Arrhythmic safety of hydroxychloroquine in COVID-19 patients from different clinical settings
Gasperetti et al.,
Arrhythmic safety of hydroxychloroquine in COVID-19 patients from different clinical settings,
EP Europace, doi:10.1093/europace/euaa216
Safety study of 649 patients finding that HCQ administration is safe for short-term treatment for patients with COVID-19 infection regardless of the clinical setting of delivery, causing only modest QTc prolongation and no directly attributable arrhythmic deaths.
Arrhythmic safety data from a large cohort of patients treated with HCQ alone or in combination with other QT-prolonging drugs.
Gasperetti et al., 24 Sep 2020, peer-reviewed, 23 authors.
Abstract: Europace (2020) 22, 1855–1863
doi:10.1093/europace/euaa216
CLINICAL RESEARCH
Arrhythmias and COVID-19
Arrhythmic safety of hydroxychloroquine in
COVID-19 patients from different clinical
settings
1
Heart Rhythm Center, Centro Cardiologico Monzino, IRCCS, Milan, Italy; 2University Heart Center, University Hospital Zürich, Zürich, Switzerland; 3Unit of Cardiology,
Department of Experimental, Diagnostic and Specialty Medicine-DIMES, University of Bologna, Bologna, Italy; 4Department of Cardiology, ASST-Fatebenefratelli Sacco, Luigi
Sacco Hospital, University of Milan, Milan, Italy; 5Department of Cardiovascular Disease, Policlinico Umberto I Hospital, Rome, Italy; 6III Division of Infectious Diseases, ASSTFatebenefratelli Sacco, Department of Biomedical and Clinical Sciences, University of Milan, Italy; 7Division of Cardiology, Spedali Civili Hospital, Brescia, Italy; 8Department of
Anesthesiology, Emergency and Intensive Care Medicine, University of Göttingen, Göttingen, Germany; 9Department of Systems Medicine, University of Rome ‘Tor Vergata’,
Rome, Italy; 10Department of Internal Medicine, Luigi Sacco Hospital, University of Milan, Milan, Italy; 11 Unit of Infectious Diseases, Department of Medical and Surgical Sciences,
S. Orsola Hospital, University of Bologna, Bologna, Italy; and 12 Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
Received 6 May 2020; editorial decision 2 July 2020; accepted after revision 3 July 2020; online publish-ahead-of-print 24 September 2020
Aims
The aim of the study was to describe ECG modifications and arrhythmic events in COVID-19 patients undergoing
hydroxychloroquine (HCQ) therapy in different clinical settings.
...................................................................................................................................................................................................
Methods
COVID-19 patients at seven institutions receiving HCQ therapy from whom a baseline and at least one ECG at
and results
48þ h were available were enrolled in the study. QT/QTc prolongation, QT-associated and QT-independent arrhythmic events, arrhythmic mortality, and overall mortality during HCQ therapy were assessed. A total of 649
COVID-19 patients (61.9 ± 18.7 years, 46.1% males) were enrolled. HCQ therapy was administrated as a home
therapy regimen in 126 (19.4%) patients, and as an in-hospital-treatment to 495 (76.3%) hospitalized and 28 (4.3%)
intensive care unit (ICU) patients. At 36–72 and at 96þ h after the first HCQ dose, 358 and 404 ECGs were
obtained, respectively. A significant QT/QTc interval prolongation was observed (P < 0.001), but the magnitude of
the increase was modest [þ13 (9–16) ms]. Baseline QT/QTc length and presence of fever (P = 0.001) at admission
represented the most important determinants of QT/QTc prolongation. No arrhythmic-related deaths were
reported. The overall major ventricular arrhythmia rate was low (1.1%), with all events found not to be related to
QT or HCQ therapy at a centralized event evaluation. No differences in QT/QTc prolongation and QT-related
arrhythmias were observed across different clinical settings, with non-QT-related arrhythmias being more common
in the intensive care setting.
...................................................................................................................................................................................................
Conclusion
HCQ..
Please send us corrections, updates, or comments. Vaccines and
treatments are complementary. All practical, effective, and safe means should
be used based on risk/benefit analysis. No treatment, vaccine, or intervention
is 100% available and effective for all current and future variants. We do not
provide medical advice. Before taking any medication, consult a qualified
physician who can provide personalized advice and details of risks and
benefits based on your medical history and situation.
FLCCC and
WCH
provide treatment protocols.
Submit