Assessment of the duration of QT interval in patients with COVID-19 during treatment with hydroxychloroquine and azithromycin

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Abstract

At the end of 2019, an outbreak of a novel coronavirus infection occurred in PRC, the causative agent of which was given the temporary name 2019-nCoV. COVID-19 is a complex multisystem disease which causes harmful effects not only on the lungs, but also on the cardiac conduction system. Aim. To assess the duration of corrected QT interval in patients with COVID-19 during treatment with hydroxychloroquine and azithromycin, and to identify the relationship between this indicator and the severity of interstitial pneumonitis. Materials and methods. We studied medical records of 40 men and 4 women, who were treated in the infectious diseases department of Acad. N.N. Burdenko Main Military Clinical Hospital from March 20 to May 20, 2020. All patients underwent resting digital 12-lead electrocardiography: at the time of admission to the hospital and after 6 days of therapy using the "Myocard-12" system. In our study, 30 patients were treated with azithromycin at a total daily dose of 500 mg for 5 to 10 days; 21 patients - with hydroxychloroquine at a dose of 400 mg 2 times a day on the 1st day of treatment and 200 mg 2 times a day for the next 5 days; and 7 patients received azithromycin and hydroxychroloquine combination. Results. To assess the duration of corrected QT interval depending on the severity of patient's status and the degree of lung damage, we compared the mean QT interval depending on the degree of lung damage on computed tomography. There was no significant difference in this indicator in patients with pneumonia of varying severity. However, when using the combination of azithromycin and hydroxychloroquine after 6 days, there was a significant increase in the mean corrected QT interval compared to its baseline value (before treatment). Conclusion. Patients hospitalized with COVID-19 have an initially prolonged corrected QTinterval. The combined use of azithromycin and hydroxychloroquine in a short time causes a significant increase in the corrected QT interval in patients with COVID-19.

About the authors

Filipp A. Orlov

Burdenko Main Military Clinical Hospital; Russian Medical Academy of Continuous Professional Education

Email: esculap1@rambler.ru
д-р мед. наук, доц., зав. терапевтическим (консультативным) отд-нием Moscow, Russia

Andrei A. Zaitsev

Burdenko Main Military Clinical Hospital; Moscow State University of Food Production

д-р мед. наук, проф., глав. пульмонолог ФГБУ Moscow, Russia

Gleb E. Kubenskii

Clinical Hospital №1 (Volynskaya)

канд. мед. наук, зав. отд-нием реанимации и интенсивной терапии Moscow, Russia

Tatiana N. Pantiukhova

Burdenko Main Military Clinical Hospital

канд. мед. наук, врач консультант-инфекционист терапевтического консультативного отд-ния Moscow, Russia

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