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

Muhammad Yamin, Amanda Ulfah Demili

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


arrhythmia; covid-19;hydroxychlorine; QT; azithromycin

References


Madjid M, Safavi-Naeini P, Solomon SD, et al. Potential effects of Coronaviruses on the cardiovascular system: A review. JAMA Cardiol. 2020;10:1–10.

Zheng YY, Ma YT, Zhang JY, et al. COVID-19 and the cardiovascular system. Nat Rev Cardiol [Internet]. 2020;17(5):259–60. Available from: http://dx.doi.org/10.1038/s41569-020-0360-5.

Wang D, Hu B, Hu C, et al. Clinical characteristics of 138 hospitalized patients with 2019 Novel Coronavirus-infected pneumonia in Wuhan, China. JAMA - J Am Med Assoc. 2020;323(11):1061–9.

Guan W, Ni Z, Hu Y, et al. Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med. 2020;382(18):1708–20.

Weiss P, Murdoch DR. Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID- company’ s public news and information website . Elsevier hereby grants permission to make all its COVID-19-r. 2020.

Wu C-I, Postema PG, Arbelo E, et al. SARS-CoV-2, COVID-19, and inherited arrhythmia syndromes. Heart Rhythm. 2020.

Roden DM, Harrington RA, Poppas A, et al. Considerations for drug interactions on QTc interval in exploratory COVID-19 treatment. J Am Coll Cardiol. 2020;75(20):2623–4.

Ventricular arrhythmia risk due to Hydroxychloroquine-Azithromycin treatment for COVID-19 - American College of Cardiology [Internet]. [cited 2020 Jun 12]. Available from: https://www.acc.org/latest-in-cardiology/articles/2020/03/27/14/00/ventricular-arrhythmia-risk-due-to-hydroxychloroquine-azithromycin-treatment-for-covid-19.

Tisdale JE, Jaynes HA, Kingery JR, et al. Interval prolongation in hospitalized patients. Circ Cardiovasc Qual Outcomes. 2014;1–21.

Vandenberk B, Vandael E, Robyns T, et al. Which QT correction formulae to use for QT monitoring? J Am Heart Assoc. 2016;5(6).

Postema PG, Neville J, De Jong JSSG, et al. Safe drug use in long QT syndrome and Brugada syndrom. Europace. 2013;15(7):1042–9.

Casado-arroyo R, Leshem E, Juang JJM. Fever-related arrhythmic events in the multicenter survey on arrhythmic events in Brugada syndrome (SABRUS) brief title: Brugada syndrome and fever-related arrhythmias. (9):1–21.

Amin AS, Klemens CA, Verkerk AO, et al. Fever-triggered ventricular arrhythmias in Brugada syndrome and type 2 long-QT syndrome. Netherlands Hear J. 2010;18(3):165–9.

Kuck KH. Arrhythmias and sudden cardiac death in the COVID-19 pandemic. Herz. 2020;3–4.

Cheung CC, Davies B, Gibbs K, et al. Multi-lead QT screening is necessary for QT measurement: Implications for management of patients in the COVID-19 era. JACC Clin Electrophysiol. 2020.

Gao L, Jiang D, Wen XS, et al. Prognostic value of NT-proBNP in patients with severe COVID-19. Respir Res. 2020;21(1).


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