Background The effect of favipiravir on the QTc interval during the treatment of Coronavirus Disease 2019 (COVID-19) patients is unclear. Thus, the current study objective was to evaluate any change in the QTc interval in patients who were hospitalized due to COVID-19 receiving favipiravir treatment. Method Patients hospitalized with COVID-19 were assessed in this single-center retrospective study. 189 patients, whose diagnosis was confirmed using real-time PCR, were included in the study. The patients were divided into three groups: those using hydroxychloroquine (Group 1, n = 66), hydroxychloroquine plus favipiravir (Group 2, n = 66), and favipiravir only (Group 3, n = 57). The QTc interval was measured before treatment (QTc-B) and 48 h after (i.e., the median) starting treatment (QTc-AT). Results The median age was 53 (39–66 IQR) and 97 (51%) of patients were female. The median QTc(Bazett)-change was 7 ms ( p = 0.028) and 12 ms ( p < 0.001) and in Group 1 and 2, respectively. In Group 3, the median QTc(Bazett)-change was observed as −3 ms and was not statistically significant ( p = 0.247). In multivariable analysis, while there was a significant relationship between QTc-AT(Bazett) and hydroxychloroquine (β coefficient = 2687, 95%CI 2599–16,976, p = 0,008), there was no significant relationship with favipiravir (β coefficient = 0,180, 95% CI -6435-7724, p = 0,858). Similarly, there was a significant relationship between the QTc-AT interval calculated using the Fredericia formula and hydroxychloroquine (β coefficient = 2120, 95% CI 0,514–14,398, p = 0,035), but not with favipiravir (β coefficient = 0,111, 95% CI -6450- 7221, p = 0,911). Conclusion In the ECG recordings received in the following days after the treatment was started in COVID-19 patients, there was a significant prolongation in the QTc interval with hydroxychloroquine, but there was no significant change with favipiravir.
Apolipoprotein E (ApoE) is a plasma protein and associated with cholesterol transport system. In several studies, the relationship between ApoE gene polymorphism and severity of coronary artery disease (CAD) has been shown. However, the relationship between ApoE gene polymorphism and severity of CAD in patients with acute myocardial infarction (MI) has not been well known. The aim of this study is to investigate the relation between ApoE polymorphism and severity of CAD in patients with acute MI by using the Gensini Score. In this study, 138 patients were admitted to cardiology clinic with diagnosis of acute MI, and angiographic assessment was performed using the Gensini Score. Blood samples were obtained from all patients in the first day. The patients with ApoE34 genotype had high Gensini scores. Besides, the patients with E4 allele carriers were associated with high Gensini score compared with the patients without E4 allele carriers (p:0,22). The patients with E4 allele carriers were associated with higher LDL cholesterol and total cholesterol compared with the patients without E4 allele carriers (p:0,001 and p:0,03, resp.). There were no statistically significant differences between ApoE genotypes and severity of CAD by using the Gensini Score. But, the patients with E4 allele carriers were associated with high lipid levels.
Red cell distribution width (RDW) and the neutrophil/lymphocyte ratio (NLR) are predictors of cardiovascular risk that have been shown to correlate with impaired reperfusion and increased morbidity and mortality in patients with an ST-segment elevation myocardial infarction (STEMI). We hypothesized that RDW and the NLR would be associated with failed thrombolysis. One hundred and two STEMI patients were included in the study; 32 had failed thrombolysis while the other 70 fulfilled the criteria for successful thrombolysis. Thrombolysis failure was defined as a need for rescue percutaneous coronary intervention (PCI), in-hospital mortality, unplanned PCI during hospitalization or complete occlusion of the culprit coronary artery on follow-up angiography. RDWs were compared between patients with failed or successful thrombolysis. There were no significant differences in the demographic or clinical baseline characteristics of the two groups. The mean RDW was significantly higher in the failed thrombolysis group than in the successful thrombolysis group (P = 0.028). The cutoff RDW value for failed thrombolysis was more than 14.3 fl with a sensitivity of 90.6% and a specificity of 61.4% (area under the curve, 0.774; 95% confidence interval, 0.680-0.851; P < 0.001) on receiver operating characteristics curve analysis. In addition, the prevalence of failed thrombolysis was significantly higher in patients with an RDW more than 14.3 fl than in those with an RDW of 14.3 fl or less (51.8 and 6.5%, respectively, P < 0.001 by multivariate analysis). The NLR was significantly higher in patients with an RDW more than 14.3 fl than in those with an RDW 14.3 fl or less (4 ± 2.5 and 2.8 ± 1.5, respectively, P = 0.007). RDW and the NLR may be used as adjunctive readily available factors for assessment of thrombolysis outcome upon admission.
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