QT interval and repolarization dispersion changes during the administration of hydroxychloroquine/chloroquine with/without azithromycin in early COVID 19 pandemic: A prospective observational study from two academic hospitals in Indonesia

Gumilang, Rizki A. and Siswanto, Siswanto and Anggraeni, Vita Y. and Trisnawati, Ika and Budiono, Eko and Hartopo, Anggoro B. (2021) QT interval and repolarization dispersion changes during the administration of hydroxychloroquine/chloroquine with/without azithromycin in early COVID 19 pandemic: A prospective observational study from two academic hospitals in Indonesia. Journal of Arrhythmia, 37 (5). 1184 – 1195. ISSN 18804276

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Abstract

Background: Hydroxychloroquine/chloroquine (HCQ/CQ) treatment for COVID-19 was associated with QT interval prolongation and arrhythmia risks. This study aimed to investigate QTc interval and ventricular repolarization dispersion changes, as markers of arrhythmia risks, after HCQ/CQ administration with/without azithromycin (AZT) during COVID-19 pandemic. Methods: A prospective observational study was performed in two academic hospitals in Indonesia. Adult patients who received HCQ/CQ alone and HCQ/CQ + AZT concomitant treatments for COVID-19 infection were enrolled. Baseline and post HCQ/CQ treatment electrocardiograms were obtained. Baseline and post HCQ/CQ treatment QT interval by Bazett (B-QTc) and Fridericia (F-QTc) formulas and ventricular repolarization dispersion indices by Tpeak-Tend (Tp-e) interval and Tpeak-Tend/QT (Tp-e/QT) ratio were calculated and analyzed. Results: The study enrolled 55 (HCQ/CQ alone) and 77 subjects (HCQ/CQ + AZT concomitant). F-QTc interval significantly lengthened in subjects with HCQ/CQ + AZT (mean difference 11.89 ms P =.028). The incidences of severe B-QTc and F-QTc lengthening were 13.1% and 12.3%, B-QTc and F-QTc prolongation were 25.4% and 12.3%, and severe B-QTc and F-QTc prolongation were 6.2% and 3.2%. Tp-e interval lengthened significantly from baseline to posttreatment in HCQ/CQ alone and HCQ/CQ + AZT (mean difference 10.83 ms P =.006 and 18.73 ms P <.001, respectively). Tp-e/QT ratio increased significantly from baseline to posttreatment in HCQ/CQ + AZT concomitant (mean difference 0.035 P <.001). No fatal arrhytmia occurred. Conclusions: During COVID-19 pandemic, HCQ/CQ + AZT concomitant treatment caused significant F-QTc lengthening, significantly increased Tp-e interval and increased Tp-e/QT ratio. HCQ/CQ alone only caused significant increase of Tp-e interval. Incidences of severe QTc lengthening and prolongation were low in both HCQ/CQ alone and HCQ/CQ + AZT concomitant. © 2021 The Authors. Journal of Arrhythmia published by John Wiley & Sons Australia, Ltd on behalf of Japanese Heart Rhythm Society

Item Type: Article
Additional Information: Cited by: 3; All Open Access, Gold Open Access, Green Open Access
Uncontrolled Keywords: azithromycin; chloroquine; hydroxychloroquine; levofloxacin; adult; Article; Bazett QTc interval; cardiovascular parameters; cohort analysis; comorbidity; controlled study; coronavirus disease 2019; disease severity; electrocardiography; female; follow up; Fridericia QTc interval; heart arrhythmia; heart repolarization; human; hypertension; incidence; major clinical study; male; observational study; outcome assessment; P wave; pandemic; prevalence; prospective study; QRS complex; QRS interval; QT dispersion; QT interval; QT prolongation; QTc interval; reverse transcription polymerase chain reaction; T wave; T-peak to T-end; Tpeak Tend QT ratio
Subjects: R Medicine > RB Biomedical Sciences
Divisions: Faculty of Medicine, Public Health and Nursing > Biomedical Sciences
Depositing User: Sri JUNANDI
Date Deposited: 27 Sep 2024 02:14
Last Modified: 27 Sep 2024 02:14
URI: https://ir.lib.ugm.ac.id/id/eprint/4578

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