Evaluation of QTc-Interval Prolongation and Arrhythmogenic Indices and Associated Factors in Patients With COVID-19

Background: Patients with a prolonged corrected QT (QTc) interval are at risk of arrhythmias, including Torsade de pointes (TdP). This interval could be affected by demographic characteristics, ischemia, and most importantly drugs. Furthermore, hospitalized patients tend to experience arrhythmias, accompanied by electrolyte abnormalities and the inflammatory status of diseases. Methods: The present retrospective study recruited 135 patients with COVID-19. We observed the QTc interval on the third post-administration day and laboratory findings for possible risk factors for QTc-interval prolongation. Results: Ischemic heart disease was markedly more common among patients with prolonged and severely prolonged QTc intervals. Laboratory findings showed a significantly higher neutrophil-to-lymphocyte ratio (NLR) in patients with prolonged or severely prolonged QTc intervals compared with those with normal QTc intervals and QTc intervals exceeding 500 milliseconds (P<0.001) on admission and the third day. Ribavirin caused the most elevation in the QTc interval after 3 days of hospitalization compared with other drugs. Forty percent of the patients who took ribavirin experienced a QTc interval exceeding 500 milliseconds, which was significant compared with other therapeutic regimens. Conclusions: In addition to the well-known predisposing factors for the prolongation of QTc interval, we suggest focusing on the history of ischemic heart disease and inflammatory status (eg, by NLR) in patients with COVID-19 before making decisions to commence drugs that greatly affect QTc intervals. Further studies are required to shed light on the cardiac side effects of medications applied for COVID-19, particularly ribavirin.

Successful surgery in acute type a dissection in a patient with covid-19

Coronaviruses are a large family of RNA viruses, the most pathogenic of which are SARS-CoV, MERS-CoV, and the newest type, SARS-CoV-2.1 Since the start of the recent spread of the coronavirus in the world, the number of patients with cardiovascular diseases referring to emergency departments has decreased due to various reasons. However, many of the patients who do refer to emergency departments may have the complications of coronavirus disease 2019 (COVID-19). We herein describe a patient who was admitted with an acute coronary syndrome after having developed the symptoms of coronavirus and was eventually diagnosed with acute Type A dissection.