Syncope in a patient being treated for hepatic and intestinal amoebiasis

Yelve, Kavita; Phatak, Sanat; Patil, Meenakshi Amit; Pazare, Amar R

doi:10.1136/bcr-2012-006687

Cited by 4 publications

(4 citation statements)

References 12 publications

(9 reference statements)

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“…Two studies described significant QT prolongation in 10 of 95 treated patients, either resulting in an QT increase to over 500 ms or discontinuation of the HCQ/AZ treatment, illustrating the A c c e p t e d M a n u s c r i p t high risk for clinically relevant arrhythmias for this treatment [15,16]. In addition, several case reports of QT prolongation related to hydroxychloroquine have also been published [17][18][19][20].…”

Section: Harmsmentioning

confidence: 99%

“…A c c e p t e d M a n u s c r i p t Background The first cases of coronavirus disease 2019 (COVID- 19) were reported from Wuhan, China in early December 2019 [1], now known to be caused by a novel beta-coronavirus, named as Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Within a span of months COVID 19 has become pandemic due to its transmissibility, spreading across continents with the number of cases and deaths rising daily [2].…”

mentioning

confidence: 99%

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Infectious Diseases Society of America Guidelines on the Treatment and Management of Patients With COVID-19 (April 2020)

Bhimraj

Morgan

Shumaker

et al. 2020

Clinical Infectious Diseases

968

1,045

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Background: There are many pharmacologic therapies that are being used or considered for treatment of COVID-19. There is a need for frequently updated practice guidelines on their use, based on critical evaluation of rapidly emerging literature. Objective: Develop evidence-based rapid guidelines intended to support patients, clinicians and other health-care professionals in their decisions about treatment and management of patients with COVID-19. Methods: IDSA formed a multidisciplinary guideline panel of infectious disease clinicians, pharmacists, and methodologists with varied areas of expertise. Process followed a rapid recommendation checklist. The panel prioritized questions and outcomes. Then a systematic review of the peer-reviewed and grey literature was conducted. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach was used to assess the certainty of evidence and make recommendations. Results: The IDSA guideline panel agreed on 7 treatment recommendations and provided narrative summaries of other treatments undergoing evaluations. Conclusions:The panel expressed the overarching goal that patients be recruited into ongoing trials, which would provide much needed evidence on the efficacy and safety of various therapies for COVID-19, given that we could not make a determination whether the benefits outweigh harms for most treatments.

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Section: Harmsmentioning

confidence: 99%

mentioning

confidence: 99%

Infectious Diseases Society of America Guidelines on the Treatment and Management of Patients With COVID-19 (April 2020)

Bhimraj

Morgan

Shumaker

et al. 2020

Clinical Infectious Diseases

968

1,045

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“…Cases of a complete heart block, an implanted pacemaker failure, and a QT-interval prolongation were described in patients treated with HCQ for autoimmune conditions [ 97 , 98 , 100 ], and cases of cardiovascular collapse, non-specified cardiac arrhythmia, and syncopal attacks with torsade de pointes were described in patients treated with CQ for malaria, amoebiasis, and a dermatological problem [ 95 , 96 , 99 ]. In patients being treated for COVID-19, six cases of cardiac adverse effects with QT interval prolongation were described, consisting of a case of QT interval prolongation and recurrent torsade de pointes with CQ [ 188 ], a case of right bundle branch block and critical QT interval prolongation with HCQ [ 181 ], a case of torsade de pointes in a patient treated with HCQ plus dexamethasone [ 190 ], a case of suspected HCQ-induced sinus bradycardia and QT interval prolongation [ 191 ], a case of QT prolongation in a patient treated with HCQ plus AZM [ 192 ], and a case of death due to progressive metabolic acidosis and multiple organ system failure in a patient being treated with HCQ plus AZM [ 186 ].…”

Section: Resultsmentioning

confidence: 99%

“…During the first days of treatment, gastrointestinal adverse effects should be considered as they were reported in most indications. In the case of cardiac events, it is noteworthy that in more than 70 years of use, only a few cases of early cardiac adverse effects were found [ 94 , 95 , 96 , 97 , 98 , 99 ]. In contrast, in the much shorter period that has elapsed since the start of the COVID-19 pandemic, a greater number of cardiac cases have been reported involving COVID-19-affected patients regardless of the drug regimen used.…”

Section: Discussionmentioning

confidence: 99%

Safety of Short-Term Treatments with Oral Chloroquine and Hydroxychloroquine in Patients with and without COVID-19: A Systematic Review

et al. 2022

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Chloroquine (CQ) and hydroxychloroquine (HCQ) have recently become the focus of global attention as possible treatments for Coronavirus Disease 2019 (COVID-19). The current systematic review aims to assess their safety in short treatments (≤14 days), whether used alone or in combination with other drugs. Following the PRISMA and SWiM recommendations, a search was conducted using four health databases for all relevant English-, Chinese-, and Spanish-language studies from inception through 30 July 2021. Patients treated for any condition and with any comparator were included. The outcomes of interest were early drug adverse effects and their frequency. A total of 254 articles met the inclusion criteria, including case and case-control reports as well as cross-sectional, cohort, and randomised studies. The results were summarised either qualitatively in table or narrative form or, when possible (99 studies), quantitatively in terms of adverse event frequencies. Quality evaluation was conducted using the CARE, STROBE, and JADAD tools. This systematic review showed that safety depended on drug indication. In COVID-19 patients, cardiac adverse effects, such as corrected QT interval prolongation, were relatively frequent (0–27.3% and up to 33% if combined with azithromycin), though the risk of torsade de pointes was low. Compared to non-COVID-19 patients, COVID-19 patients experienced a higher frequency of cardiac adverse effects regardless of the regimen used. Dermatological adverse effects affected 0–10% of patients with autoimmune diseases and COVID-19. A broad spectrum of neuropsychiatric adverse effects affected patients treated with CQ for malaria with variable frequencies and some cases were reported in COVID-19 patients. Gastrointestinal adverse effects occurred regardless of drug indication affecting 0–50% of patients. In conclusion, CQ and HCQ are two safe drugs widely used in the treatment of malaria and autoimmune diseases. However, recent findings on their cardiac and neuropsychiatric adverse effects should be considered if these drugs were to be proposed as antivirals again.

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