Cardiovascular impact of COVID-19 with a focus on children: A systematic review

Table 11 Potential cardiovascular side-effects of the different drugs used against severe acute respiratory syndrome coronavirus 2 infection

Drugs	Cardiovascular adverse effect	Cardiovascular monitoring
Hydroxychloroquine	Vomiting with low-potassium levels. QT-prolonging and TdP. Conduction abnormalities; Heart block. Myocardial injury and Cardiomyopathy.	Monitor QTc interval, specially when using in combination with other QT-prolonging drugs and CYP3A4-inhibiting drugs. Monitor myocardial function by echocardiography and pro-BNP levels.
Azithromycin	QT-prolonging and TdP. Moderate CYP3A4 inhibitor.	Monitor QTc interval, specially when using in combination with other QT-prolonging drugs and CYP3A4-inhibiting drugs.
Lopinavir/Ritonavir	Vomiting with low-potassium levels. PR-prolonging. QT-prolonging and TdP. Major CYP3A4 inhibitor.	Monitor QTc interval, specially when using in combination with other QT-prolonging drugs and CYP3A4-inhibiting drugs.
Remdesivir	Limited data. Severe Hypotension and cardiac arrest after loading dose in Ebola patients. Possible CYP3A4 inducer.	Monitor Hemodynamics with infusion. Carful with unstable patients.
Steroids	Exacerbation of Lymphopenia. Can induce hypertension.	Monitor Hemodynamics with infusion. Monitor LVOTO in HCM by echocardiography. Careful in HCM.
Tocilizumab	Hypertension. Volume retention. Hypersensitivity. Increased lipid profile.	Monitor Hemodynamics with infusion. Monitor myocardial ischemia (ECG; Troponin). Careful in patients with myocardial dysfunction, chamber dilation or pulmonary edema.

SARS-CoV-2: Severe acute respiratory syndrome coronavirus 2; HCM: Hypertrophic cardiomyopathy.