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Investigation of QT Prolongation with Hydroxychloroquine and Azithromycin for the Treatment of COVID-19.

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OBJECTIVE To assess and identify the risk of prolonged QT about hydroxychloroquine (HQ) and azithromycin (AZ) used in the treatment of patients with COVID-19. STUDY DESIGN Cohort study. PLACE AND… Click to show full abstract

OBJECTIVE To assess and identify the risk of prolonged QT about hydroxychloroquine (HQ) and azithromycin (AZ) used in the treatment of patients with COVID-19. STUDY DESIGN Cohort study. PLACE AND DURATION OF STUDY Kartal Dr. Lütfi Kırdar City Hospital, İstanbul, Turkey, from March to May 2020. METHODOLOGY One hundred and forty-four patients with the diagnosis of COVID-19, confirmed by Rt-PCR (reverse transcription-polymerase chain reaction), were restrospectively reviewed. Patients who were hospitalised, received HQ or HQ plus AZ treatment, had a baseline electrocardiogram (ECG), and had at least one ECG after treatment were included in the study. Patients with missing data were excluded. RESULTS Fifty-one (35.4%) patients were given hydroxychloroquine monoterapy (HQ), 93 (64.6%) were given hydroxychloroquine plus azithromycin (HA), and 70 (48.6%) were women. Pre-treatment mean QTc measurements were calculated as 410.61 ± 29.44 milliseconds (ms) for HQ group and 412.02 ± 25.37 ms for HA group, while the mean values of post-treatment QTc measurements were calculated as 432.31 ± 33.97 ms for HQ group and 432.03 ± 27.0 ms for the HA group. Post-treatment QTc measurements of both HA group and HQ group were prolonged compared to pre-treatment measurements. Ventricular arrhythmia was not observed in any patient. CONCLUSION For COVID-19, no globally accepted definite treatment has yet been found. Both of hydroxychloroquine monotherapy and hydroxychloroquine plus azithromycin treatment regimens cause QTc measurement to increase at a statistically significant level. We concluded that this increase in QTc did not cause ventricular arrhythmia. Key Words: COVID-19, QTc interval, Hydroxychloroquine, Azithromycin.

Keywords: azithromycin treatment; hydroxychloroquine; treatment; hydroxychloroquine azithromycin; group

Journal Title: Journal of the College of Physicians and Surgeons--Pakistan : JCPSP
Year Published: 2020

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