QTc interval prolongation in patients infected with SARS-CoV-2 and treated with antiviral drugs.
An Pediatr (Engl Ed)
; 96(3): 213-220, 2022 Mar.
Article
in English
| MEDLINE | ID: covidwho-1693952
ABSTRACT
INTRODUCTION:
Many antiviral agents, such as hydroxychloroquine, have been used to treat COVID-19, without being broadly accepted. QTc prolongation is a worrisome adverse effect, scarcely studied in pediatrics. PATIENTS ANDMETHODS:
Paediatric patients affected from COVID-19 who received antivirals were matched (12) with controls not infected nor exposed. Electrocardiograms were prospectively analyzed at baseline, during the first 72â¯h of treatment and after 72â¯h.RESULTS:
Eleven (22.9%) out of 48 patients admitted due to COVID-19 (March-July 2020) received antiviral therapy. All had underlying diseases congenital heart disease (4/11; 36.4%) and immunosuppression (3/11; 27.3%) stand out. 5/11 (45.5%) received treatment at baseline with a potential effect on QTc. There where no differences observed in the baseline QTc between cases and controls 414.8â¯ms (49.2) vs 416.5â¯ms (29.4), (Pâ¯=â¯.716). Baseline long QT was observed in 2/11 cases and 2/22. Among cases, 10/11 (90.9%) received hydroxychloroquine, mainly associated with azithromycin (8/11; 72.7%), 3 received lopinavir/ritonavir and one remdesivir. The median increase in QTc after 72â¯h under treatment was 28.9â¯ms [IQR 48.7] (Pâ¯=â¯.062). 4/11 (36.4%) patients had a long QTc at 72â¯h, resulting in 3 patients ≥500â¯ms; treatment was stopped in one (QTc 510â¯ms) but ventricular arrhythmias were not documented.CONCLUSIONS:
The use of antivirals caused an increase on the QTc interval after 72â¯h of treatment, being the QTc long in 36.3% of the patients, although no arrhythmic events were observed. The use of hydroxychloroquine and antivirals requires active QTc monitoring and it is recommended to discontinue treatment if QTcâ¯>â¯500â¯ms.Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Long QT Syndrome
/
COVID-19 Drug Treatment
Type of study:
Observational study
Limits:
Child
/
Humans
Language:
English
Journal:
An Pediatr (Engl Ed)
Year:
2022
Document Type:
Article
Affiliation country:
J.anpede.2021.04.006
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