Abstract

JACOBO-VARGAS, Thalia Berenice; OROZCO-GUTIERREZ, Juan José  and  RIVERO-MARTINEZ, Jesús Arturo. Early bradycardia in patients with COVID-19 and triple therapy. Cardiovasc. metab. sci [online]. 2021, vol.32, n.1, pp.22-31.  Epub Mar 19, 2024. ISSN 2954-3835.  https://doi.org/10.35366/98227.

Because there is still no effective medical treatment for COVID-19, off-label drugs have been used such as hydroxychloroquine or chloroquine, lopinavir/ritonavir and/or azithromycin, whose safety information is limited with the risk of developing potential cardiac adverse effects. In order to contribute with the safety information about combined drugs used in COVID-19, we used the CARE Guidelines: Consensus based Clinical Case Reporting Guideline Development by EQUATOR Network (Enhancing the Quality and Transparency of Health Research) to present four patients, without known cardiac pathology or evidence of cardiac rhythm disorders, who developed early sinus bradycardia, 1 to 3 days after the concomitant use of triple therapy with hydroxychloroquine, lopinavir/ritonavir and azithromycin, which solved after the suspension of one or more of the mentioned medications. These cases contribute to improving the awareness of safety concerns about the past use of off-label drugs for COVID-19. The risk of bradycardia with the triple therapy presented should be considered.

Keywords : Bradycardia; COVID-19; hydroxychloroquine; azithromycin; lopinavir-ritonavir drug combination.

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