, Al Maryah Island, PO Box 112412, Abu Dhabi, UAE.; Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH USA., Hamour I; Cleveland Clinic Abu Dhabi, Heart and Vascular Institute, Al Maryah Island, PO Box 112412, Abu Dhabi, UAE., Mallah SI; School of Medicine, Royal College of Surgeons in Ireland, Bahrain, Kingdom of Bahrain., Bonilla MF; Department of Infectious Disease, Cleveland Clinic Abu Dhabi, Al Maryah Island, PO Box 112412, Abu Dhabi, UAE., Bader F; Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH USA.; Cleveland Clinic Abu Dhabi, Heart and Vascular Institute, Al Maryah Island, PO Box 112412, Abu Dhabi, UAE.
Jazyk: angličtina
Zdroj: Drugs & therapy perspectives : for rational drug selection and use [Drugs Ther Perspect] 2021; Vol. 37 (1), pp. 29-34. Date of Electronic Publication: 2020 Oct 31.
DOI: 10.1007/s40267-020-00792-0
Abstrakt: Heart transplantation (HT) has become a standard option for patients with end-stage heart failure (HF). However, the scarcity of donor availability remains a major hurdle for receiving this novel therapy, especially in the context of the rapidly spreading severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2; COVID-19) pandemic. We report the case of a patient in the United Arab Emirates (UAE) with advanced HF who was glucose-6-phosphate dehydrogenase deficient and had a history of type 2 diabetes mellitus with diabetic retinopathy and nephropathy, chronic kidney disease stage II, and hyperlipidemia. He was referred for HT abroad and was subsequently caught in the midst of the COVID-19 pandemic in New York, the US state most affected by the crisis at the time. Despite limited experience with favipiravir, we judged it to be the most appropriate agent with this patient's complex history given the lower risk for QT prolongation, no need for renal-dose adjustment, and no reported drug-drug interactions. Given the limited clinical experience with this agent, particularly for our patient, we decided to adopt strategies to mitigate and monitor the potential for QT prolongation. We outline the logistical, clinical, and pharmacological challenges that the poly-morbid patient and our HT program in the Middle-East faced under those novel circumstances.
Competing Interests: Conflicts of interestBassam Atallah, Iman Hamour, Saad I. Mallah, Maria-Fernanda Bonilla, and Feras Bader have no conflicts of interest that are directly relevant to the content of this article.
(© Springer Nature Switzerland AG 2020.)
Databáze: MEDLINE
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