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Corrected QT interval in hospitalized patients with coronavirus disease 2019: Focus on drugs therapy.
Ding, Jiaxing; Liu, Wei; Guan, Hongquan; Feng, Yu; Bao, Yintu; Li, Huili; Wang, Xuehua; Zhou, Zihua; Chen, Zhijian.
  • Ding J; Department of Cardiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Medicine (Baltimore) ; 100(28): e26538, 2021 Jul 16.
Article in English | MEDLINE | ID: covidwho-1494086
ABSTRACT
ABSTRACT Corrected QT (QTc) interval prolongation has been associated with poor patient prognosis. In this study, we assessed the effects of different drugs and cardiac injury on QTc interval prolongation in patients with coronavirus disease 2019 (COVID-19).The study cohort consisted of 395 confirmed COVID-19 cases from the Wuhan Union Hospital West Campus. All hospitalized patients were treated with chloroquine/hydroxychloroquine (CQ/HCQ), lopinavir/ritonavir (LPV/r), quinolones, interferon, Arbidol, or Qingfei Paidu decoction (QPD) and received at least 1 electrocardiogram after drug administration.Fifty one (12.9%) patients exhibited QTc prolongation (QTc ≥ 470 ms). QTc interval prolongation was associated with COVID-19 severity and mortality (both P < .001). Administration of CQ/HCQ (odds ratio [OR], 2.759; 95% confidence interval [CI], 1.318-5.775; P = .007), LPV/r (OR, 2.342; 95% CI, 1.152-4.760; P = .019), and quinolones (OR, 2.268; 95% CI, 1.171-4.392; P = .015) increased the risk of QTc prolongation. In contrast, the administration of Arbidol, interferon, or QPD did not increase the risk of QTc prolongation. Notably, patients treated with QPD had a shorter QTc duration than those without QPD treatment (412.10 [384.39-433.77] vs 420.86 [388.19-459.58]; P = .042). The QTc interval was positively correlated with the levels of cardiac biomarkers (creatine kinase-MB fraction [rho = 0.14, P = .016], high-sensitivity troponin I [rho = .22, P < .001], and B-type natriuretic peptide [rho = 0.27, P < .001]).In conclusion, QTc prolongation was associated with COVID-19 severity and mortality. The risk of QTc prolongation was higher in patients receiving CQ/HCQ, LPV/r, and quinolones. QPD had less significant effects on QTc prolongation than other antiviral agents.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: Antiviral Agents / Long QT Syndrome / SARS-CoV-2 / COVID-19 Type of study: Etiology study / Observational study / Randomized controlled trials / Risk factors Limits: Aged / Female / Humans / Male / Middle aged Language: English Journal: Medicine (Baltimore) Year: 2021 Document Type: Article Affiliation country: MD.0000000000026538

Full text: Available Collection: International databases Database: MEDLINE Main subject: Antiviral Agents / Long QT Syndrome / SARS-CoV-2 / COVID-19 Type of study: Etiology study / Observational study / Randomized controlled trials / Risk factors Limits: Aged / Female / Humans / Male / Middle aged Language: English Journal: Medicine (Baltimore) Year: 2021 Document Type: Article Affiliation country: MD.0000000000026538