Evidence map›Paper›PMID 33063447›Full record

Observational studyInternational journal of clinical practice2021

QTc prolongation among hydroxychloroquine sulphate-treated COVID-19 patients: An observational study.

Bashar Fteiha, Hani Karameh, Ramzi Kurd, Batsheva Ziff-Werman, Itamar Feldman, Alon Bnaya, Sharon Einav, Amir Orlev, Eli Ben-Chetrit

Open access · greenAbstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in International journal of clinical practice, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 1 pooled it
0.3field-weighted citation impact, top 29% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 1 synthesis or guideline pooled it, 14 citations in OpenAlex.

  1. Pooled it
  2. Trial
  3. Observational
  4. Review
  5. The COVID-19 Patient in the Surgical Intensive Care Unit.The Surgical clinics of North America · 2022
    Review
  6. Review
  7. Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 2 institutions in 1 country.

Bashar FteihaInternal Medicine Department, Shaare Zedek Medical Center, School of Medicine, Hebrew University, Jerusalem, Israel.ORCID https://orcid.org/0000-0001-7676-9447
Hani KaramehInternal Medicine Department, Shaare Zedek Medical Center, School of Medicine, Hebrew University, Jerusalem, Israel.
Ramzi KurdInternal Medicine Department, Shaare Zedek Medical Center, School of Medicine, Hebrew University, Jerusalem, Israel.
Batsheva Ziff-WermanInternal Medicine Department, Shaare Zedek Medical Center, School of Medicine, Hebrew University, Jerusalem, Israel.
Itamar FeldmanInternal Medicine Department, Shaare Zedek Medical Center, School of Medicine, Hebrew University, Jerusalem, Israel.
Alon BnayaThe Adult Nephrology institute, Shaare Zedek Medical Center, School of Medicine, Hebrew University, Jerusalem, Israel.
Sharon EinavFaculty of Medicine, Hebrew University, Jerusalem, Israel.
Amir OrlevFaculty of Medicine, Hebrew University, Jerusalem, Israel.
Eli Ben-ChetritFaculty of Medicine, Hebrew University, Jerusalem, Israel.
Shaare Zedek Medical Center · ILHebrew University of Jerusalem · IL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe liberal administration of hydroxychloroquine-sulphate (HCQ) to COVID-19 patients has raised concern regarding the risk of QTc prolongation and cardiac arrhythmias, particularly when prescribed with azithromycin. We evaluated the incidence of QTc prolongation among moderately and severely ill COVID-19 patients treated with HCQ and of the existence of concomitant alternative causes.

methodsAll COVID-19 patients treated with HCQ (between Mar 1 and Apr 14, 2020) in a tertiary medical centre were included. Clinical characteristics and relevant risk factors were collected from the electronic medical records. Individual patient QTc intervals were determined before and after treatment with HCQ. The primary outcome measure sought was a composite end point comprised of either an increase ≥60 milliseconds (ms) in the QTc interval compared with pre-treatment QTc, and/or a maximal QTc interval >500 ms

resultsNinety patients were included. Median age was 65 years (IQR 55-75) and 57 (63%) were male. Thirty-nine patients (43%) were severely or critically ill. Hypertension and obesity were common (n = 23 each, 26%). QTc prolongation evolved in 14 patients (16%). Age >65 years, congestive heart failure, severity of disease, C-reactive protein level, hypokalaemia and furosemide treatment, were all associated with QTc prolongation. Adjusted analysis showed that QTc prolongation was five times more likely with hypokalaemia [OR 5, (95% CI, 1.3-20)], and three times more likely with furosemide treatment [OR 3 (95% CI, 1.01-13.7)].

conclusionIn patients treated with HCQ, QTc prolongation was associated with the presence of traditional risk factors such as hypokalaemia and furosemide treatment.

Indexed as

COVID-19 Drug TreatmentLong QT SyndromeAgedAzithromycinDrug Therapy, CombinationElectrocardiographyFemaleHumansHydroxychloroquineMaleSARS-CoV-2AzithromycinHydroxychloroquine

Identifiers

PMID33063447
PMCPMC7646017
OpenAlexW3092984449

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.