Antimalarial and cytotoxic drugs on COVID-19 and the cardiovascular burden: Literature review and lessons to be learned.
Vascular
; 29(2): 220-227, 2021 Apr.
Article
in English
| MEDLINE | ID: covidwho-660824
ABSTRACT
BACKGROUND:
The world is witnessing an unprecedented crisis with Coronavirus disease 2019 (COVID-19). It is important to accurately analyze the available evidence to provide correct clinical guidance for optimal patient care. We aim to discuss current clinical evidence regarding chloroquine, hydroxychloroquine, azithromycin, remdesivir, and the cardiovascular burden of COVID-19.METHODS:
A literature review was performed using PubMed and Google Scholar. Additional clinical trials were identified through the "TrialsTracker" project.RESULTS:
We found conflicting evidence of chloroquine, hydroxychloroquine plus azithromycin, and remdesivir in COVID-19 despite promising early reports of in vitro antiviral activity against severe acute respiratory syndrome coronavirus 2. Some of the current studies have demonstrated adverse drug reactions to chloroquine and hydroxychloroquine + azithromycin. Widespread systemic inflammation and procoagulant/hypercoagulable state, including thrombotic microangiopathy, endothelial dysfunction, bleeding disorder, and thrombosis are increasingly being witnessed in COVID-19. Evidence of cardiac injury and stroke is mostly reported in hospitalized patients; however, large specialized studies that focus on cardiac or neuropathology are lacking.DISCUSSION:
There is no convincing clinical evidence of chloroquine, hydroxychloroquine with or without azithromycin, and remdesivir use in COVID-19. As evidence of systemic inflammation is rapidly unfolding, there is a dire need to maximize our resources to find the best possible solutions to the current crisis while conclusive evidence from clinical trials emerges.Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Cardiovascular Diseases
/
Adenosine Monophosphate
/
Chloroquine
/
Azithromycin
/
Alanine
/
Chemically-Induced Disorders
/
COVID-19 Drug Treatment
Type of study:
Observational study
/
Prognostic study
/
Reviews
Limits:
Humans
Language:
English
Journal:
Vascular
Journal subject:
Vascular Diseases
/
Cardiology
Year:
2021
Document Type:
Article
Affiliation country:
1708538120941635
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