Current evidence for the risk of PR prolongation, QRS widening, QT prolongation, from lopinavir, ritonavir, atazanavir, and saquinavir

Ridjab, D.; Ivan, Ignatius; Budiman, Fanny; Juliawati, Dwi Jani

doi:10.1097/md.0000000000026787

Cited by 4 publications

(2 citation statements)

References 40 publications

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“…In other studies, ECG findings were also frequently found to be associated with echocardiogram demonstrating ejection fraction lower than 50%, hypokinesis, and slight wall thickening. 57,[71][72][73]…”

Section: Discussionmentioning

confidence: 99%

Covid-19 and Heart Involvement: A Systematic Review of Literature

Moraes¹,

Santos²,

Campos³

et al. 2023

International Journal of Cardiovascular Sciences

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Background: Recent reports in the literature have indicated that infection by coronavirus disease 2019 (COVID-19) causes cardiac complications, such as heart failure, arrhythmia, myocardial infarction, and even fulminant myocarditis. These complications have been identified as the cause of death in some patients infected with SARS-CoV-2. Objectives:To analyze echocardiographic and electrocardiographic changes, treatments used, and clinical outcomes in patients with myocarditis and COVID-19. Methods:The items described for Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) were followed. This review included articles in English, Portuguese, and Spanish that reported cardiac involvement, injury, or myocardial inflammation in patients who acquired COVID-19 (SARS-CoV-2).Results: Five databases were consulted to find 1,726 articles. After applying the eligibility criteria, a total of 22 studies were considered qualified. ST-segment (section of the electrocardiogram corresponding the end of the S wave to the beginning of the T wave) elevation and tachyarrhythmia were the most common changes found in the electrocardiographic analysis of patients affected with COVID-19. Concerning echocardiography, there was a high frequency of decreased ejection fraction and occurrence of pericardial effusion. Conclusion:This systematic review provides a potential tool for the analysis of cardiac changes and implications caused in patients affected by SARS-CoV-2 infection, with emphasis on the presence of tachyarrhythmia on electrocardiogram (ECG) and decreased ejection fraction on echocardiogram.

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Section: Discussionmentioning

confidence: 99%

Covid-19 and Heart Involvement: A Systematic Review of Literature

Moraes¹,

Santos²,

Campos³

et al. 2023

International Journal of Cardiovascular Sciences

View full text Add to dashboard Cite

show abstract

“…Fever, headache, cough, exhaustion, breathing difficulties, and loss of smell and taste are all frequent symptoms. [ 1 ] The symptoms might be seen 1–15 days after the virus has been exposed. Some COVID-19-infected people do not show any signs or symptoms.…”

Section: Introductionmentioning

confidence: 99%

Awareness on current status of usage of ritonavir in the management of covid among dental students

Ramamoorthy

Ganapathy

Pandurangan

et al. 2022

Journal of Advanced Pharmaceutical Technology &Amp; Research

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Ritonavir's pharmacodynamics raise questions regarding whether medication concentrations high enough to block the SARS-CoV-2 proteases can be obtained. Ritonavir may have a therapeutic benefit at any stage of the disease, although pharmacodynamic issues and the absence of clinical benefit data among hospitalized COVID-19 patients cast doubt on this claim. To study the awareness on current status of usage of ritonavir in the management of COVID among dental students. This study, which is survey-based, involved a sample of 100 individuals and was carried out on the website Survey Planet. The study included undergraduate and graduate dental students. The dental students were given a questionnaire containing 10 questions. Their responses were gathered. The number and percentage were used to summarize the data. Dental students from Chennai showed adequate knowledge of COVID-19 in the medical environment. Postgraduate students were more aware about the current status of usage of Ritonavir for COVID-19. This study demonstrates the urgent necessity for all health-care workers to regularly implement educational interventions and training program on infection control procedures for COVID-19.

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Increased interleukin‐6 levels are associated with atrioventricular conduction delay in severe COVID‐19 patients

Accioli,

Lazzerini,

Salvini

et al. 2024

Journal of Arrhythmia

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BackgroundSeverely ill patients with coronavirus disease 2019 (COVID‐19) show an increased risk of new‐onset atrioventricular blocks (AVBs), associated with high rates of short‐term mortality. Recent data suggest that the uncontrolled inflammatory activation observed in these patients, specifically interleukin (IL)‐6 elevation, may play an important pathogenic role by directly affecting cardiac electrophysiology. The aim of our study was to assess the acute impact of IL‐6 changes on electrocardiographic indices of atrioventricular conduction in severe COVID‐19.MethodsWe investigated (1) the behavior of PR‐interval and PR‐segment in patients with severe COVID‐19 during active phase and recovery, and (2) their association with circulating IL‐6 levels over time.ResultsDuring active disease, COVID‐19 patients showed a significant increase of PR‐interval and PR‐segment. Such atrioventricular delay was transient as these parameters rapidly normalized during recovery. PR‐indices significantly correlated with circulating IL‐6 levels over time. All these changes and correlations persisted also in the absence of laboratory signs of cardiac strain/injury or concomitant treatment with PR‐prolonging drugs, repurposed or not.ConclusionsOur study provides evidence that in patients with severe COVID‐19 and high‐grade systemic inflammation, IL‐6 elevation is associated with a significant delay of atrioventricular conduction, independent of concomitant confounding factors. While transient, such alterations may enhance the risk of severe AVB and associated short‐term mortality. Our data provide further support to current anti‐inflammatory strategies for severe COVID‐19, including IL‐6 antagonists.

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Current evidence for the risk of PR prolongation, QRS widening, QT prolongation, from lopinavir, ritonavir, atazanavir, and saquinavir

Cited by 4 publications

References 40 publications

Covid-19 and Heart Involvement: A Systematic Review of Literature

Covid-19 and Heart Involvement: A Systematic Review of Literature

Awareness on current status of usage of ritonavir in the management of covid among dental students

Increased interleukin‐6 levels are associated with atrioventricular conduction delay in severe COVID‐19 patients

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