Article ; Online: Experience With Hydroxychloroquine and Azithromycin in the Coronavirus Disease 2019 Pandemic: Implications for QT Interval Monitoring.
Journal of the American Heart Association
2020 Volume 9, Issue 12, Page(s) e017144
Abstract: Background Despite a lack of clinical evidence, hydroxychloroquine and azithromycin are being ... may increase risk of lethal arrhythmias associated with QT interval prolongation. Methods and Results ... We evaluated baseline and postmedication QT interval (corrected QT interval [QTc]; Bazett) using 12-lead ECGs ...
| Abstract | Background Despite a lack of clinical evidence, hydroxychloroquine and azithromycin are being administered widely to patients with verified or suspected coronavirus disease 2019 (COVID-19). Both drugs may increase risk of lethal arrhythmias associated with QT interval prolongation. Methods and Results We analyzed a case series of COVID-19-positive/suspected patients admitted between February 1, 2020, and April 4, 2020, who were treated with azithromycin, hydroxychloroquine, or a combination of both drugs. We evaluated baseline and postmedication QT interval (corrected QT interval [QTc]; Bazett) using 12-lead ECGs. Critical QTc prolongation was defined as follows: (1) maximum QTc ≥500 ms (if QRS <120 ms) or QTc ≥550 ms (if QRS ≥120 ms) and (2) QTc increase of ≥60 ms. Tisdale score and Elixhauser comorbidity index were calculated. Of 490 COVID-19-positive/suspected patients, 314 (64%) received either/both drugs and 98 (73 COVID-19 positive and 25 suspected) met study criteria (age, 62±17 years; 61% men). Azithromycin was prescribed in 28%, hydroxychloroquine in 10%, and both in 62%. Baseline mean QTc was 448±29 ms and increased to 459±36 ms ( |
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| MeSH term(s) | Anti-Bacterial Agents/therapeutic use ; Antimalarials/therapeutic use ; Azithromycin/therapeutic use ; Betacoronavirus ; COVID-19 ; Coronavirus Infections/complications ; Coronavirus Infections/drug therapy ; Drug Therapy, Combination ; Electrocardiography/drug effects ; Female ; Humans ; Hydroxychloroquine/therapeutic use ; Long QT Syndrome/chemically induced ; Long QT Syndrome/physiopathology ; Male ; Middle Aged ; Pandemics ; Pneumonia, Viral/complications ; Pneumonia, Viral/drug therapy ; Prognosis ; Risk Factors ; SARS-CoV-2 |
| Chemical Substances | Anti-Bacterial Agents ; Antimalarials ; Hydroxychloroquine (4QWG6N8QKH) ; Azithromycin (83905-01-5) |
| Keywords | covid19 |
| Language | English |
| Publishing date | 2020-05-28 |
| Publishing country | England |
| Document type | Journal Article |
| ZDB-ID | 2653953-6 |
| ISSN | 2047-9980 ; 2047-9980 |
| ISSN (online) | 2047-9980 |
| ISSN | 2047-9980 |
| DOI | 10.1161/JAHA.120.017144 |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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