Cardiovascular Considerations in Treating Patients With Coronavirus Disease 2019 (COVID-19)

Dixon, Dave L.; Tassell, Benjamin Van; Vecchiè, Alessandra; Bonaventura, Aldo; Talasaz, Azita Hajhossein; Kakavand, Hessam; D’Ascenzo, Fabrizio; Perciaccante, Antonio; Castagno, Davide; Ammirati, Enrico; Biondi‐Zoccai, Giuseppe; Stevens, Michael P.; Abbate, Antonio

doi:10.1097/fjc.0000000000000836

Cited by 57 publications

(82 citation statements)

References 61 publications

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“…Studies have shown that tocilizumab, an IL-6 receptor antibody, could reverse CRS in the setting of chimeric antigen receptor T-cell therapy for cancer [36]. Because of the greatly elevated serum levels of IL-6 in patients with COVID-19 [3], its off-label used in the early stage of the diseases suggests a favorable impact on the course of COVID-19 [37]. Moreover, in 2 small retrospective studies of COVID-19 patients in China suffering from severe lung injury it was observed that the use of this agent could provide significant clinical improvement without important side effects [38, 39].…”

Section: Cytokine-targeting Therapiesmentioning

confidence: 99%

Weathering the Cytokine Storm in COVID-19: Therapeutic Implications

et al. 2020

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Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) recently emerged in Wuhan, Hubei-China, as responsible for the coronavirus disease 2019 (COVID-19) and then spread rapidly worldwide. While most individuals remain asymptomatic or develop only mild symptoms, approximately 5% develop severe forms of COVID-19 characterized by acute respiratory distress syndrome (ARDS) and multiple-organ failure (MOF) that usually require intensive-care support and often yield a poor prognosis. Summary: The pathophysiology of COVID-19 is far from being completely understood, and the lack of effective treatments leads to a sense of urgency to develop new therapeutic strategies based on pathophysiological assumptions. The exaggerated cytokine release in response to viral infection, a condition known as cytokine release syndrome (CRS) or cytokine storm, is emerging as the mechanism leading to ARDS and MOF in COVID-19, thus endorsing the hypothesis that properly timed

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Section: Cytokine-targeting Therapiesmentioning

confidence: 99%

Weathering the Cytokine Storm in COVID-19: Therapeutic Implications

et al. 2020

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“…8), several novel therapeutic approaches have been proposed, encompassing antivirals, antimalarials, and immunomodulators that have shown activity against SARS-CoV-2. 35,36 In particular, hydroxychloroquine, remdesivir, interferon β-1b, lopinavir-ritonavir, ribavirin, favipiravir, arbidol, tocilizumab, and bevacizumab have been investigated. 35 Mostly, however, these therapies have been evaluated in single cases or small-scale studies.…”

Section: Novel Therapeutic Approaches In Covid-19mentioning

confidence: 99%

COVID-19-Induced Cytokine Release Syndrome Associated with Pulmonary Vein Thromboses, Atrial Cardiomyopathy, and Arterial Intima Inflammation

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Patscheke

Henschke³

et al. 2020

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Coronavirus disease 2019 (COVID-19) is a viral disease induced by severe acute respiratory syndrome–coronavirus-2 (SARS-CoV-2), which may cause an acute respiratory distress syndrome (ARDS). First reports have shown that elevated levels of inflammatory cytokines might be involved in the development of organ dysfunction in COVID-19. Here, we can present a case of cytokine release syndrome induced by SARS–CoV-2 causing multiorgan failure and death. Of note, we can report on pulmonary vein thromboses as potential source of cerebrovascular embolic events. Furthermore, we present a specific form of an isolated inflammatory atrial cardiomyopathy encompassing atrial myocardium, perivascular matrix, as well as atrial autonomic nerve ganglia, causing atrial fibrillation, sinus node arrest, as well as atrial clot formation in the right atrial appendage. An associated acute glomerulonephritis caused acute kidney failure. Furthermore, all the described pathologies of organs and vessels were associated with increased local expression of interleukin-6 and monocyte chemoattractant protein-1 (MCP-1). This report provides new evidence about fatal pathologies and summarizes the current knowledge about organ manifestations observed in COVID-19.

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“…Based on their experimental properties, chloroquine (CQ) and especially its analog hydroxychloroquine (HCQ) have been suggested [5], often associated with the macrolide antibiotic azithromycin (AZI) for alleged synergistic properties [6]. The anti-HIV protease inhibitor lopinavir, with ritonavir as a booster (LOPI), has also been used in this perspective.…”

Section: Introductionmentioning

confidence: 99%

“Off-label” use of hydroxychloroquine, azithromycin, lopinavir-ritonavir and chloroquine in COVID-19: A survey of cardiac adverse drug reactions by the French Network of Pharmacovigilance Centers

et al. 2020

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Introduction.-COVID-19 is an unprecedented challenge for physicians and scientists. Several publicized drugs are being used with not much evidence of their efficacy such as hydroxychloroquine, azithromycin or lopinavir-ritonavir. Yet, the cardiac safety of these drugs in COVID-19 deserves scrutiny as they are known to foster cardiac adverse ADRs, notably QTc interval prolongation on the electrocardiogram and its arrhythmogenic consequences. Methods.-Since March 27th, 2020, the French Pharmacovigilance Network directed all cardiac adverse drug reactions associated with ''off-label'' use of hydroxychloroquine, azithromycin and lopinavir-ritonavir in COVID-19 to the Nice Regional Center of Pharmacovigilance. Each Regional Center of Pharmacovigilance first assessed causality of drugs. We performed a specific analysis of these cardiac adverse drug reactions amidst an array of risk factors, reassessed the electrocardiograms and estimated their incidence in coronavirus disease 2019.

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Cardiovascular Considerations in Treating Patients With Coronavirus Disease 2019 (COVID-19)

Cited by 57 publications

References 61 publications

Weathering the Cytokine Storm in COVID-19: Therapeutic Implications

Weathering the Cytokine Storm in COVID-19: Therapeutic Implications

COVID-19-Induced Cytokine Release Syndrome Associated with Pulmonary Vein Thromboses, Atrial Cardiomyopathy, and Arterial Intima Inflammation

“Off-label” use of hydroxychloroquine, azithromycin, lopinavir-ritonavir and chloroquine in COVID-19: A survey of cardiac adverse drug reactions by the French Network of Pharmacovigilance Centers

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