Cardiovascular risks of hydroxychloroquine in treatment and prophylaxis of COVID-19 patients: A scientific statement from the Indian Heart Rhythm Society

Kapoor, Aditya; Pandurangi, Ulhas; Arora, Vanita; Gupta, Anoop K.; Jaswal, Aparna; Nabar, Ashish; Naik, Ajay; Naik, Nitish; Namboodiri, Narayanan; Vora, Amit; Yadav, Rakesh Kumar; Saxena, Anil

doi:10.1016/j.ipej.2020.04.003

Cited by 73 publications

(84 citation statements)

References 12 publications

(5 reference statements)

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“…Antimalarial drugs have been reported to effectively block several viral infections 67 , including SARS-CoV-2 26 . However, the activities of many of these, in particular chloroquine derivatives, have not been recapitulated in clinical trials 17,18 . Drugs belonging to this class are generally reported to be less effective in blocking viral infections compared to their anti-malarial activity, with EC 50 generally in a µM range 67 .…”

Section: Discussionmentioning

confidence: 99%

“…A French study that used hydroxychloroquine together with azithromycin reported a significant reduction in viral load in patients when used in combination 16 . However, a sufficiently powered case-control study has not yet been reported, and thus it is unclear if there are therapeutic benefits of chloroquine administration to SARS-CoV-2-infected patients, although several concerns are being raised recently, due to the severe cardiac complications potentially resulting from the use of this treatment in COVID-19 patients 17,18 .…”

Section: Introductionmentioning

confidence: 99%

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A Large-scale Drug Repositioning Survey for SARS-CoV-2 Antivirals

Riva

Yuan

Yin

et al. 2020

Preprint

107

111

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The emergence of novel SARS coronavirus 2 (SARS-CoV-2) in 2019 has triggered an ongoing global pandemic of severe pneumonia-like disease designated as coronavirus disease 2019 . To date, more than 2.1 million confirmed cases and 139,500 deaths have been reported worldwide, and there are currently no medical countermeasures available to prevent or treat the disease. As the development of a vaccine could require at least 12-18 months, and the typical timeline from hit finding to drug registration of an antiviral is >10 years, repositioning of known drugs can significantly accelerate the development and deployment of therapies for COVID-19. To identify therapeutics that can be repurposed as SARS-CoV-2 antivirals, we profiled a library of known drugs encompassing approximately 12,000 clinical-stage or FDAapproved small molecules. Here, we report the identification of 30 known drugs that inhibit viral replication. Of these, six were characterized for cellular dose-activity relationships, and showed effective concentrations likely to be commensurate with therapeutic doses in patients. These include the PIKfyve kinase inhibitor Apilimod, cysteine protease inhibitors MDL-28170, Z LVG CHN2, VBY-825, and ONO 5334, and the CCR1 antagonist MLN-3897. Since many of these molecules have advanced into the clinic, the known pharmacological and human safety profiles of these compounds will accelerate their preclinical and clinical evaluation for COVID-19 treatment.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

A Large-scale Drug Repositioning Survey for SARS-CoV-2 Antivirals

Riva

Yuan

Yin

et al. 2020

Preprint

107

111

View full text Add to dashboard Cite

show abstract

“…In this guideline, the KardiaMobile 6L device by AliveCor, Inc, a handheld ECG monitor that received an emergency clearance from the FDA for QTc monitoring, has been suggested to measure the QTc of COVID-19 patients as a vital indicator to help guide the rapid and safe usage of these drugs. Such mobile technology is also recommended by the Indian Heart Rhythm Society for a similar purpose of monitoring drug interactions on QTc [173]. Another application of wearable technology with mHealth was reported in the University of Oxford, where the technology has been used to monitor COVID-19 patients in the isolation ward [109].…”

Section: B Remote Physiological Monitoringmentioning

confidence: 99%

Wearable Sensing and Telehealth Technology with Potential Applications in the Coronavirus Pandemic

Ding

Clifton

et al. 2021

IEEE Rev. Biomed. Eng.

194

155

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Coronavirus disease 2019 (COVID-19) has emerged as a pandemic with serious clinical manifestations including death.A pandemic at the large-scale like COVID-19 places extraordinary demands on the world's health systems, dramatically devastates vulnerable populations, and critically threatens the global communities in an unprecedented way. While tremendous efforts at the frontline are placed on detecting the virus, providing treatments and developing vaccines, it is also critically important to examine the technologies and systems for tackling disease emergence, arresting its spread and especially the strategy for diseases prevention. The objective of this article is to review enabling technologies and systems with various application scenarios for handling the COVID-19 crisis. The article will focus specifically on 1) wearable devices suitable for monitoring the populations at risk and those in quarantine, both for evaluating the health status of caregivers and management personnel, and for facilitating triage processes for admission to hospitals; 2) unobtrusive sensing systems for detecting the disease and for monitoring patients with relatively mild symptoms whose clinical situation could suddenly worsen in improvised hospitals; and 3) telehealth technologies for the remote monitoring and diagnosis of COVID-19 and related diseases. Finally, further challenges and opportunities for future directions of development are highlighted.

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“…macrolides such as azithromycin, quinolones, antihistamines, antiviral and antifungal drugs, antiarrhythmic medications, etc.). (2,(42)(43)(44) (42)(43)(44)(45)(46)(47)(48)(49)(50)(51) With regard to the renal function, chronic kidney disease can result in reduced HCQ clearance, increased drug bioavailability and subsequent augmented risk of HCQ-related side effects. (1) Furthermore, certain drugs (such as tamoxifen, glycosides, methotrexate and ciclosporin) can influence the pharmacokinetics of HCQ.…”

Section: Potential Risks Of Hcq Use In Patients With Diabetesmentioning

confidence: 99%

“…Besides the well-known contraindications to HCQ use (including known hypersensitivity to 4aminoquinoline compounds), (2,44) other conditions or circumstances under which HCQ should be contraindicated or used with caution in the context of diabetes include the following:…”

Section: Potential Risks Of Hcq Use In Patients With Diabetesmentioning

confidence: 99%

Antihyperglycemic properties of hydroxychloroquine in patients with diabetes: Risks and benefits at the time of COVID‐19 pandemic

Infante

Ricordi

Fabbri

2020

Journal of Diabetes

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The antimalarial drug hydroxychloroquine (HCQ) has long been used as a disease-modifying antirheumatic drug for the treatment of several inflammatory rheumatic diseases. Over the last three decades, various studies have shown that HCQ plays also a role in the regulation of glucose homeostasis. Although the mechanisms of action underlying the glucose-lowering properties of HCQ are still not entirely clear, evidence suggests that this drug may exert multifaceted effects on glucose regulation, including improvement of insulin sensitivity, increase of insulin secretion, reduction of hepatic insulin clearance and reduction of systemic inflammation. Preliminary studies have shown the safety and efficacy of HCQ (at a dose ranging from 400 to 600 mg/day) in patients with type 2 diabetes over a short-term period. In 2014, HCQ has been approved in India as an addon hypoglycemic agent for patients with uncontrolled type 2 diabetes. However, large randomized controlled trials are needed to establish the safety and efficacy profile of HCQ in patients with type 2 diabetes over a long-term period. With regard to the COVID-19 pandemic, several medications (including HCQ) have been used as off-label drugs due to the lack of proven effective therapies.However, emerging evidence shows limited benefit from HCQ use in COVID-19 in general. The aim of this manuscript is to comprehensively summarize the current knowledge on the antihyperglycemic properties of HCQ and to critically evaluate the potential risks and benefits related to HCQ use in patients with diabetes, even in light of the current pandemic scenario. Highlights Hydroxychloroquine (HCQ) has been shown to exert antihyperglycemic properties by virtue of potential multifaceted effects on glucose homeostasis, including improvement of insulin sensitivity, increase of insulin secretion and reduction of systemic inflammation. This article is protected by copyright. All rights reserved. Accepted Article Preliminary studies have shown the safety and efficacy of HCQ as an antihyperglycemic agent in type 2 diabetes over a short-term period. A careful risk-benefit assessment of HCQ is critical for a cautious use of this drug in diabetic patients, particularly in light of the current COVID-19 pandemic.

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Cardiovascular risks of hydroxychloroquine in treatment and prophylaxis of COVID-19 patients: A scientific statement from the Indian Heart Rhythm Society

Cited by 73 publications

References 12 publications

A Large-scale Drug Repositioning Survey for SARS-CoV-2 Antivirals

A Large-scale Drug Repositioning Survey for SARS-CoV-2 Antivirals

Wearable Sensing and Telehealth Technology with Potential Applications in the Coronavirus Pandemic

Antihyperglycemic properties of hydroxychloroquine in patients with diabetes: Risks and benefits at the time of COVID‐19 pandemic

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