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Effect of Hydroxychloroquine on QTc in Patients Diagnosed with COVID-19: A Systematic Review and Meta-Analysis.
Arfaras-Melainis, Angelos; Tzoumas, Andreas; Kokkinidis, Damianos G; Salgado Guerrero, Maria; Varrias, Dimitrios; Xu, Xiaobo; Cerna, Luis; Avendano, Ricardo; Kemal, Cameron; Palaiodimos, Leonidas; Faillace, Robert T.
  • Arfaras-Melainis A; Jacobi Medical Center, Albert Einstein College of Medicine, Bronx, NY 10461, USA.
  • Tzoumas A; School of Medicine, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece.
  • Kokkinidis DG; Section of Cardiovascular Medicine, Yale New Haven Hospital, Yale University School of Medicine, New Haven, CT 06510, USA.
  • Salgado Guerrero M; Jacobi Medical Center, Albert Einstein College of Medicine, Bronx, NY 10461, USA.
  • Varrias D; Jacobi Medical Center, Albert Einstein College of Medicine, Bronx, NY 10461, USA.
  • Xu X; Jacobi Medical Center, Albert Einstein College of Medicine, Bronx, NY 10461, USA.
  • Cerna L; Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY 10467, USA.
  • Avendano R; Section of Cardiovascular Medicine, Yale New Haven Hospital, Yale University School of Medicine, New Haven, CT 06510, USA.
  • Kemal C; Leon H. Charney Division of Cardiology, New York University, New York, NY 10016, USA.
  • Palaiodimos L; Jacobi Medical Center, Albert Einstein College of Medicine, Bronx, NY 10461, USA.
  • Faillace RT; Jacobi Medical Center, Albert Einstein College of Medicine, Bronx, NY 10461, USA.
J Cardiovasc Dev Dis ; 8(5)2021 May 13.
Article in English | MEDLINE | ID: covidwho-1227033
Semantic information from SemMedBD (by NLM)
1. hydroxychloroquine TREATS COVID-19
Subject
hydroxychloroquine
Predicate
TREATS
Object
COVID-19
2. COVID-19 PROCESS_OF Patients
Subject
COVID-19
Predicate
PROCESS_OF
Object
Patients
3. hydroxychloroquine TREATS Patients
Subject
hydroxychloroquine
Predicate
TREATS
Object
Patients
4. azithromycin TREATS COVID-19
Subject
azithromycin
Predicate
TREATS
Object
COVID-19
5. azithromycin TREATS Patients
Subject
azithromycin
Predicate
TREATS
Object
Patients
6. chloroquine AFFECTS QTC interval
Subject
chloroquine
Predicate
AFFECTS
Object
QTC interval
7. hydroxychloroquine AFFECTS QTC interval
Subject
hydroxychloroquine
Predicate
AFFECTS
Object
QTC interval
8. COVID-19 PROCESS_OF hospitalized patients
Subject
COVID-19
Predicate
PROCESS_OF
Object
hospitalized patients
9. Combined Modality Therapy USES azithromycin
Subject
Combined Modality Therapy
Predicate
USES
Object
azithromycin
10. Corrected Prolonged QT Interval by ECG Finding PROCESS_OF Patients
Subject
Corrected Prolonged QT Interval by ECG Finding
Predicate
PROCESS_OF
Object
Patients
11. hydroxychloroquine TREATS COVID-19
Subject
hydroxychloroquine
Predicate
TREATS
Object
COVID-19
12. COVID-19 PROCESS_OF Patients
Subject
COVID-19
Predicate
PROCESS_OF
Object
Patients
13. hydroxychloroquine TREATS Patients
Subject
hydroxychloroquine
Predicate
TREATS
Object
Patients
14. azithromycin TREATS COVID-19
Subject
azithromycin
Predicate
TREATS
Object
COVID-19
15. azithromycin TREATS Patients
Subject
azithromycin
Predicate
TREATS
Object
Patients
16. chloroquine AFFECTS QTC interval
Subject
chloroquine
Predicate
AFFECTS
Object
QTC interval
17. hydroxychloroquine AFFECTS QTC interval
Subject
hydroxychloroquine
Predicate
AFFECTS
Object
QTC interval
18. COVID-19 PROCESS_OF hospitalized patients
Subject
COVID-19
Predicate
PROCESS_OF
Object
hospitalized patients
19. Combined Modality Therapy USES azithromycin
Subject
Combined Modality Therapy
Predicate
USES
Object
azithromycin
20. Corrected Prolonged QT Interval by ECG Finding PROCESS_OF Patients
Subject
Corrected Prolonged QT Interval by ECG Finding
Predicate
PROCESS_OF
Object
Patients
ABSTRACT

BACKGROUND:

Hydroxychloroquine or chloroquine with or without the concomitant use of azithromycin have been widely used to treat patients with SARS-CoV-2 infection, based on early in vitro studies, despite their potential to prolong the QTc interval of patients.

OBJECTIVE:

This is a systematic review and metanalysis designed to assess the effect of hydroxychloroquine with or without the addition of azithromycin on the QTc of hospitalized patients with COVID-19. MATERIALS AND

METHODS:

PubMed, Scopus, Cochrane and MedRxiv databases were reviewed. A random effect model meta-analysis was used, and I-square was used to assess the heterogeneity. The prespecified endpoints were ΔQTc, QTc prolongation > 500 ms and ΔQTc > 60 ms.

RESULTS:

A total of 18 studies and 7179 patients met the inclusion criteria and were included in this systematic review and meta-analysis. The use of hydroxychloroquine with or without the addition of azithromycin was associated with increased QTc when used as part of the management of patients with SARS-CoV-2 infection. The combination therapy with hydroxychloroquine plus azithromycin was also associated with statistically significant increases in QTc. Moreover, the use of hydroxychloroquine alone, azithromycin alone, or the combination of the two was associated with increased numbers of patients that developed QTc prolongation > 500 ms.

CONCLUSION:

This systematic review and metanalysis revealed that the use of hydroxychloroquine alone or in conjunction with azithromycin was linked to an increase in the QTc interval of hospitalized patients with SARS-CoV-2 infection that received these agents.
Keywords

Full text: Available Collection: International databases Database: MEDLINE Type of study: Experimental Studies / Randomized controlled trials / Reviews / Systematic review/Meta Analysis Language: English Year: 2021 Document Type: Article Affiliation country: Jcdd8050055

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Full text: Available Collection: International databases Database: MEDLINE Type of study: Experimental Studies / Randomized controlled trials / Reviews / Systematic review/Meta Analysis Language: English Year: 2021 Document Type: Article Affiliation country: Jcdd8050055