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Review
. 2020 Sep;17(9):1487-1492.
doi: 10.1016/j.hrthm.2020.04.045. Epub 2020 May 5.

Genetic susceptibility for COVID-19-associated sudden cardiac death in African Americans

John R Giudicessi  1 , Dan M Roden  2 , Arthur A M Wilde  3 , Michael J Ackerman  4
Affiliations
Review

Genetic susceptibility for COVID-19-associated sudden cardiac death in African Americans

John R Giudicessi et al. Heart Rhythm. 2020 Sep.
No abstract available

Keywords: COVID-19; Genetics; Health disparities; Long QT syndrome; Sudden cardiac death.

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Figures

Figure 1
Figure 1
Potential gene-environment interactions leading to an increased risk of ventricular arrhythmias and sudden cardiac death in p.Ser1103Tyr-SCN5A–positive patients with COVID-19. APD = action potential duration; CHF = congestive heart failure; CKD = chronic kidney disease; COPD = chronic obstructive pulmonary disease; COVID-19 = coronavirus disease 2019; IL-6 = interleukin-6; INa = sodium current; QTc = heart rate–corrected QT; SARS-CoV-2 = severe acute respiratory syndrome coronavirus 2; SCD = sudden cardiac death; SSRI = selective serotonin reuptake inhibitor; VA = ventricular arrhythmia.
Figure 2
Figure 2
Proposed approach to mitigating the risk of DI-TdP/DI-SCD in patients with COVID-19 treated with ≥1 QTc-prolonging drug. The estimated 99th percentile QTc values, derived from otherwise healthy individuals, that place a patient in the “green light” category are <460 ms before puberty, <470 ms in men, and <480 ms in women. We estimate that the baseline QTc assessment will place 90% in the “green light,” 9% in the “yellow light,” and 1% in the “red light” category. No randomized controlled trial data are available to support the clinical efficacy of any of the COVID-19–directed QTc-prolonging drugs despite the Food and Drug Administration’s Emergency Use Approval of hydroxychloroquine. COVID-19 = coronavirus disease 19; CV = cardiovascular; DI-SCD = drug-induced sudden cardiac death; DI-TdP = drug-induced torsades de pointes; ECG = electrocardiogram; QTc = heart rate–corrected QT; SARS-CoV-2 = severe acute respiratory syndrome coronavirus 2; TdP = torsades de pointes. Adapted from Giudicessi et al, with permission. Copyright © Elsevier, 2020.
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