Covid -19 is often more serious in older people. In an effort to help minimize infection risk for seniors, HEB and Favor have partnered to provide safe delivery of groceries for them at a minimal additional cost.
I’ve previously written about the concerns of using hydroxychloroquine and/or azithromycin(zithromax) for Covid-19 infections due to the unproven effectiveness and the concerns of cardiac side effects especially in people with underlying heart disease or those who are on medications that can affect the heart’s electrical activity. The following is a statement by the American Heart Association and the American College of Cardiology.
Joint Statement Issued on Reducing
Arrhythmia Risk With COVID-19
Diana Ernst, RPh
Cardiovascular complications should be considered when hydroxychloroquine and azithromycin are
used to treat patients with coronavirus disease 2019 (COVID-19), according to new guidance jointly
published by the American Heart Association (AHA), the American College of Cardiology (ACC) and
the Heart Rhythm Society (HRS).
Although not approved by the Food and Drug Administration (FDA) for COVID-19,
hydroxychloroquine and azithromycin have been gaining momentum as potential treatments based on
results of small studies. However, these agents are associated with cardiac effects that could
potentially be harmful to patients, especially those with existing cardiovascular disease.
Specifically, both drugs can prolong the QT interval ( this is a measurement of part of the cardiac cycle), increasing the risk of arrhythmias and Torsades de
Pointes ( a type of ventricular arrhythmia that may result in death). In addition, life-threatening and fatal cardiomyopathy has been reported with the use of
hydroxychloroquine, as well as with chloroquine. In severely ill COVID-19 patients, comorbidities such
as hypokalemia(low potassium), hypomagnesemia (low magnesium), and fever can increase the risk of arrhythmia.
The new recommendations provided by the organizations detail these important cardiovascular
considerations and offer ways of minimizing the risk of arrhythmias. These include:
Magnesium levels >2mg/dL
Avoiding other QTc prolonging agents whenever feasible:
These may include quinolones, antifungals, atypical antipsychotics, antidepressants and
opioids, among others.
Additionally, the statement includes a table indicating the number of cases of adverse cardiac events
associated with therapies repurposed for COVID-19 such as chloroquine, hydroxychloroquine,
lopinavir/ritonavir, and azithromycin.
It is also recommended that patients beginning these medications have a baseline ECG.