Elsevier

Mayo Clinic Proceedings

Volume 95, Issue 6, June 2020, Pages 1213-1221
Mayo Clinic Proceedings

Special article
Urgent Guidance for Navigating and Circumventing the QTc-Prolonging and Torsadogenic Potential of Possible Pharmacotherapies for Coronavirus Disease 19 (COVID-19)

https://doi.org/10.1016/j.mayocp.2020.03.024Get rights and content

Abstract

As the coronavirus disease 19 (COVID-19) global pandemic rages across the globe, the race to prevent and treat this deadly disease has led to the “off-label” repurposing of drugs such as hydroxychloroquine and lopinavir/ritonavir, which have the potential for unwanted QT-interval prolongation and a risk of drug-induced sudden cardiac death. With the possibility that a considerable proportion of the world’s population soon could receive COVID-19 pharmacotherapies with torsadogenic potential for therapy or postexposure prophylaxis, this document serves to help health care professionals mitigate the risk of drug-induced ventricular arrhythmias while minimizing risk of COVID-19 exposure to personnel and conserving the limited supply of personal protective equipment.

Abbreviations and Acronyms

COVID-19
coronavirus disease 19
DI-SCD
drug-induced sudden cardiac death
DI-TdP
drug-induced torsades de pointes
ECG
electrocardiogram
FDA
Food and Drug Administration
LQTS
long QT syndrome
PPE
personal protective equipment
SARS-CoV-2
severe acute respiratory syndrome coronavirus 2

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Grant Support: This work was supported by the Mayo Clinic Windland Smith Rice Comprehensive Sudden Cardiac Death Program.

Potential Competing Interests: Dr Ackerman is a consultant for Abbott, Audentes Therapeutics, BIOTRONIK SE & Co. KG, Boston Scientific Corporation, Invitae Corporation, LQT Therapeutics Inc, Medtronic, and MyoKardia. Drs Noseworthy, Friedman, and Ackerman and Mayo Clinic are involved in an equity/royalty relationship with AliveCor, Inc (not involved in this study). Dr Giudicessi reports no competing interests.

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