COVID-19 and cardiovascular disease in elderly patients: a challenge in the challenge

Abstract

On 11 March 2020, the World Health Organization declared a pandemic state, in relation to the spread of the severe acute respiratory syndrome-coronavirus disease-2, responsible for the coronavirus disease-2019 (COVID-19). The pandemical blast of COVID-19 uncovered well known weakness of financial chain and put our economic organizations facing off dramatic consequences if new strategies will not be developed to adapt health-care on detailed sub-groups of patients. Frail individual aged >65 years affected by cardiovascular disease are an aged population that showed a particular attitude to contract infection and a higher mortality rate compared to general population. In this brief article, we will focus on the management of issues related to cardiovascular patients facing coronavirus infection, in particular in the most fragile groups of the population such as the elderly, increasingly numerous and affected by multimorbidity. Protecting aged populations will be a central question, probably primary in everyone's interest.

Proarrhythmia assessment in treatment with hydroxychloroquine and azithromycin hospitalized elderly COVID-19 patients - our experience

“…12 It is not uncommon for patients with a prolonged cQT interval to be routinely prescribed drugs that prolong the cQT interval, despite the increased risk. 13,14 Our data confirmed the prolongation of the cQT interval following the use of HCQ, and that the magnitude of the increase in cQT and ∆cQT from baseline was more pronounced in patients treated with HCQ especially in combination with additional drugs potentially at risk of prolonging the cQT interval, including AZY. The repolarization disturbance, detected with the different parameters derived from the ECG trace, could have been further amplified in the context of COVID-19 as well as due to the drug-drug interaction (HCQ, AZY, antivirals, antipsychotics), also by the clinical characteristics acute infection which can manifest itself with fever, dehydration and electrolyte abnormalities.…”