Cardiac Complications Attributed to Chloroquine and Hydroxychloroquine: A Systematic Review of the Literature

Abstract

Clinicians should be warned that chloroquine- or hydroxychloroquine-related cardiac manifestations, even conduction disorders without repercussion, may be initial manifestations of toxicity, and are potentially irreversible. Therefore, treatment withdrawal is required when cardiac manifestations are present.

Clinical and microbiological effect of a combination of hydroxychloroquine and azithromycin in 80 COVID-19 patients with at least a six-day follow up: A pilot observational study

“…Chloroquine and hydroxychloroquine are extremely well-known drugs which have already been prescribed to billions of people. Because of anecdotical reports of heart complications with such drugs in patients with underlying conditions, it would be useful to perform an ECG before or at the very beginning of the treatment [27]. This problem is solved by hospitalising patients at risk in continuing care units with ECG monitoring allowing for the early detection and treatment of possible cardiac side-effects.…”

Challenges and cares to promote rational use of chloroquine and hydroxychloroquine in the management of coronavirus disease 2019 (COVID-19) pandemic: a timely review

“…Liu et al (2018) performed a meta-analysis to investigate the effects of using CQ and HCQ in 16,679 (pooled) patients with rheumatic diseases, but their effects on the cardiomyopathy and neuromyopathy were not confirmed. Chatre et al (2018) examined cardiac complications attributed to CQ and HCQ in a systematic review of the literature and noted that CQ-or HCQ-related cardiac disorders were rare but severe adverse events occurred after long-term administration.…”

Coronavirus: la emergencia geriátrica de 2020. Documento conjunto de la Sección de Cardiología Geriátrica de la Sociedad Española de Cardiología y la Sociedad Española de Geriatría y Gerontología

“…Además, la infección por COVID-19 se ha asociado con múltiples complicaciones directas e indirectas en el sistema cardiovascular, como el daño miocárdico agudo, la miocarditis, las arritmias y la tromboembolia venosa 8,23 . A todo esto se añade que los tratamientos que se están investigando para la COVID-19 pueden tener efectos secundarios cardiovasculares (tabla 3) 24 ; estas interacciones motivan que con frecuencia se retire a estos pacientes ingresados su tratamiento farmacológico habitual, y todo ello puede conllevar una descompensación cardiológica de base. Además, en el paciente mayor la polifarmacia, con el uso de fármacos antipsicóticos y otros antibióticos que alargan el QT, podría contribuir a una cardiotoxicidad derivada de estas combinaciones.…”