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Common antivirals may lead to heart failure in COVID-19 patients

Common antivirals may lead to heart failure in COVID-19 patients
Doctors prescribing these drugs should be aware of the potential for bradycardia and carefully monitor patients.

A new research says that a combination of lopinavir and ritonavir may lead to adverse complications in older patients with COVID-19. Read on to know more.

Written by Jahnavi Sarma |Published : July 11, 2020 6:55 PM IST

In their quest to find an effective vaccine for the COVID-19 virus, researchers are looking at many existing drugs and vaccines that may help in fighting this disease. They are also considering may existing antiviral drugs as an option. Clinical trials for the same have also been conducted and results remain positive in most of the cases. But now, a new research says that a combination of lopinavir and ritonavir may lead to adverse complications in older patients with COVID-19.

According to French researchers, older, critically ill COVID-19 patients who are given a combination of these two common antiretroviral drugs can experience a drastic slowing of their heart rate. In a new study at Amiens University Hospital, in France, and the University of California, Los Angeles, researchers saw that out of 41 patients treated with lopinavir and ritonavir twice daily for 10 days, 22 per cent developed a slow heart rate condition called bradycardia. When the drugs were stopped or doses lowered, the patients' heart rates returned to normal. They say that extensive investigations are underway to find therapies that are effective at treating patients infected with COVID-19. The journal Circulation: Arrhythmia and Electrophysiology published this study.

Lopinavir-ritonavir combo may lead to bradycardia

The lopinavir-ritonavir combo had been considered a promising treatment for COVID-19 based on very small reports, randomized clinical trials and off-label use. But earlier studies have suggested that this combination may also lead to heart block, a problem with electrical signals in the heart. Researchers are now saying that determining how these drugs lead to the bradycardia will require further study. Doctors prescribing these drugs should be aware of the potential for bradycardia and carefully monitor patients, they added.

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Older patients more likely to experience complications

Patients in the French study who developed the problem were older than ones who did not, averaging 62 to 80 years of age. The two-drug combo had not helped hospitalized COVID-19 patients in other recent trials. Researchers warn that the treatment should not be used with COVID-19 because it's not effective in either critically ill patients or in the early stages of the disease. They further add that this combination of drugs may work in early disease progression. But the significant amount of bradycardia in these critically ill patients raises the question that this combo is not well tolerated in many patients.

Heart failure is a real danger

Lopinavir and ritonavir have also been used to treat other viruses, including SARS (severe acute respiratory syndrome), MERS (Middle East respiratory syndrome) and HIV. The researchers noted that bradycardia has also been seen among HIV patients treated with the drugs. Normally, adults' hearts beat between 60 and 100 times a minute. In bradycardia, the rate falls below 60 beats per minute, causing decreased blood flow that can lead to fainting, chest pain, low blood pressure and heart failure. However, it is to be noted that another experimental antiviral drug remdesivir appears to be effective. This is already being to treat COVID-19 patients.

(With inputs from Agencies)