QT Interval Prolongation Under Hydroxychloroquine/Azithromycin Association for Inpatients With SARS-CoV-2 Lower Respiratory Tract Infection

© 2020 The Authors Clinical Pharmacology & Therapeutics © 2020 American Society for Clinical Pharmacology and Therapeutics..

Association between Hydroxychloroquine (HCQ) and Azithromycin (AZT) is under evaluation for patients with lower respiratory tract infection (LRTI) caused by the Severe Acute Respiratory Syndrome (SARS-CoV-2). Both drugs have a known torsadogenic potential, but sparse data are available concerning QT prolongation induced by this association. Our objective was to assess for COVID-19 LRTI variations of QT interval under HCQ/AZT in patients hospitalized, and to compare manual versus automated QT measurements. Before therapy initiation, a baseline 12 lead-ECG was electronically sent to our cardiology department for automated and manual QT analysis (Bazett and Fridericia's correction), repeated 2 days after initiation. According to our institutional protocol (Pasteur University Hospital), HCQ/AZT was initiated only if baseline QTc ≤ 480ms and potassium level> 4.0 mmol/L. From March 24th to April 20th 2020, 73 patients were included (mean age 62 ± 14 years, male 67%). Two patients out of 73 (2.7%) were not eligible for drug initiation (QTc ≥ 500 ms). Baseline average automated QTc was 415 ± 29 ms and lengthened to 438 ± 40 ms after 48 hours of combined therapy. The treatment had to be stopped because of significant QTc prolongation in two out of 71 patients (2.8%). No drug-induced life-threatening arrhythmia, nor death was observed. Automated QTc measurements revealed accurate in comparison with manual QTc measurements. In this specific population of inpatients with COVID-19 LRTI, HCQ/AZT could not be initiated or had to be interrupted in less than 6% of the cases.

Media Type:

Electronic Article

Year of Publication:

2020

Contained In:

Clinical pharmacology and therapeutics - Vol. 108, No. 5 (2020), p. 1090-1097

Language:

English

Contributors:

Bun, Sok-Sithikun
Taghji, Philippe
Courjon, Johan
Squara, Fabien
Scarlatti, Didier
Theodore, Guillaume
Baudouy, Delphine
Sartre, Benjamin
Labbaoui, Mohamed
Dellamonica, Jean
Doyen, Denis
Marquette, Charles-Hugo
Levraut, Jacques
Esnault, Vincent
Bun, Sok-Siya
Ferrari, Emile

Links:

Volltext

Keywords:

*Azithromycin
*Coronavirus Infections
*Drug Monitoring
*Hydroxychloroquine
*Long QT Syndrome
*Pandemics
4QWG6N8QKH
83905-01-5
Anti-Infective Agents
Azithromycin
Betacoronavirus
Dimensional Measurement Accuracy
Electrocardiography
Female
Humans
Hydroxychloroquine
Journal Article
Male
Middle Aged
Outcome Assessment, Health Care
Pneumonia, Viral
Torsades de Pointes

Notes:

Date Completed 27.10.2020

Date Revised 27.10.2020

published: Print-Electronic

Citation Status MEDLINE

Copyright: From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

Physical Description:

Online-Ressource

doi:

10.1002/cpt.1968

PMID:

32588427

PPN (Catalogue-ID):

NLM312572778