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10.1016/j.ijcard.2020.05.036

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suck abstract from ncbi


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pmid32439366      Int+J+Cardiol 2020 ; 316 (ä): 280-284
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  • Arrhythmic profile and 24-hour QT interval variability in COVID-19 patients treated with hydroxychloroquine and azithromycin #MMPMID32439366
  • Cipriani A; Zorzi A; Ceccato D; Capone F; Parolin M; Donato F; Fioretto P; Pesavento R; Previato L; Maffei P; Saller A; Avogaro A; Sarais C; Gregori D; Iliceto S; Vettor R
  • Int J Cardiol 2020[Oct]; 316 (ä): 280-284 PMID32439366show ga
  • BACKGROUND: Hydroxychloroquine and azithromycin combination therapy is often prescribed for coronavirus disease 2019 (COVID-19). Electrocardiographic (ECG) monitoring is warranted because both medications cause corrected QT-interval (QTc) prolongation. Whether QTc duration significantly varies during the day, potentially requiring multiple ECGs, remains to be established. METHODS: We performed 12?lead ECGs and 12?lead 24-h Holter ECG monitoring in all patients aged <80 years admitted to our medical unit for COVID-19, in oral therapy with hydroxychloroquine (200 mg, twice daily) and azithromycin (500 mg, once daily) for at least 3 days. A group of healthy individuals matched for age and sex served as control. RESULTS: Out of 126 patients, 22 (median age 64, 82% men) met the inclusion criteria. ECG after therapy showed longer QTc-interval than before therapy (450 vs 426 ms, p = .02). Four patients had a QTc >/= 480 ms: they showed higher values of aspartate aminotransferase (52 vs 30 U/L, p = .03) and alanine aminotransferase (108 vs 33 U/L, p < .01) compared with those with QTc < 480 ms. At 24-h Holter ECG monitoring, 1 COVID-19 patient and no control had >/=1 run of non-sustained ventricular tachycardia (p = .4). No patients showed "R on T" premature ventricular beats. Analysis of 24-h QTc dynamics revealed that COVID-19 patients had higher QTc values than controls, with no significant hourly variability. CONCLUSION: Therapy with hydroxychloroquine and azithromycin prolongs QTc interval in patients with COVID-19, particularly in those with high levels of transaminases. Because QTc duration remains stable during the 24 h, multiple daily ECG are not recommendable.
  • |*Azithromycin/administration & dosage/adverse effects[MESH]
  • |*Hydroxychloroquine/administration & dosage/adverse effects[MESH]
  • |*Long QT Syndrome/chemically induced/complications/diagnosis[MESH]
  • |*Pandemics[MESH]
  • |Antiviral Agents/administration & dosage/adverse effects[MESH]
  • |Betacoronavirus/isolation & purification[MESH]
  • |COVID-19[MESH]
  • |Coronavirus Infections/diagnosis/*drug therapy/physiopathology[MESH]
  • |Death, Sudden, Cardiac/etiology/prevention & control[MESH]
  • |Drug Monitoring/methods[MESH]
  • |Electrocardiography/*methods[MESH]
  • |Female[MESH]
  • |Hospitalization/statistics & numerical data[MESH]
  • |Humans[MESH]
  • |Male[MESH]
  • |Middle Aged[MESH]
  • |Outcome and Process Assessment, Health Care[MESH]
  • |Pneumonia, Viral/diagnosis/*drug therapy/physiopathology[MESH]


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