Effect of Hydroxychloroquine and Azithromycin on QT Interval Prolongation and Other Cardiac Arrhythmias in COVID-19 Confirmed Patients
Background. Hydroxychloroquine with or without azithromycin was one of the common therapies at the beginning of the COVID-19 pandemic. They can prolong QT interval, cause torsade de pointes, and lead to sudden cardiac death. We aimed to assess QT interval prolongation and its risk factors in patient...
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| Format: | Article |
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Wiley
2021-01-01
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| Series: | Cardiovascular Therapeutics |
| Online Access: | http://dx.doi.org/10.1155/2021/6683098 |
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| author | Seyed Parsa Eftekhar Sohrab Kazemi Mohammad Barary Mostafa Javanian Soheil Ebrahimpour Naghmeh Ziaei |
| author_facet | Seyed Parsa Eftekhar Sohrab Kazemi Mohammad Barary Mostafa Javanian Soheil Ebrahimpour Naghmeh Ziaei |
| author_sort | Seyed Parsa Eftekhar |
| collection | DOAJ |
| description | Background. Hydroxychloroquine with or without azithromycin was one of the common therapies at the beginning of the COVID-19 pandemic. They can prolong QT interval, cause torsade de pointes, and lead to sudden cardiac death. We aimed to assess QT interval prolongation and its risk factors in patients who received hydroxychloroquine with or without azithromycin. Methods. This study was a retrospective cohort study. One hundred seventy-two confirmed COVID-19 patients were included in this study, hospitalized at Babol University of Medical Sciences hospitals between March 5, 2020, and April 3, 2020. Patients were divided into two groups: hydroxychloroquine alone and hydroxychloroquine with azithromycin. Electrocardiograms were used for outcome assessment. Results. 83.1% of patients received hydroxychloroquine plus azithromycin vs. 16.9% of patients who received only hydroxychloroquine. The mean age of patients was 59.2±15.4.The mean of posttreatment QTc interval in the monotherapy group was shorter than the mean of posttreatment QTc interval in the combination therapy group, but it had no significant statistical difference (462.5±43.1 milliseconds vs. 464.3±59.1 milliseconds; p=0.488). Generally, 22.1% of patients had a prolonged QTc interval after treatment. Male gender, or baseline QTc≥450 milliseconds, or high-risk Tisdale score increased the likelihood of prolonged QTc interval. Due to QTc prolongation, fourteen patients did not continue therapy after four days. Conclusions. Hospitalized patients treated by hydroxychloroquine with or without azithromycin had no significant difference in prolongation of QT interval and outcome. The numbers of patients with prolonged QT intervals in this study emphasize careful cardiac monitoring during therapy, especially in high-risk patients. |
| format | Article |
| id | doaj-art-e0d20340568a4d21bcc5275111224169 |
| institution | Kabale University |
| issn | 1755-5914 1755-5922 |
| language | English |
| publishDate | 2021-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Cardiovascular Therapeutics |
| spelling | doaj-art-e0d20340568a4d21bcc52751112241692025-02-03T06:05:27ZengWileyCardiovascular Therapeutics1755-59141755-59222021-01-01202110.1155/2021/66830986683098Effect of Hydroxychloroquine and Azithromycin on QT Interval Prolongation and Other Cardiac Arrhythmias in COVID-19 Confirmed PatientsSeyed Parsa Eftekhar0Sohrab Kazemi1Mohammad Barary2Mostafa Javanian3Soheil Ebrahimpour4Naghmeh Ziaei5Student Research Committee, Health Research Center, Babol University of Medical Sciences, Babol, IranCellular and Molecular Biology Research Center, Health Research Center, Babol University of Medical Sciences, Babol, IranStudent Research Committee, Health Research Center, Babol University of Medical Sciences, Babol, IranInfectious Diseases and Tropical Medicine Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, IranInfectious Diseases and Tropical Medicine Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, IranDepartment of Cardiology, Babol University of Medical Sciences, Babol, IranBackground. Hydroxychloroquine with or without azithromycin was one of the common therapies at the beginning of the COVID-19 pandemic. They can prolong QT interval, cause torsade de pointes, and lead to sudden cardiac death. We aimed to assess QT interval prolongation and its risk factors in patients who received hydroxychloroquine with or without azithromycin. Methods. This study was a retrospective cohort study. One hundred seventy-two confirmed COVID-19 patients were included in this study, hospitalized at Babol University of Medical Sciences hospitals between March 5, 2020, and April 3, 2020. Patients were divided into two groups: hydroxychloroquine alone and hydroxychloroquine with azithromycin. Electrocardiograms were used for outcome assessment. Results. 83.1% of patients received hydroxychloroquine plus azithromycin vs. 16.9% of patients who received only hydroxychloroquine. The mean age of patients was 59.2±15.4.The mean of posttreatment QTc interval in the monotherapy group was shorter than the mean of posttreatment QTc interval in the combination therapy group, but it had no significant statistical difference (462.5±43.1 milliseconds vs. 464.3±59.1 milliseconds; p=0.488). Generally, 22.1% of patients had a prolonged QTc interval after treatment. Male gender, or baseline QTc≥450 milliseconds, or high-risk Tisdale score increased the likelihood of prolonged QTc interval. Due to QTc prolongation, fourteen patients did not continue therapy after four days. Conclusions. Hospitalized patients treated by hydroxychloroquine with or without azithromycin had no significant difference in prolongation of QT interval and outcome. The numbers of patients with prolonged QT intervals in this study emphasize careful cardiac monitoring during therapy, especially in high-risk patients.http://dx.doi.org/10.1155/2021/6683098 |
| spellingShingle | Seyed Parsa Eftekhar Sohrab Kazemi Mohammad Barary Mostafa Javanian Soheil Ebrahimpour Naghmeh Ziaei Effect of Hydroxychloroquine and Azithromycin on QT Interval Prolongation and Other Cardiac Arrhythmias in COVID-19 Confirmed Patients Cardiovascular Therapeutics |
| title | Effect of Hydroxychloroquine and Azithromycin on QT Interval Prolongation and Other Cardiac Arrhythmias in COVID-19 Confirmed Patients |
| title_full | Effect of Hydroxychloroquine and Azithromycin on QT Interval Prolongation and Other Cardiac Arrhythmias in COVID-19 Confirmed Patients |
| title_fullStr | Effect of Hydroxychloroquine and Azithromycin on QT Interval Prolongation and Other Cardiac Arrhythmias in COVID-19 Confirmed Patients |
| title_full_unstemmed | Effect of Hydroxychloroquine and Azithromycin on QT Interval Prolongation and Other Cardiac Arrhythmias in COVID-19 Confirmed Patients |
| title_short | Effect of Hydroxychloroquine and Azithromycin on QT Interval Prolongation and Other Cardiac Arrhythmias in COVID-19 Confirmed Patients |
| title_sort | effect of hydroxychloroquine and azithromycin on qt interval prolongation and other cardiac arrhythmias in covid 19 confirmed patients |
| url | http://dx.doi.org/10.1155/2021/6683098 |
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