Effects of Chloroquine and Hydroxychloroquine on the Cardiovascular System - Limitations for Use in the Treatment of COVID-19

Brazão, Stephani Correia; Autran, Lis Jappour; Lopes, Rosane de Oliveira; Scaramello, Christianne Brêtas Vieira; Brito, Fernanda; Motta, Nadia Alice Vieira

doi:10.36660/ijcs.20200162

Cited by 3 publications

(2 citation statements)

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“…In most of the studies, although significant prolongations in QT interval were observed with Chloroquine, relatively less prolongations in QT interval were observed with HCQ, which is a less toxic metabolite of chloroquine [ 23 ]. Studies have shown prolongations in the QT interval between 5 and 6 ms, generally 1–3 days after the initiation of treatment [ 14 , 15 , 24 ].…”

Section: Discussionmentioning

confidence: 99%

The association between QT interval changes and the treatment protocols of COVID-19 patients

Sertbaş¹

2022

North Clin Istanbul

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OBJECTIVE This study aimed to investigate the QT, QTc, and QTc dispersion changes that may occur with the use of hydroxychloroquine (HCQ), favipiravir, and moxifloxacin in combination or alone in COVID 19 patients. METHODS This study was retrospectively conducted on 193 inpatients diagnosed with COVID-19. We divided the patients into four separate groups due to their medications as, group-1: favipiravir, group-2: favipiravir + HCQ, group-3: favipiravir + moxifloxacin, and group-4: favipiravir + moxifloxacin + HCQ. We recorded their pre and post-treatment QT parameters of each group and evaluated the changes of these parameters with the SPSS statistical program. RESULTS The mean age of the patients was 63.1±17.7. In group 1 and 2, although there were slight changes in QT parameters, these results were not statistically significant. In group 3, significant increases in QT and QTc dispersion occurred (p=0.005 and p=0.018). In the 4 th group where the triple therapy was applied, there was a significant increase only in the QTc values (p=0.027). When we compared the changes of QT parameters for each group, a significant difference was found in ΔQTc dispersion, and post hoc analysis showed that it was due to changes in the third group (p=0.047). CONCLUSION We thought that, if there is a COVID-19 infection with an additional bacterial infection, and if there is a need of using moxifloxacin alone or together with HCQ, additional risk factors that may cause QT interval prolongation should be reviewed and ECG monitoring of the patients should be performed during the treatment period.

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Section: Discussionmentioning

confidence: 99%

The association between QT interval changes and the treatment protocols of COVID-19 patients

Sertbaş¹

2022

North Clin Istanbul

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“…It is believed that HCQ has several modes of action, such as the inhibition of viral entry, as well as the liberation of viral RNA into the host cells, in addition to modulation of the immune system [6,7]. However, most studies indicated its limited efficacy [8]. It was suggested that pulmonary acidosis associated with severe SARS-CoV-2 infection diminishes the access of this weakly basic drug to lung tissues.…”

Section: Introductionmentioning

confidence: 99%

Pulmonary Delivery of Hydroxychloroquine Nanostructured Lipid Carrier as a Potential Treatment of COVID-19

et al. 2022

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Coronavirus Disease 2019 (COVID-19) is a pandemic caused by severe acute respiratory syndrome coronavirus 2. Pneumonia is considered the most severe and long-term complication of COVID-19. Among other drugs, hydroxychloroquine (HCQ) was repurposed for the management of COVID-19; however, low efficacy and cardiac toxicity of the conventional dosage form limited its use in COVID-19. Therefore, utilizing nanotechnology, a pulmonary delivery system of HCQ was investigated to overcome these limitations. HCQ was formulated in nanostructured lipid carriers (HCQ-NLCs) using the hot emulsification–ultrasonication method. Furthermore, the prepared formulation was evaluated in vitro. Moreover, the efficacy was tested in vivo in a bleomycin-induced acute lung injury mice model. Intriguingly, nanoformulations were given by the intratracheal route for 6 days. HCQ-NLCs showed a mean particle size of 277 nm and a good drug release profile. Remarkably, acute lung injury induced by bleomycin was associated with a marked elevation of inflammatory markers and histological alterations in lung tissues. Astoundingly, all these changes were significantly attenuated with HCQ-NLCs. The pulmonary delivery of HCQ-NLCs likely provided adequate targeting to lung tissues. Nevertheless, there is hope that this novel strategy will eventually lead to the improved effectiveness and diminished probability of alarming adverse drug reactions.

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Pandemic Religion in Brazil—Temptation and Responsibility

Sinner

Zeferino

2022

Religions

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Religious incidence in Brazilian public space is a widespread fact that has been gaining new visibility in pandemic times. Responsibility in liminal situations represents specific theological hermeneutics, as well as what matters for the respective religious agents. Thus, based on a bibliographical review connected to an analysis of websites, this article aims to reflect on the current Brazilian context, the challenges to doing theology in Brazil today and points to some possible responses. “Pandemic religion”, as we call it, is the synthesis of theologies and religious practices that legitimise irresponsible approaches to life, vulnerabilising the other instead of assuming care-based ethics. Firstly, we briefly describe current theological trends, followed by an analysis of the Brazilian scenario by way of three representative scenes of public religious incidence that reflect a lack of responsibility in view of the pandemic challenges caused by COVID-19. Subsequently, we look back into history for alternative responses to public health crises that required theological positioning. In a Brazilian perspective of a public theology, we finally reflect on a responsible ethics that may help respond to the current challenges, particularly for pandemic religion.

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Effects of Chloroquine and Hydroxychloroquine on the Cardiovascular System - Limitations for Use in the Treatment of COVID-19

Cited by 3 publications

References 123 publications

The association between QT interval changes and the treatment protocols of COVID-19 patients

The association between QT interval changes and the treatment protocols of COVID-19 patients

Pulmonary Delivery of Hydroxychloroquine Nanostructured Lipid Carrier as a Potential Treatment of COVID-19

Pandemic Religion in Brazil—Temptation and Responsibility

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