Medication Optimization Needed for Patients with Long COVID
Investigators said there is an imperative to optimize medication utilization and explore the consequences of medication burden on treatment outcomes in patients with long COVID.
The current approach to managing long COVID with medications largely targets nervous system symptoms and carries significant risks associated with polypharmacy and drug-drug interactions, according to recent research published in the Journal of the American Pharmacists Association.1 The authors of the study said the findings highlight the need to enhance the safety of long COVID symptom management.
Medication Optimization Needed for Patients with Long COVID / Tatiana - stock.adobe.com
About 7% of adults in the United States have reported ever having long COVID, according to data from the Medical Expenditure Panel Survey Household Component.2 The condition is defined as symptoms lasting 3 months or longer after the initial infection, with higher rates seen in women, individuals with chronic conditions, and people aged 35 to 64 years. Long COVID can often be a debilitating illness that impacts an individual’s quality of life and can last weeks, months, or even years.3
READ MORE: Overweight, Obesity Linked with Increased Long COVID Risk in Pediatric Patients
“Management of [long COVID] is fragmented; however, a multidisciplinary approach, focusing on personalized symptom alleviation is recommended due to the divergent symptom clusters spanning various organ systems among individuals,” the authors said. “While this approach is designed to enhance overall function and quality of life, there are prescription-related challenges, which can result in polypharmacy, potential drug interactions, plausible iatrogenic consequences, and subsequent prescribing cascades.”
Investigators from the Research Institute of McGill University Health Centre conducted a study to describe medication use patterns among patients with long COVID and estimate the prevalence of polypharmacy, potential drug–drug interactions, and anticholinergic and sedative burden. Data from the study was gathered from the Quebec Action for Post-COVID cohort, a patient-centered longitudinal study tracking symptom patterns, impacts, and intervention needs in individuals with persistent long COVID.
The study cohort included 414 adult patients who self-identified with symptoms lasting over 12 weeks after a confirmed or presumed SARS-CoV-2 infection. The patients were recruited between September 2022 to September 2023 and had comprehensive follow-up every 3 months. The patients provided health-related data, such as demographics, comorbidities, medication usage, and the effects of symptoms on their quality of life.
Among the participants, the most commonly reported symptoms included fatigue and distress. Postexertional malaise was noted by 83.6% of patients. Investigators found there were minimal differences in symptom severity between medicated and unmedicated patients.
The study found that 154 of the patients had been prescribed medications for long COVID. These patients were significantly more likely to be on paid sick leave compared to patients who were not prescribed medications. Of these patients, 78% were female, 46.1% acknowledged alcohol consumption, and the median comorbidity count was 1. Nearly 55% were administered medications falling under ATC level 1 Class N that specifically targeted the nervous system. This was followed by respiratory system, alimentary tract and metabolism, and the cardiovascular system.
The patients prescribed medications typically used a median of 2 and polypharmacy—defined as the concurrent use of 5—was observed in 11.7% of patients. Among these patients, 25% were at risk of encountering at least 1 clinically significant potential drug–drug interaction. There were a total of 418 unique drug combinations prescribed, of which 71 exhibited clinically relevant potential interactions.
“Given the paucity of comparable research, this report adds valuable evidence for healthcare providers, researchers, and stakeholders, emphasizing the imperative to optimize medication utilization and explore the consequences of medication burden on treatment outcomes and functional aspects among individuals with [long COVID],” the authors concluded.
READ MORE: COVID-19 Resource Center
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