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QTc Interval Prolongation and Life-Threatening Arrhythmias During Hospitalization in Patients With Coronavirus Disease 2019 (COVID-19): Results From a Multicenter Prospective Registry.
Santoro, Francesco; Monitillo, Francesco; Raimondo, Pasquale; Lopizzo, Agostino; Brindicci, Gaetano; Gilio, Michele; Musaico, Francesco; Mazzola, Michele; Vestito, Domenico; Benedetto, Rossella Di; Abumayyaleh, Mohammad; El-Battrawy, Ibrahim; Santoro, Carmen Rita; Di Martino, Luigi Flavio Massimiliano; Akin, Ibrahim; De Stefano, Giulio; Fiorilli, Rosario; Cannone, Michele; Saracino, Annalisa; Angarano, Salvatore; Carbonara, Sergio; Grasso, Salvatore; Di Biase, Luigi; Brunetti, Natale Daniele.
  • Santoro F; Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy.
  • Monitillo F; Department of Cardiology, Bonomo Hospital, Andria, Italy.
  • Raimondo P; Emergency Cardiology Unit, University Hospital of Bari, Bari, Italy.
  • Lopizzo A; Section of Anesthesia and Intensive Care, Department of Emergency and Organ Transplantation, "Aldo Moro" University of Bari, Bari, Italy.
  • Brindicci G; Department of Cardiology, San Carlo Hospital, Potenza, Italy.
  • Gilio M; Unit of Infectious Diseases, Hospital-University Polyclinic of Bari, Bari, Italy.
  • Musaico F; Department of Infectious Disease, San Carlo Hospital, Potenza, Italy.
  • Mazzola M; Department of Cardiology, Vittorio Emanuele II Hospital, Bisceglie, Italy.
  • Vestito D; Department of Infectious Disease, Vittorio Emanuele II Hospital, Bisceglie, Italy.
  • Benedetto RD; Emergency Cardiology Unit, University Hospital of Bari, Bari, Italy.
  • Abumayyaleh M; Section of Anesthesia and Intensive Care, Department of Emergency and Organ Transplantation, "Aldo Moro" University of Bari, Bari, Italy.
  • El-Battrawy I; University Mannheim, Mannheim, Germany.
  • Santoro CR; University Mannheim, Mannheim, Germany.
  • Di Martino LFM; Department of Infectious and Tropical Disease, San Giuseppe Moscati Hospital, Taranto, Italy.
  • Akin I; Department of Cardiology, Santa Maria Degli Angeli Hospital, Putignano, Italy.
  • De Stefano G; University Mannheim, Mannheim, Germany.
  • Fiorilli R; Unit of Infectious Diseases, Hospital-University Polyclinic of Bari, Bari, Italy.
  • Cannone M; Department of Cardiology, San Carlo Hospital, Potenza, Italy.
  • Saracino A; Department of Cardiology, Bonomo Hospital, Andria, Italy.
  • Angarano S; Unit of Infectious Diseases, Hospital-University Polyclinic of Bari, Bari, Italy.
  • Carbonara S; Unit of Infectious Diseases, Hospital-University Polyclinic of Bari, Bari, Italy.
  • Grasso S; Department of Infectious Disease, Vittorio Emanuele II Hospital, Bisceglie, Italy.
  • Di Biase L; Section of Anesthesia and Intensive Care, Department of Emergency and Organ Transplantation, "Aldo Moro" University of Bari, Bari, Italy.
  • Brunetti ND; Department of Medicine, Cardiology Division, Montefiore Medical Center, Bronx, New York, USA.
Clin Infect Dis ; 73(11): e4031-e4038, 2021 12 06.
Article in English | MEDLINE | ID: covidwho-1559750
Semantic information from SemMedBD (by NLM)
1. COVID-19 PROCESS_OF Patients
Subject
COVID-19
Predicate
PROCESS_OF
Object
Patients
2. Cardiac Arrhythmia PROCESS_OF Patients
Subject
Cardiac Arrhythmia
Predicate
PROCESS_OF
Object
Patients
3. Corrected Prolonged QT Interval by ECG Finding PROCESS_OF Patients
Subject
Corrected Prolonged QT Interval by ECG Finding
Predicate
PROCESS_OF
Object
Patients
4. Hospitalization TREATS COVID-19
Subject
Hospitalization
Predicate
TREATS
Object
COVID-19
5. Prolonged QTc PROCESS_OF Patients
Subject
Prolonged QTc
Predicate
PROCESS_OF
Object
Patients
6. Cardiac Arrest PROCESS_OF Patients
Subject
Cardiac Arrest
Predicate
PROCESS_OF
Object
Patients
7. Sustained ventricular tachycardia PROCESS_OF Patients
Subject
Sustained ventricular tachycardia
Predicate
PROCESS_OF
Object
Patients
8. Poor outcome COEXISTS_WITH Cardiac Arrhythmia
Subject
Poor outcome
Predicate
COEXISTS_WITH
Object
Cardiac Arrhythmia
9. COVID-19 PROCESS_OF Patients
Subject
COVID-19
Predicate
PROCESS_OF
Object
Patients
10. Cardiac Arrhythmia PROCESS_OF Patients
Subject
Cardiac Arrhythmia
Predicate
PROCESS_OF
Object
Patients
11. Corrected Prolonged QT Interval by ECG Finding PROCESS_OF Patients
Subject
Corrected Prolonged QT Interval by ECG Finding
Predicate
PROCESS_OF
Object
Patients
12. Hospitalization TREATS COVID-19
Subject
Hospitalization
Predicate
TREATS
Object
COVID-19
13. Prolonged QTc PROCESS_OF Patients
Subject
Prolonged QTc
Predicate
PROCESS_OF
Object
Patients
14. Cardiac Arrest PROCESS_OF Patients
Subject
Cardiac Arrest
Predicate
PROCESS_OF
Object
Patients
15. Sustained ventricular tachycardia PROCESS_OF Patients
Subject
Sustained ventricular tachycardia
Predicate
PROCESS_OF
Object
Patients
16. Poor outcome COEXISTS_WITH Cardiac Arrhythmia
Subject
Poor outcome
Predicate
COEXISTS_WITH
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Cardiac Arrhythmia
ABSTRACT

BACKGROUND:

Prolonged QTc intervals and life-threatening arrhythmias (LTA) are potential drug-induced complications previously reported with antimalarials, antivirals, and antibiotics. Our objective was to evaluate the prevalence and predictors of QTc interval prolongation and incidences of LTA during hospitalization for coronavirus disease 2019 (COVID-19) among patients with normal admission QTc.

METHODS:

We enrolled 110 consecutive patients in a multicenter international registry. A 12-lead electrocardiograph was performed at admission, after 7, and at 14 days; QTc values were analyzed.

RESULTS:

After 7 days, 15 (14%) patients developed a prolonged QTc (pQTc; mean QTc increase 66 ± 20 msec; +16%; P < .001); these patients were older and had higher basal heart rates, higher rates of paroxysmal atrial fibrillation, and lower platelet counts. The QTc increase was inversely proportional to the baseline QTc level and leukocyte count and directly proportional to the basal heart rate (P < .01).We conducted a multivariate stepwise analysis including age, male gender, paroxysmal atrial fibrillation, basal QTc values, basal heart rate, and dual antiviral therapy; age (odds ratio [OR], 1.06; 95% confidence interval [CI], 1.00-1.13; P < .05), basal heart rate (OR, 1.07; 95% CI, 1.02-1.13; P < .01), and dual antiviral therapy (OR, 12.46; 95% CI, 2.09-74.20; P < .1) were independent predictors of QT prolongation.The incidence rate of LTA during hospitalization was 3.6%. There was 1 patient who experienced cardiac arrest and 3 with nonsustained ventricular tachycardia. LTAs were recorded after a median of 9 days from hospitalization and were associated with 50% of the mortality rate.

CONCLUSIONS:

After 7 days of hospitalization, 14% of patients with COVID-19 developed pQTc; age, basal heart rate, and dual antiviral therapy were found to be independent predictors of pQTc. Life-threatening arrhythmias have an incidence rate of 3.6%, and were associated with a poor outcome.
Subject(s)
Keywords

Full text: Available Collection: International databases Database: MEDLINE Main subject: Long QT Syndrome / COVID-19 Type of study: Experimental Studies / Observational study / Prognostic study Limits: Humans / Male Language: English Journal: Clin Infect Dis Journal subject: Communicable Diseases Year: 2021 Document Type: Article Affiliation country: Cid

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Long QT Syndrome / COVID-19 Type of study: Experimental Studies / Observational study / Prognostic study Limits: Humans / Male Language: English Journal: Clin Infect Dis Journal subject: Communicable Diseases Year: 2021 Document Type: Article Affiliation country: Cid