An Umbrella Review of Clinical Efficacy and Adverse Cardiac Events Associated with Hydroxychloroquine or Chloroquine with or Without Azithromycin in Patients with COVID-19

Overview

Journal Anesth Pain Med

Publisher Brieflands

Date 2021 Oct 25

PMID 34692436

Citations 13

Authors

Kavous Shahsavarinia

Morteza Ghojazadeh

Amir Ghabousian

Faezeh Hatefnia

Maryam Soleimanpour

Hassan Soleimanpour

Affiliations

Soon will be listed here.

Abstract

Context: The safety and efficacy of several repurposed drugs, including hydroxychloroquine and chloroquine, with or without azithromycin, were presumed to be miraculous in treating patients with COVID-19. However, as it later transpired, these therapeutic agents seem to be associated with critical adverse cardiac events.

Objectives: Given the skepticism around the advantages and disadvantages of the aforementioned treatment strategies, the present study aimed to investigate the clinical efficacy and cardiac toxicity of hydroxychloroquine or chloroquine with or without azithromycin in the setting of COVID-19 infection.

Method: This was an umbrella review conducted on patients with COVID-19 who received hydroxychloroquine or chloroquine with or without azithromycin from January 2020 to November 2020. We systematically searched PubMed, Scopus, Cochrane, ProQuest, Web of Science, and Embase databases.

Results: Three studies (systematic review and meta-analysis) were analyzed to evaluate the arrhythmogenic potential of hydroxychloroquine or chloroquine with or without azithromycin in patients with COVID-19 and identify the clinical efficacy of such a combination.

Conclusions: We found no benefit for patients with COVID-19 who received hydroxychloroquine or chloroquine alone or in combination with azithromycin. Moreover, it is noteworthy that these medications, particularly when considering co-administration, could result in both statistically and clinically elevated risks of notorious arrhythmias, such as TdP.

Citing Articles

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Sarbazi E, Sadeghi-Bazargani H, Sheikhalipour Z, Farahbakhsh M, Ala A, Soleimanpour H J Caring Sci. 2024; 13(2):116-137.

PMID: 39318733 PMC: 11417298. DOI: 10.34172/jcs.33152.

Stroke and COVID-19: An Umbrella Review.

Shahsavarinia K, Hajipoor Kashgsaray N, Ghojazadeh M, Falaki Z, Soleimanpour M, Soleimanpour H Arch Acad Emerg Med. 2024; 12(1):e65.

PMID: 39290764 PMC: 11407545. DOI: 10.22037/aaem.v12i1.2385.

Therapeutic Impact of Tocilizumab in the Setting of Severe COVID-19; an Updated and Comprehensive Review on Current Evidence.

Rezabakhsh A, Mojtahedi F, Tahsini Tekantapeh S, Mahmoodpoor A, Ala A, Soleimanpour H Arch Acad Emerg Med. 2024; 12(1):e47.

PMID: 38994467 PMC: 11239185. DOI: 10.22037/aaem.v12i1.2217.

High-Dose Vitamin C in the Treatment of Covid-19 Patients in Intensive Care Unit; A Letter to the Editor.

Balafar M, Mahmoodpoor A, Arjmandi H, Maddah Khelejani A, Soleimanpour H Arch Acad Emerg Med. 2024; 12(1):e41.

PMID: 38962363 PMC: 11221818. DOI: 10.22037/aaem.v12i1.2233.

Trust in primary health care and COVID-19 vaccine uptake among Iranian pediatric: a web-based cross-sectional survey.

Sarbazi E, Masoudi N, Mehri A, Esfanjani R, Azizi H, Soleimanpour M BMC Pediatr. 2024; 24(1):356.

PMID: 38778272 PMC: 11110261. DOI: 10.1186/s12887-024-04816-w.

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