Potential pro-arrhythmic effects of pharmacotherapy against SARS-CoV-2

Arch Cardiol Mex. 2020;90(Supl):36-40. doi: 10.24875/ACM.M20000061.

Abstract

The pandemic caused by the SARS-COV-2 or COVID-19 virus has been a global challenge given its high rate of transmission and lack of effective therapy or vaccine. This scenario has led to the use of various drugs that have demonstrated a potential effect against the virus in vitro. However, time has not been enough to properly evaluate their clinical effectiveness. The use of chloroquine/hydroxychloroquine, azithromycin and antiviral treatment and has been proposed by various groups, supported by in-vitro studies and limited patient series, without the adequate scientific rigor that precedes drug prescription. Although it may represent the only hope for many patients, it is important to know the main adverse effects associated with the use of these drugs and to better select patients who may benefit from them.

La pandemia por el virus SARS-COV-2 causante de la enfermedad COVID-19 representa un reto mundial dada su alta tasa de transmisión y ausencia de una terapia efectiva o vacuna. Este escenario ha propiciado el uso de diversos fármacos que in vitro han demostrado un potencial efecto contra el virus. Sin embargo, el tiempo no ha sido suficiente para evaluar su efectividad clínica con el adecuado rigor científico que precede a la prescripción de medicamentos. El uso de cloroquina/hidroxicloroquina, azitromicina y esquemas antivirales ha sido propuesto por diversos grupos, apoyado por series de pacientes limitada en número. Si bien puede representar la única esperanza para muchos enfermos, es importante conocer los principales efectos adversos asociados al uso de estas drogas y seleccionar mejor a los pacientes que puedan beneficiarse de ellas. El riesgo de arritmias ventriculares incrementa tanto por el uso de fármacos como por la gravedad de la propia enfermedad viral.

Keywords: Azithromycin; Azitromicina; COVID-19 treatment; Chloroquine; Cloroquina; Long QT syndrome; Pandemia; Pandemic; SARS-COV-2; Síndrome de QT largo; Tratamiento COVID-19.

MeSH terms

  • Antiviral Agents / adverse effects
  • Antiviral Agents / therapeutic use
  • Arrhythmias, Cardiac / chemically induced*
  • Azithromycin / adverse effects
  • Azithromycin / therapeutic use
  • COVID-19
  • COVID-19 Drug Treatment
  • Chloroquine / adverse effects
  • Chloroquine / therapeutic use
  • Coronavirus Infections / drug therapy*
  • Coronavirus Infections / epidemiology
  • Humans
  • Hydroxychloroquine / adverse effects
  • Hydroxychloroquine / therapeutic use
  • Pandemics
  • Pneumonia, Viral / drug therapy*
  • Pneumonia, Viral / epidemiology

Substances

  • Antiviral Agents
  • Hydroxychloroquine
  • Azithromycin
  • Chloroquine