Modelling sudden cardiac death risks factors in patients with coronavirus disease of 2019: the hydroxychloroquine and azithromycin case

Abstract Aims Coronavirus disease of 2019 (COVID-19) has rapidly become a worldwide pandemic. Many clinical trials have been initiated to fight the disease. Among those, hydroxychloroquine and azithromycin had initially suggested improve outcomes. Despite any demonstrated beneficial effects, they are still in use some countries but reported prolong QT interval induce life-threatening arrhythmia. Since significant proportion world population may be treated with such COVID-19 therapies, evaluation arrhythmogenic risk candidate drug is needed. Methods results Using O'Hara-Rudy computer model human ventricular wedge, we evaluate potential factors that can further alter repolarization patients addition (HCQ) (AZM) as tachycardia, hypokalaemia, subclinical mild long syndrome. Hydroxychloroquine AZM drugs little impact on duration do not substrate prone arrhythmia normal cardiac reserve. Nevertheless, every tested condition which this reserve reduced, predicts larger electrocardiogram impairments, dofetilide. In conditions, suggests mexiletine limits deleterious effects HCQ. Conclusion By studying HCQ co-administration case, show easy-to-use applied assess QT-prolongation off-label drugs, beyond AZM, different conditions representative additional used limit risk.