Senior Interventional Cardiologist talks about the precaution heart patient should take during ongoing covid-19 pandemic

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In patients taking drugs like ACE inhibitors and ARB blockers there is up-regulation of ACE receptors through which coronavirus act.

Senior Interventional Cardiologist and Educator at Dr Ram Manohar Lohiya hospital (Delhi), Dr. Tarun Kumar, DM (Cardiology) FESC, FSCAI, is our guest on Medlarge for Doctor Says Column this time to talk on the precaution heart patients should take during ongoing corona pandemic. Read on the interview.

1. How much the heart patient is at risk of coronavirus and what precautions need to be taken to prevent viral infection?

Persons associated with Heart problems, Blood Pressure or Asthma need to take extra care during the ongoing corona pandemic. If such a patient is found corona positive, the death risk increases many folds. These people must avoid going outside and prevent external exposure as much as they can. These people must avoid going outside and follow proper social distancing and Hand hygiene measures. As the age of patient increases mortality associated with coronavirus infection increases. Most vulnerable are elderly patients with multiple comorbidities.

2.  Does the Heart-related medicine impact on corona in anyways

 Generally, patients associated with heart disease and BP take medicines such as ACE inhibitors or ARB Blockers etc. In patients taking drugs like ACE inhibitors and ARB blockers there is up-regulation of ACE receptors through which coronavirus act. These are the receptors where coronavirus attacks more and affects more. There is a possibility of the virus coming through those receptors. Such receptors can occur in many places like lungs, heart and in other tissues. Therefore, the possibility of coronavirus attack increases through these receptors. There is a chance of being more vulnerable to corona for such patients using these medicines. However, no advise has been given by any organisation or institution to change or stop using such medicines.  

3.  One medicine – Hydroxychloroquine is in discussion currently, claiming that it can prevent corona infection. Can heart patients also take it?

Hydroxychloroquine can cause heart rhythm abnormalities. It has a propensity to prolong QT interval and can lead to tachyarrhythmias which can lead to sudden death. Heart patients need to get their baseline ECG and monitor their QT interval if they are planning to take HCQ.

4. What is the need for people with hypertension?

People with hypertension especially need to be more careful during this pandemic. If one is taking the medicines of BP and Heart along with Hydroxychloroquine for corona then one should take special care. Especially, one should avoid drugs like Diuretics, Sotalol and some antiarrhythmic drugs along with HCQ as they likely to prolong QT interval.

5. Does Hydroxychloroquine prevent infection?

The regular intake of Hydroxychloroquine lowers the chances of catching corona infection. In some trials, we have seen that it has acted positively and has proved beneficial. Also, we don’t have much more option to prevent this infection, so this is the only alternative we have left. The drugs like Remdesivir, Tocilizumab and plasma therapy can be tried in severe cases. However, Remdesivir is currently not available in India. HCQ can be used for both prophylaxis and treatment for coronavirus infection.

Dr. Tarun Kumar, DM (Cardiology) FESC, FSCAI.

Senior Interventional Cardiologist and Educator, Dr Ram Manohar Lohiya hospital (Delhi)

Over fifty national and international publications is to his credit in reputed journals.