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. 2021 Dec 9;146:112518. doi: 10.1016/j.biopha.2021.112518

Table 1.

List of currently approved and investigational treatments for COVID-19 and their potential cardiac side effects.

Class Drug Mechanism Efficacy and Dosing Potential cardiac side effects
Antiviral Remdesivir Nucleotide analog and inhibits viral RNA-dependent RNA polymerase In hospitalized patients not requiring mechanical ventilation; 200 mg IV initially and then 100 mg once daily for 4–9 days (total 5–10 days) [103] QT prolongation, Bradycardia.
Favipiravir RNA polymerase inhibitor Limited data; high-quality trials are ongoing. QTc prolongation (maybe due to combination with other antivirals) [104], [105]
Lopinavir/Ritonavir Lopinavir is a protease inhibitor. Ritonavir increases bioavailability of lopinavir via CYP3A4 inhibition. Role in COVID-19 treatment is controversial. Low-density Lipoprotein (LDL) elevation leading to cardiovascular disease (CVD), QT prolongation [106], [107]
Molnupiravir Enhances viral RNA mutations and impairs virus replication [108] Phase 3 clinical trials still ongoing – 200/400/800 mg twice daily for 5 days [109] No significant side effects
Oseltamivir Neuraminidase inhibitor [110] Limited data on efficacy against COVID-19 No significant side effects
Umifenovir Inhibition of viral membrane fusion [111] Limited data on efficacy against COVID-19. 200 mg PO (1 capsule is 100 mg) thrice a day for up to 14 days [112] No significant side effects
Glucocorticoids Dexamethasone Immunosuppressive and an anti-inflammatory agent Reduces all-cause mortality in hospitalized patients with severe COVID-19 disease. Administered as 6 mg IV daily for 10 days or until discharge. Decreased resting heart rate [113]
Immunosuppressants Tocilizumab IL-6 receptor blocker Reduces all-cause mortality in hospitalized patients requiring supplemental oxygen within 24 h of admission to ICU. 400 mg IV – one dose only [114] Increased risk of secondary infections. Avoid use in conjunction with JK inhibitors.
Barcitinib Janus-kinase inhibitor May reduce all-cause mortality in hospitalized COVID-19 patients requiring supplemental oxygen or non-invasive ventilation. 4 mg PO once daily for up to 14 days [115] Do not use in conjunction with IL-6 inhibitors.