Aims: The aim of the study was to describe ECG modifications and arrhythmic events in COVID-19 patients undergoing hydroxychloroquine (HCQ) therapy in different clinical settings. Methods and results: COVID-19 patients at seven institutions receiving HCQ therapy from whom a baseline and at least one ECG at 48+ h were available were enrolled in the study. QT/QTc prolongation, QT-associated and QT-independent arrhythmic events, arrhythmic mortality, and overall mortality during HCQ therapy were assessed. A total of 649 COVID-19 patients (61.9 ± 18.7 years, 46.1% males) were enrolled. HCQ therapy was administrated as a home therapy regimen in 126 (19.4%) patients, and as an in-hospital-treatment to 495 (76.3%) hospitalized and 28 (4.3%) intensive care unit (ICU) patients. At 36-72 and at 96+ h after the first HCQ dose, 358 and 404 ECGs were obtained, respectively. A significant QT/QTc interval prolongation was observed (P < 0.001), but the magnitude of the increase was modest [+13 (9-16) ms]. Baseline QT/QTc length and presence of fever (P = 0.001) at admission represented the most important determinants of QT/QTc prolongation. No arrhythmic-related deaths were reported. The overall major ventricular arrhythmia rate was low (1.1%), with all events found not to be related to QT or HCQ therapy at a centralized event evaluation. No differences in QT/QTc prolongation and QT-related arrhythmias were observed across different clinical settings, with non-QT-related arrhythmias being more common in the intensive care setting. Conclusion: HCQ administration is safe for a short-term treatment for patients with COVID-19 infection regardless of the clinical setting of delivery, causing only modest QTc prolongation and no directly attributable arrhythmic deaths.
Arrhythmic safety of hydroxychloroquine in COVID-19 patients from different clinical settings / A. Gasperetti, M. Biffi, F. Duru, M. Schiavone, M. Ziacchi, G. Mitacchione, C. Lavalle, A. Saguner, A. Lanfranchi, G. Casalini, M. Tocci, D. Fabbricatore, F. Salghetti, M.V. Mariani, M. Busana, A. Bellia, C.B. Cogliati, P. Viale, S. Antinori, M. Galli, N. Galiè, C. Tondo, G.B. Forleo. - In: EUROPACE. - ISSN 1099-5129. - 22:12(2020), pp. 1855-1863.
|Titolo:||Arrhythmic safety of hydroxychloroquine in COVID-19 patients from different clinical settings|
GASPERETTI, ALESSIO (Corresponding)
|Parole Chiave:||SARS-CoV-2; COVID-19; Hydroxychloroquine; QT interval; Arrhythmias|
|Settore Scientifico Disciplinare:||Settore MED/11 - Malattie dell'Apparato Cardiovascolare|
|Data di pubblicazione:||2020|
|Digital Object Identifier (DOI):||http://dx.doi.org/10.1093/europace/euaa216|
|Appare nelle tipologie:||01 - Articolo su periodico|