Available medications used as potential therapeutics for COVID-19: What are the known safety profiles in pregnancy.
<h4>Background</h4>Medications already available to treat other conditions are presently being studied in clinical trials as potential treatments for COVID-19. Given that pregnant women are excluded from these trials, we aimed to investigate their safety when used during pregnancy within...
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doaj-d3bd899eda48473490cb440f4f432ac72021-06-25T04:31:27ZengPublic Library of Science (PLoS)PLoS ONE1932-62032021-01-01165e025174610.1371/journal.pone.0251746Available medications used as potential therapeutics for COVID-19: What are the known safety profiles in pregnancy.Anick BérardOdile SheehyJin-Ping ZhaoEvelyne VinetCaroline QuachBehrouz KassaiSasha Bernatsky<h4>Background</h4>Medications already available to treat other conditions are presently being studied in clinical trials as potential treatments for COVID-19. Given that pregnant women are excluded from these trials, we aimed to investigate their safety when used during pregnancy within a unique population source.<h4>Methods</h4>Using the population-based Quebec Pregnancy Cohort, we identified women who delivered a singleton liveborn (1998-2015). Taking potential confounders into account including indications for use, the risk of prematurity, low birth weight (LBW), small for gestational age (SGA), and major congenital malformation (MCM) associated with COVID-19 repurposed drug use during pregnancy were quantified using generalized estimation equations.<h4>Results</h4>Of the 231,075 eligible pregnancies, 107 were exposed to dexamethasone (0.05%), 31 to interferons (0.01%), 1,398 to heparins (0.60%), 24 to angiotensin-receptor blockers (ARB) (0.01%), 182 to chloroquine (0.08%), 103 to hydroxychloroquine (0.05%), 6,206 to azithromycin (2.70%), 230 to oseltamivir (0.10%), and 114 to HIV medications (0.05%). Adjusting for potential confounders, we observed an increased risk of prematurity related to dexamethasone (aOR 1.92, 95%CI 1.11-3.33; 15 exposed cases), anti-thrombotics (aOR 1.58, 95%CI 1.31-1.91; 177 exposed cases), and HIV medications (aOR 2.04, 95%CI 1.01-4.11; 20 exposed cases) use. An increased risk for LBW associated with anti-thrombotics (aOR 1.72, 95%CI 1.41-2.11; 152 exposed cases), and HIV medications (aOR 2.48, 95%CI 1.25-4.90; 21 exposed cases) use were also found. Gestational exposure to anti-thrombotics (aOR 1.20, 95%CI 1.00-1.44; 176 exposed cases), and HIV medications (aOR 2.61, 95%CI 1.51-4.51; 30 exposed cases) were associated with SGA. First-trimester dexamethasone (aOR 1.66, 95%CI 1.02-2.69; 20 exposed cases) and azithromycin (aOR 1.10, 95%CI 1.02-1.19; 747 exposed cases) exposures were associated with MCM.<h4>Conclusions</h4>Many available medications considered as treatments for COVID-19 are associated with adverse pregnancy outcomes. Caution is warranted when considering these medications during the gestational period.https://doi.org/10.1371/journal.pone.0251746 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Anick Bérard Odile Sheehy Jin-Ping Zhao Evelyne Vinet Caroline Quach Behrouz Kassai Sasha Bernatsky |
spellingShingle |
Anick Bérard Odile Sheehy Jin-Ping Zhao Evelyne Vinet Caroline Quach Behrouz Kassai Sasha Bernatsky Available medications used as potential therapeutics for COVID-19: What are the known safety profiles in pregnancy. PLoS ONE |
author_facet |
Anick Bérard Odile Sheehy Jin-Ping Zhao Evelyne Vinet Caroline Quach Behrouz Kassai Sasha Bernatsky |
author_sort |
Anick Bérard |
title |
Available medications used as potential therapeutics for COVID-19: What are the known safety profiles in pregnancy. |
title_short |
Available medications used as potential therapeutics for COVID-19: What are the known safety profiles in pregnancy. |
title_full |
Available medications used as potential therapeutics for COVID-19: What are the known safety profiles in pregnancy. |
title_fullStr |
Available medications used as potential therapeutics for COVID-19: What are the known safety profiles in pregnancy. |
title_full_unstemmed |
Available medications used as potential therapeutics for COVID-19: What are the known safety profiles in pregnancy. |
title_sort |
available medications used as potential therapeutics for covid-19: what are the known safety profiles in pregnancy. |
publisher |
Public Library of Science (PLoS) |
series |
PLoS ONE |
issn |
1932-6203 |
publishDate |
2021-01-01 |
description |
<h4>Background</h4>Medications already available to treat other conditions are presently being studied in clinical trials as potential treatments for COVID-19. Given that pregnant women are excluded from these trials, we aimed to investigate their safety when used during pregnancy within a unique population source.<h4>Methods</h4>Using the population-based Quebec Pregnancy Cohort, we identified women who delivered a singleton liveborn (1998-2015). Taking potential confounders into account including indications for use, the risk of prematurity, low birth weight (LBW), small for gestational age (SGA), and major congenital malformation (MCM) associated with COVID-19 repurposed drug use during pregnancy were quantified using generalized estimation equations.<h4>Results</h4>Of the 231,075 eligible pregnancies, 107 were exposed to dexamethasone (0.05%), 31 to interferons (0.01%), 1,398 to heparins (0.60%), 24 to angiotensin-receptor blockers (ARB) (0.01%), 182 to chloroquine (0.08%), 103 to hydroxychloroquine (0.05%), 6,206 to azithromycin (2.70%), 230 to oseltamivir (0.10%), and 114 to HIV medications (0.05%). Adjusting for potential confounders, we observed an increased risk of prematurity related to dexamethasone (aOR 1.92, 95%CI 1.11-3.33; 15 exposed cases), anti-thrombotics (aOR 1.58, 95%CI 1.31-1.91; 177 exposed cases), and HIV medications (aOR 2.04, 95%CI 1.01-4.11; 20 exposed cases) use. An increased risk for LBW associated with anti-thrombotics (aOR 1.72, 95%CI 1.41-2.11; 152 exposed cases), and HIV medications (aOR 2.48, 95%CI 1.25-4.90; 21 exposed cases) use were also found. Gestational exposure to anti-thrombotics (aOR 1.20, 95%CI 1.00-1.44; 176 exposed cases), and HIV medications (aOR 2.61, 95%CI 1.51-4.51; 30 exposed cases) were associated with SGA. First-trimester dexamethasone (aOR 1.66, 95%CI 1.02-2.69; 20 exposed cases) and azithromycin (aOR 1.10, 95%CI 1.02-1.19; 747 exposed cases) exposures were associated with MCM.<h4>Conclusions</h4>Many available medications considered as treatments for COVID-19 are associated with adverse pregnancy outcomes. Caution is warranted when considering these medications during the gestational period. |
url |
https://doi.org/10.1371/journal.pone.0251746 |
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