More about chloroquine and hydroxychloroquine, CEBM

VERDICT: The hypothesis that the 4-aminoquinolines chloroquine and hydroxychloroquine may be beneficial in the treatment of COVID-19 is a weak one, based on poor mechanistic reasoning and inconsistent results of studies in vitro, in laboratory animals, and in humans. It is likely that even if chloroquine and hydroxychloroquine are effective in COVID-19, the beneficial effects will be small. The risks of adverse reactions to these drugs may be increased in patients who are acutely ill with severe COVID-19, in many of whom high doses are being used. Macrolide antibacterial drugs, such as azithromycin, clarithromycin, erythromycin, and telithromycin, interact adversely with the 4-amino quinolines, since both types of drug prolong the electrocardiographic QT interval. The combination increases the risk of the serious ventricular tachycardia called torsades de pointes, which is often fatal. Macrolide antibacterial drugs should be avoided in patients taking chloroquine or hydroxychlo roquine. Other drugs that prolong the QT interval should also be avoided or used with care.
Source: Current Awareness Service for Health (CASH) - Category: Consumer Health News Source Type: news

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VERDICT The hypothesis that the 4-aminoquinolines chloroquine and hydroxychloroquine may be beneficial in the treatment of COVID-19 is a weak one, based on poor mechanistic reasoning and inconsistent results of studies in vitro, in laboratory animals, and in humans. It is likely that even if chloroquine and hydroxychloroquine are effective in COVID-19, the beneficial effects will be small. The risks of adverse reactions to these drugs may be increased in patients who are acutely ill with severe COVID-19, in many of whom high doses are being used. Macrolide antibacterial drugs, such as azithromycin, clarithromycin, ery...
Source: Current Awareness Service for Health (CASH) - Category: Consumer Health News Source Type: news
Fight Aging! publishes news and commentary relevant to the goal of ending all age-related disease, to be achieved by bringing the mechanisms of aging under the control of modern medicine. This weekly newsletter is sent to thousands of interested subscribers. To subscribe or unsubscribe from the newsletter, please visit: https://www.fightaging.org/newsletter/ Longevity Industry Consulting Services Reason, the founder of Fight Aging! and Repair Biotechnologies, offers strategic consulting services to investors, entrepreneurs, and others interested in the longevity industry and its complexities. To find out m...
Source: Fight Aging! - Category: Research Authors: Tags: Newsletters Source Type: blogs
Cardiac arrhythmia is a known manifestation of novel coronavirus 2019 (COVID-19) infection. Herein, we describe the clinical course of an otherwise healthy patient who experienced persistent ventricular tachycardia and fibrillation which is believed to be directly related to inflammation, as opposed to acute myocardial injury or medications that can prolong the QT interval.
Source: The American Journal of Cardiology - Category: Cardiology Authors: Source Type: research
AbstractIn this review, we provide a brief description of recently published articles addressing topics relevant to pediatric cardiologists. Our aim is to provide a summary of the latest articles published recently in other journals in our field. The articles address (1) cardiac resynchronization in children with symptomatic ventricular dysfunction and dyssynchrony which seems to result in higher transplant-free survival, (2) outcomes of aortic leaflet reconstruction including Ozaki procedure to repair aortic valve disease in adolescents, (3) meta-analysis for risk factors of ventricular tachycardia and death after repaire...
Source: Pediatric Cardiology - Category: Cardiology Source Type: research
mar K Abstract BACKGROUND: Cardiac injury is common in severe coronavirus disease 2019 (COVID-19) and is associated with poor outcomes. We aimed to study predictors of in-hospital death, characteristics of arrhythmias and the effects of QT-prolonging therapy in patients with cardiac injury. METHODS: We conducted a retrospective cohort study involving patients with severe COVID-19 who were admitted to Tongji Hospital in Wuhan, China, between Jan. 29 and Mar. 8, 2020. Among patients who had cardiac injury, which we defined as an elevated level of cardiac troponin I (cTnI), we identified demographic and clinical...
Source: cmaj - Category: General Medicine Authors: Tags: CMAJ Source Type: research
The Food and Drug Administration (FDA) warned against the use of Hydroxychloroquine or chloroquine for Covid-19 outside of a hospital or a clinical trial setting due to the risk of QT interval prolongation, ventricular tachycardia and the increased risk of these complications when combined with some antibiotics such as azithromycin. In a large study, Mehra et al. reported no benefit of Hydroxychloroquine or chloroquine, when used alone or with a macrolide in COVID-19 hospitalized patients.Despite these warnings, in several developing countries the official guidelines for treatment of Covid-19 patients at the primary care l...
Source: Journal of the Neurological Sciences - Category: Neurology Authors: Tags: Editorial Source Type: research
ConclusionsIn this global survey of>  1100 EP professionals regarding hospitalized COVID-19 patients, a variety of arrhythmic manifestations were observed, ranging from benign to potentially life-threatening. Observed adverse events related to use of HCQ + AZM included prolonged QTc requiring drug discontinuation as well as Torsade d e Pointes. Large prospective studies to better define arrhythmic manifestations as well as the safety of treatment strategies in COVID-19 patients are warranted.
Source: Journal of Interventional Cardiac Electrophysiology - Category: Cardiology Source Type: research
ConclusionWe presented the fast reorganization of an EP referral center during the ongoing COVID-19 healthcare emergency. Our hub-and-spoke model may be useful for other centers, aiming at a cost-effective management of resources in the context of a global crisis.
Source: Journal of Interventional Cardiac Electrophysiology - Category: Cardiology Source Type: research
In the context of the current global COVID-19 pandemic, this Consensus Statement provides current recommendations for patients with, or at risk of developing, genetic heart disease, and for their health care management and service provision in Australia and New Zealand. Apart from general recommendations, there are specific recommendations for the following conditions: cardiomyopathy, Brugada syndrome (including in children), long QT syndrome (LQTS) and catecholaminergic polymorphic ventricular tachycardia (CPVT).
Source: Heart, Lung and Circulation - Category: Cardiology Authors: Tags: Consensus Statement Source Type: research
I discussed the use of hydroxychloroquine and azithromycin for patients with COVID19 on my March 27th edition of This Week in Cardiology Podcast. This is an important topic not only because of the specifics of treating patients but also vital because it shows how easily human beings can be misled. Here is a an edited transcript of my words: A conversation I had with my Dad this week made me realize the seriousness of this matter. My Dad is a retired insurance executive with a background in electrical engineering.  He is smart, but I could not convince him that the evidence prompting people to advoc...
Source: Dr John M - Category: Cardiology Authors: Source Type: blogs
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