key: cord-1020324-8bfsstfe
authors: Aminnejad, Reza; Hashemi, Seyed Masoud; Safari, Saeid; Dadkhah, Payman; Bastanhagh, Ehsan
title: Impact of COVID-19 on Advanced Cancer Patients’ Pain Care: Warning About Chloroquine and Hydroxychloroquine
date: 2021-02-28
journal: Anesth Pain Med
DOI: 10.5812/aapm.111641
sha: bc1ea389ff369bda30a00ac66f53d5157f3dd9a9
doc_id: 1020324
cord_uid: 8bfsstfe

nan

In recent few months, the world has experienced a new and unique situation with the spreading of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (1, 2). Signs and symptoms include fever, sore throat, cough, fatigue, headache, nausea, vomiting, diarrhea, and shortness of breath (3) . Close contact with infected people and touching contaminated surfaces are the most important ways of coronavirus spreading (4). Old age is known as a risk factor for poor prognosis of COVID-19 and ICU admission. Old age is not only a major risk factor for COVID-19 infection but also a risk factor for many cancers (5, 6) . Cancer patients receive diverse palliative care medications, especially for the control of pain, some of which such as methadone can prolong QTc interval (7) . The QTc interval prolongation can be seen in up to 20% of patients. However, its clinical importance is not so significant (8, 9) . Many protocols are described for the treatment of COVID-19 (10) . Two of the most prevalent drugs used for COVID-19 treatment are chloroquine and hydroxychloroquine (11) (12) (13) . Chloroquine and hydroxychloroquine can be associated with electrocardiographic QT interval prolongation. The QT interval prolongation is a risk predictor of developing potentially lethal Torsade de Pointes dysrhythmia (14) . Since old age is a risk factor for both cancer and COVID-19, it is important to pay special attention to fatal drug interactions in elderly cancer patients with SARS-CoV-2 infection. From this point of view, in any patient with cancer or noncancer chronic pain, even a young person who is infected with SARS-CoV-2 at the same time, it should be noted that drug interactions do not affect his/her outcome.

Authors' Contribution: Study conception/design: All authors. Drafting of the article: RA. Revising of the article critically for important intellectual content: MH. Final approval of the version to be published and agreement to be accountable for all aspects of the work: All authors.

The authors declare that they have no conflicts of interest.

Funding/Support: The study had no sponsor.

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