Skip to main content
Erschienen in: Rheumatology International 2/2021

01.01.2021 | COVID-19 | Review Zur Zeit gratis

COVID-19, hydroxychloroquine and sudden cardiac death: implications for clinical practice in patients with rheumatic diseases

verfasst von: Hussain Ahmed Raza, Javeria Tariq, Vikas Agarwal, Latika Gupta

Erschienen in: Rheumatology International | Ausgabe 2/2021

Einloggen, um Zugang zu erhalten

Abstract

Sudden cardiac death is commonly seen due to arrhythmias, which is a common cardiac manifestation seen in COVID-19 patients, especially those with underlying cardiovascular disease (CVD). Administration of hydroxychloroquine (HCQ) as a potential treatment option during SARS-CoV-2, initially gained popularity, but later, its safe usage became questionable due to its cardiovascular safety, largely stemming from instances of cardiac arrhythmias in COVID-19. Moreover, in the setting of rheumatic diseases, in which patients are usually on HCQ for their primary disease, there is a need to scale the merits and demerits of HCQ usage for the treatment of COVID-19. In this narrative review, we aim to address the association between usage of HCQ and sudden cardiac death in COVID-19 patients. MEDLINE, EMBASE, ClinicalTrials.gov and SCOPUS databases were used to review articles in English ranging from case reports, case series, letter to editors, systematic reviews, narrative reviews, observational studies and randomized control trials. HCQ is a potential cause of sudden cardiac death in COVID-19 patients. As opposed to the reduction in CVD with HCQ in treatment of systemic lupus erythematous, rheumatoid arthritis, and other rheumatic diseases, safe usage of HCQ in COVID-19 patients is unclear; whereby, it is observed to result in QTc prolongation and Torsades de pointes even in patients with no underlying cardiovascular comorbidity. This is occasionally associated with sudden cardiac death or cardiac arrest; hence, its clinical efficacy needs further investigation by large-scale clinical trials.
Anhänge
Nur mit Berechtigung zugänglich
Literatur
22.
Zurück zum Zitat Bonow RO, Fonarow GC, O’Gara PT, Yancy CW (2020) Association of coronavirus disease 2019 (COVID-19) with myocardial injury and mortality. JAMA Cardiol 5:751–753CrossRefPubMed Bonow RO, Fonarow GC, O’Gara PT, Yancy CW (2020) Association of coronavirus disease 2019 (COVID-19) with myocardial injury and mortality. JAMA Cardiol 5:751–753CrossRefPubMed
71.
Zurück zum Zitat Yao X, Ye F, Zhang M et al (2020) In vitro antiviral activity and projection of optimized dosing design of hydroxychloroquine for the treatment of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Clin Infect Dis 71:732–739CrossRefPubMed Yao X, Ye F, Zhang M et al (2020) In vitro antiviral activity and projection of optimized dosing design of hydroxychloroquine for the treatment of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Clin Infect Dis 71:732–739CrossRefPubMed
96.
Zurück zum Zitat Cohen MS (2020) Hydroxychloroquine for the prevention of covid-19 —searching for evidence. N Engl J Med 383:585–586CrossRefPubMed Cohen MS (2020) Hydroxychloroquine for the prevention of covid-19 —searching for evidence. N Engl J Med 383:585–586CrossRefPubMed
99.
Zurück zum Zitat Meo SA, Klonoff DC, Akram J (2020) Efficacy of chloroquine and hydroxychloroquine in the treatment of COVID-19. Eur Rev Med Pharmacol Sci 24:4539–4547PubMed Meo SA, Klonoff DC, Akram J (2020) Efficacy of chloroquine and hydroxychloroquine in the treatment of COVID-19. Eur Rev Med Pharmacol Sci 24:4539–4547PubMed
102.
Zurück zum Zitat Gurjar M, Agarwal V (2020) Usefulness of hydroxychloroquine for COVID-19: Does answer lie in timing to start? Indian J Rheumatol 15:249 Gurjar M, Agarwal V (2020) Usefulness of hydroxychloroquine for COVID-19: Does answer lie in timing to start? Indian J Rheumatol 15:249
104.
Zurück zum Zitat Offerhaus JA, Wilde AAM, Remme CA (2020) Prophylactic (hydroxy)chloroquine in COVID-19: potential relevance for cardiac arrhythmia risk. Heart Rhythm 17:1480–1486CrossRefPubMedPubMedCentral Offerhaus JA, Wilde AAM, Remme CA (2020) Prophylactic (hydroxy)chloroquine in COVID-19: potential relevance for cardiac arrhythmia risk. Heart Rhythm 17:1480–1486CrossRefPubMedPubMedCentral
110.
Zurück zum Zitat Stevenson A, Kirresh A, Conway S et al (2020) Hydroxychloroquine use in COVID-19: is the risk of cardiovascular toxicity justified? Open Heart 7:e001362CrossRefPubMed Stevenson A, Kirresh A, Conway S et al (2020) Hydroxychloroquine use in COVID-19: is the risk of cardiovascular toxicity justified? Open Heart 7:e001362CrossRefPubMed
111.
Zurück zum Zitat Polak S, Wiśniowska B, Brandys J (2009) Collation, assessment and analysis of literaturein vitrodata on hERG receptor blocking potency for subsequent modeling of drugs’ cardiotoxic properties. J Appl Toxicol 29:183–206CrossRefPubMed Polak S, Wiśniowska B, Brandys J (2009) Collation, assessment and analysis of literaturein vitrodata on hERG receptor blocking potency for subsequent modeling of drugs’ cardiotoxic properties. J Appl Toxicol 29:183–206CrossRefPubMed
113.
Zurück zum Zitat Singh AP, Tousif S, Umbarkar P, Lal H (2020) A pharmacovigilance study of hydroxychloroquine cardiac safety profile: potential implication in COVID-19 mitigation. J Clin Med 9:1867CrossRefPubMedCentral Singh AP, Tousif S, Umbarkar P, Lal H (2020) A pharmacovigilance study of hydroxychloroquine cardiac safety profile: potential implication in COVID-19 mitigation. J Clin Med 9:1867CrossRefPubMedCentral
119.
Zurück zum Zitat Belardinelli L, Giles WR, Rajamani S et al (2015) Cardiac late Na current: Proarrhythmic effects, roles in long QT syndromes, and pathological relationship to CaMKII and oxidative stress. Heart Rhythm 12:440–448CrossRefPubMed Belardinelli L, Giles WR, Rajamani S et al (2015) Cardiac late Na current: Proarrhythmic effects, roles in long QT syndromes, and pathological relationship to CaMKII and oxidative stress. Heart Rhythm 12:440–448CrossRefPubMed
121.
Zurück zum Zitat Morgan ND, Patel SV, Dvorkina O (2013) Suspected hydroxychloroquine-associated QT-interval prolongation in a patient with systemic lupus erythematosus. J Clin Rheumatol 19:286–288CrossRefPubMed Morgan ND, Patel SV, Dvorkina O (2013) Suspected hydroxychloroquine-associated QT-interval prolongation in a patient with systemic lupus erythematosus. J Clin Rheumatol 19:286–288CrossRefPubMed
122.
Zurück zum Zitat O’Laughlin JP, Mehta PH, Wong BC (2016) Life threatening severe QTc prolongation in patient with systemic lupus erythematosus due to hydroxychloroquine. Case Rep Cardiol 2016:1–4 O’Laughlin JP, Mehta PH, Wong BC (2016) Life threatening severe QTc prolongation in patient with systemic lupus erythematosus due to hydroxychloroquine. Case Rep Cardiol 2016:1–4
128.
Zurück zum Zitat Hung Y-M, Wang Y-H, Lin L et al (2018) Hydroxychloroquine may be associated with reduced risk of coronary artery diseases in patients with rheumatoid arthritis: a nationwide population-based cohort study. Int J Clin Pract 72:e13095CrossRefPubMed Hung Y-M, Wang Y-H, Lin L et al (2018) Hydroxychloroquine may be associated with reduced risk of coronary artery diseases in patients with rheumatoid arthritis: a nationwide population-based cohort study. Int J Clin Pract 72:e13095CrossRefPubMed
136.
Zurück zum Zitat Huang Y, Chen Z, Wang Y et al (2020) Clinical characteristics of 17 patients with COVID-19 and systemic autoimmune diseases: a retrospective study. Ann Rheum Dis 79:1163–1169CrossRefPubMed Huang Y, Chen Z, Wang Y et al (2020) Clinical characteristics of 17 patients with COVID-19 and systemic autoimmune diseases: a retrospective study. Ann Rheum Dis 79:1163–1169CrossRefPubMed
138.
Zurück zum Zitat Finkelstein Y, Adler Y, Harel L et al (1997) Anti-Ro (SSA) and anti-La (SSB) antibodies and complete congenital heart block. Ann Med Interne 148:205–208 Finkelstein Y, Adler Y, Harel L et al (1997) Anti-Ro (SSA) and anti-La (SSB) antibodies and complete congenital heart block. Ann Med Interne 148:205–208
143.
Zurück zum Zitat Morin DP, Homoud MK, Mark Estes NA (2017) Prediction and prevention of sudden cardiac death. Cardiac Electrophysiol Clin 9:631–638CrossRef Morin DP, Homoud MK, Mark Estes NA (2017) Prediction and prevention of sudden cardiac death. Cardiac Electrophysiol Clin 9:631–638CrossRef
157.
Zurück zum Zitat Asli R, Abdullah MS, Chong PL et al (2020) Case report: right bundle brunch block and QTc prolongation in a patient with COVID-19 treated with hydroxychloroquine. Am J Trop Med Hyg 103:79–82CrossRefPubMedPubMedCentral Asli R, Abdullah MS, Chong PL et al (2020) Case report: right bundle brunch block and QTc prolongation in a patient with COVID-19 treated with hydroxychloroquine. Am J Trop Med Hyg 103:79–82CrossRefPubMedPubMedCentral
161.
Zurück zum Zitat Bessière F, Roccia H, Delinière A et al (2020) Assessment of QT intervals in a case series of patients with coronavirus disease 2019 (COVID-19) infection treated with hydroxychloroquine alone or in combination with azithromycin in an intensive care unit. JAMA Cardiol 5:1067CrossRefPubMed Bessière F, Roccia H, Delinière A et al (2020) Assessment of QT intervals in a case series of patients with coronavirus disease 2019 (COVID-19) infection treated with hydroxychloroquine alone or in combination with azithromycin in an intensive care unit. JAMA Cardiol 5:1067CrossRefPubMed
Metadaten
Titel
COVID-19, hydroxychloroquine and sudden cardiac death: implications for clinical practice in patients with rheumatic diseases
verfasst von
Hussain Ahmed Raza
Javeria Tariq
Vikas Agarwal
Latika Gupta
Publikationsdatum
01.01.2021
Verlag
Springer Berlin Heidelberg
Schlagwort
COVID-19
Erschienen in
Rheumatology International / Ausgabe 2/2021
Print ISSN: 0172-8172
Elektronische ISSN: 1437-160X
DOI
https://doi.org/10.1007/s00296-020-04759-2

Weitere Artikel der Ausgabe 2/2021

Rheumatology International 2/2021 Zur Ausgabe

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.