Table 2.

Current therapeutic considerations and concerns with cardiovascular treatment in COVID-19.

Drug	Consideration		Concerns
Antiplatelets	Chronic antiplatelet therapy should be continued if no contraindications COVID-19 patients not requiring hospitalization should not be given antiplatelet therapy for prevention of VTE		Active bleeding Increased risk of bleeding with ticagrelor and decreased antiplatelet activity with clopidogrel in patients receiving lopinavir/ritonavir treatment
	P2Y12 inhibitors	Clopidogrel is preferred in patients receiving fibrinolytics Prasugrel is recommended with lopinavir/ritonavir treatment
	Glycoprotein IIb/IIIa inhibitors	Should be avoided	Increased risk of bleeding
Anticoagulants	Chronic anticoagulation therapy should be continued if no contraindications COVID-19 patients not requiring hospitalization should not be given anticoagulation therapy for prevention of VTE Prophylactic dose of LMWH is recommended for hospitalized COVID-19 patients UFH may be considered in case of severe renal impairment or RRT Fondaparinux is preferred in patients with HIT		Increased risk of bleeding DOACs not recommended with lopinavir/ritonavir treatment
ACEi/ARB	Chronic therapy should be continued if indicated		Decreased effect of losartan and irbesartan can be expected in patients receiving lopinavir/ritonavir treatment
Diuretics	Loop diuretics can be safely administered		Concentration of indapamide increases with lopinavir/ritonavir treatment
Mineralocorticoid receptor antagonists	Spironolactone is preferred		Increased risk of adverse effect with lopinavir/ritonavir treatment
Statins	Statin therapy should be continued with periodical liver function monitoring		Dose reduction should be considered in patients receiving lopinavir/ritonavir treatment
Beta-blockers	Beta-1 selective beta-blockers are preferred (metoprolol and bisoprolol)		Higher risk of bradyarrhythmias and hypotension with concomitant use of protease inhibitors
Antiarrhythmics	Monitor ECG and serum electrolyte levels before initiation		Increased risk of QT prolongation and TdP with chloroquine/hydroxychloroquine Increased antiarrhythmic effects with protease inhibitors

ACEi: angiotensin-converting enzyme inhibitor; ARB: angiotensin receptor blocker; DOACs: direct oral anticoagulants; HIT: heparin-induced thrombocytopenia.