Ventricular repolarization indexes in patients treated with hydroxychloroquine – azithromycin combination for COVID-19

GÜNAY Ş. , Caliskan S., SIĞIRLI D. , Sahin E.

Bratislava Medical Journal, vol.121, no.11, pp.817-821, 2020 (Journal Indexed in SCI) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 121 Issue: 11
  • Publication Date: 2020
  • Doi Number: 10.4149/bll_2020_134
  • Title of Journal : Bratislava Medical Journal
  • Page Numbers: pp.817-821
  • Keywords: hydroxychloroquine, azithromycin, QTc prolongation, Tp-e, repolarization, arrhythmia, TP-E/QT RATIO, E INTERVAL, TRANSMURAL DISPERSION, TPEAK-TEND, RISK


© 2020BACKGROUND: Combination of hydroxychloroquine and azithromycin for the treatment of coronavirus disease 2019 (COVID-19) carries increased risk of corrected QT (QTc) prolongation and cardiac arrhythmias. OBJECTIVE: To characterize the ventricular repolarization indexes which are associated with malignant ventricular arrhythmias in patients treated with hydroxychloroquine and concomitant azithromycin for COVID-19. METHOD: A total of 81 patients who had hydroxychloroquine and azithromycin combination therapy because of possible or reverse-transcription polymertase chain reaction (RT-PCR) confirmed diagnosis of COVID-19 were included in the study. Baseline and control electrocardiograms (before and after treatment) were analyzed retrospectively. Tp-e interval, Tp-e/QT and Tp-e/QTc ratios, which are ventricular repolarization indexes, were calculated. RESULTS: While there was no significant increase in QTc interval in patients receiving combination therapy, there was a significant increase in ventricular repolarization indexes. CONCLUSION: The increase in ventricular replarization indexes is associated with the risk of arrhythmia. In patients using QTc prolonging medication for COVID-19 treatment, QTc monitoring alone may not be sufficient to follow-up for arrhythmia. Even if there is no prolongation in QTc, an increase in ventricular repolarization indexes may be seen (Tab. 5, Ref. 37). Text in PDF