Key Information
Patients with systemic amyloidosis should be considered at increased risk of complications and mortality in case of SARS-CoV2 infection. This may be particularly relevant for patients with heart involvement, because subjects with SARS-CoV2 infection and pre-existing cardiovascular disease have an increased risk of severe clinical manifestations and death. The infection has been associated with cardiovascular complications, and therapies under investigation for COVID-19 may have cardiovascular side effects.
In particular, COVID-19 treatment commonly includes hydroxychloroquine and azithromycin. This combination is associated with the risk of ventricular arrhythmias related to QT prolongation, and if started, close cardiological monitoring or at least regular ECG with QTc is required. This is particularly relevant in patients with amyloid cardiac involvement. In addition, patients with renal involvement might be more susceptible to COVID-19, since they have impaired humoral immunity.