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Cardiovascular Considerations in Treating Patients With Coronavirus Disease 2019 (COVID-19)

Dave L Dixon1,2, Benjamin W Van Tassell1,2, Alessandra Vecchié2

  • 1Department of Pharmacotherapy and Outcomes Science, Virginia Commonwealth University School of Pharmacy, Richmond, VA.

Journal of Cardiovascular Pharmacology
|April 14, 2020
PubMed

Insights

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes COVID-19, leading to cardiovascular complications. This review details the pharmacology of potential treatments for cardiovascular patients with COVID-19.

Area of Science:

  • Virology and Epidemiology
  • Cardiovascular Medicine
  • Pharmacology

Background:

  • Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged in December 2019, causing a global pandemic.
  • Coronavirus disease 2019 (COVID-19) presents a higher mortality rate than seasonal influenza, particularly impacting older adults and those with cardiovascular disease.
  • Reported cardiovascular sequelae of COVID-19 include myocarditis, acute myocardial infarction, and heart failure.

Purpose of the Study:

  • To review the pharmacology of emerging therapies for COVID-19.
  • To provide cardiovascular clinicians with essential information on these treatments for patients with cardiovascular conditions.
  • To contextualize the use of remdesivir, hydroxychloroquine/chloroquine, and IL-6 inhibitors in managing COVID-19 patients with cardiovascular risks.

Main Methods:

  • Literature review of pharmacological properties of key COVID-19 therapies.
  • Analysis of existing clinical trial data and off-label usage.
  • Synthesis of information relevant to cardiovascular clinicians.

Main Results:

  • Several therapies, including remdesivir, hydroxychloroquine/chloroquine, and IL-6 inhibitors, are under investigation for COVID-19.
  • These treatments are not standard for cardiovascular clinicians, necessitating a review of their mechanisms and applications.
  • Understanding the pharmacology is crucial for safe and effective management of COVID-19 in patients with cardiovascular disease.

Conclusions:

  • Cardiovascular clinicians require specific knowledge regarding the pharmacology of COVID-19 treatments.
  • This review aims to bridge the knowledge gap concerning remdesivir, hydroxychloroquine/chloroquine, and IL-6 inhibitors in cardiovascular patients.
  • Informed application of these therapies can improve outcomes for COVID-19 patients with co-existing cardiovascular conditions.

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