ArticleInternational journal of cardiology2021
Assessing QT interval in COVID-19 patients:safety of hydroxychloroquine-azithromycin combination regimen.
Article in International journal of cardiology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 2 of them syntheses that pooled it.
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Who cites it
18 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Antibiotics for the treatment of COVID-19.The Cochrane database of systematic reviews · 2021Pooled it
- QTc prolongation in COVID-19 patients treated with hydroxychloroquine, chloroquine, azithromycin, or lopinavir/ritonavir: A systematic review and meta-analysis.Pharmacoepidemiology and drug safety · 2021Pooled it
- Hydroxychloroquine-azithromycin, doubase C, and QTc prolongation in congolese patients with COVID-19: Myth or reality?World journal of virology · 2024Trial
- Prevalence, Outcomes, and Predictors of Prolonged Corrected QT Interval in Hydroxychloroquine-Naïve Hospitalized COVID-19 Patients.Cardiovascular toxicology · 2024Article
- Unknown adverse drug reactions from spontaneous reports in a hospital setting: characterization, follow-up, and contribution to the pharmacovigilance system.Frontiers in pharmacology · 2023Article
- Safety of Drugs Used during the First Wave of COVID-19: A Hospital-Registry-Based Study.Diagnostics (Basel, Switzerland) · 2022Article
- Serious Cardiovascular Adverse Events Associated with Hydroxychloroquine/Chloroquine Alone or with Azithromycin in Patients with COVID-19: A Pharmacovigilance Analysis of the FDA Adverse Event Reporting System (FAERS).Drugs - real world outcomes · 2022Article
- Safety of Short-Term Treatments with Oral Chloroquine and Hydroxychloroquine in Patients with and without COVID-19: A Systematic Review.Pharmaceuticals (Basel, Switzerland) · 2022Review
- Off-Label Use of Hydroxychloroquine in COVID-19: Analysis of Reports of Suspected Adverse Reactions From the Italian National Network of Pharmacovigilance.Journal of clinical pharmacology · 2022Article
- Arrhythmogenic Risk and Mechanisms of QT-Prolonging Drugs to Treat COVID-19.Cardiac electrophysiology clinics · 2022Review
- Electrocardiogram abnormalities and prognosis in COVID-19.Frontiers in cardiovascular medicine · 2022Article
- Efficacy of chloroquine and hydroxychloroquine for the treatment of hospitalized COVID-19 patients: a meta-analysis.Future virology · 2021Review
- Efficacy and Safety of Azithromycin for the Treatment of COVID-19: A Systematic Review and Meta-analysis.Tuberculosis and respiratory diseases · 2021Article
- The impact of hydroxychloroquine-azithromycin combination on Tpeak-to-end and Tpeak-to-end/QT ratio during a short treatment course.Annals of noninvasive electrocardiology : the official journal of the International Society for Holter and Noninvasive Electrocardiology, Inc · 2021Observational
- Cardiotoxic Potential of Hydroxychloroquine, Chloroquine and Azithromycin in Adult Human Primary Cardiomyocytes.Toxicological sciences : an official journal of the Society of Toxicology · 2021Article
- Coronavirus disease 2019 (COVID-19) and QTc prolongation.BMC cardiovascular disorders · 2021Observational
- Role of Pharmacogenetics in Adverse Drug Reactions: An Update towards Personalized Medicine.Frontiers in pharmacology · 2021Review
- Prevention and treatment of COVID-19: Focus on interferons, chloroquine/hydroxychloroquine, azithromycin, and vaccine.Biomedicine & pharmacotherapy = Biomedecine & pharmacotherapie · 2021Review
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Authors and funding
16 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundHydroxychloroquine (HCQ) and azithromycin (AZT) have been proposed for COVID-19 treatment. Data available in the literature reported a potential increased risk of fatal arrhythmias under these therapies. The aim of this study was to assess the effects of these drugs on QT interval and outcome in a COVID-19 population.
methodA total of 112 consecutive COVID-19 patients were included in this analysis and were divided in 3 groups according to the receiving therapeutic regimens: 19 (17%) patients in Group 1 (no treatment), 40 (36%) in Group 2 (HCQ only), 53 (47%) in Group 3 (HCQ/AZT).
resultsA prolonged QTc interval was found in 61% of patients treated with HCQ alone or in combination with AZT, but only 4 (4%) patients showed a QTc > 500 ms. HCQ/AZT combination determined a greater increase of QTc duration compared to the other two strategies (Group 3 452 ± 26.4 vs Group 2 436.3 ± 28.4 vs Group 1 424.4 ± 24.3 ms, respectively; p < 0.001). Multivariate analysis demonstrated that HCQ/AZT combination (OR 9.02, p = 0.001) and older age (OR 1.04, p = 0.031) were independent predictors of QTc prolongation. The risk increased with age (incremental utility analysis p = 0.02). Twenty patients (18%) died, and no cardiac arrest neither arrhythmic fatalities were documented.
conclusionsThe HCQ/AZT combination therapy causes a significantly increase of QT interval compared to HCQ alone. Older patients under such regimen are at higher risk of experiencing QT prolongation. The use of such drugs may be considered as safe relating to arrhythmic risk in the treatment of COVID-19 patients as no arrhythmic fatalities occurred.
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