Prevention of Ventricular Arrhythmia and Sudden Cardiac Death in COVID-19 Patients

Acta Med Indones. 2020 Jul;52(3):290-296.

Abstract

Since the first case was reported at the end of 2019, COVID-19 has spread throughout the world and has become a pandemic. The high transmission rate of the virus has made it a threat to public health globally. Viral infections may trigger acute coronary syndromes, arrhythmias, and exacerbation of heart failure, due to a combination of effects including significant systemic inflammatory responses and localized vascular inflammation at the arterial plaque level. Indonesian clinical practice guideline stated that (hydroxy)chloroquine alone or in combination with azithromycin may be used to treat for COVID-19. However, chloroquine, hydroxychloroquine, and azithromycin all prolong the QT interval, raising concerns about the risk of arrhythmic death from individual or concurrent use of these medications. To date, there is still no vaccine or specific antiviral treatment for COVID-19. Therefore, prevention of infection in people with cardiovascular risk and mitigation of the adverse effects of treatment is necessary.

Keywords: QT; arrhythmia; azithromycin; covid-19; hydroxychlorine.

Publication types

  • Review

MeSH terms

  • Anti-Arrhythmia Agents / therapeutic use*
  • Betacoronavirus*
  • COVID-19
  • Coronavirus Infections / complications*
  • Coronavirus Infections / epidemiology
  • Death, Sudden, Cardiac / etiology
  • Death, Sudden, Cardiac / prevention & control*
  • Electrocardiography
  • Humans
  • Pandemics
  • Pneumonia, Viral / complications*
  • Pneumonia, Viral / epidemiology
  • Prognosis
  • SARS-CoV-2
  • Tachycardia, Ventricular / etiology
  • Tachycardia, Ventricular / prevention & control*

Substances

  • Anti-Arrhythmia Agents