QTc prolongation among hydroxychloroquine sulphate‐treated COVID‐19 patients: An observational study

Fteiha, Bashar; Karameh, Hani; Kurd, Ramzi; Ziff-Werman, Batsheva; Feldman, Itamar; Bnaya, Alon; Einav, Sharon; Orlev, Amir; Ben‐Chetrit, Eli

doi:10.1111/ijcp.13767

Cited by 11 publications

(5 citation statements)

References 24 publications

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“…Hydroxychloroquine was widely prescribed during the first wave. However, its use has not been shown to improve COVID-19 outcomes and indeed, it may even increase mortality due to cardiac arrhythmia, especially in old and very old vulnerable patients who have significant comorbidities [ 37 ]. Given that the use of hydroxychloroquine in our series was less frequent in NC than in CAC patients, the overall higher IHM observed in NC patients seems to be independent of this therapy.…”

Section: Discussionmentioning

confidence: 99%

Nosocomial COVID-19: A Nationwide Spanish Study

Ramos‐Rincón¹,

López-Sampalo²,

Cobos-Palacios³

et al. 2023

Gerontology

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Introduction: SARS-CoV-2 is a highly contagious virus, and despite professionals’ best efforts, nosocomial COVID-19 (NC) infections have been reported. This work aimed to describe differences in symptoms and outcomes between patients with NC and community-acquired COVID-19 (CAC) and to identify risk factors for severe outcomes among NC patients. Methods: This is a nationwide, retrospective, multicenter, observational study that analyzed patients hospitalized with confirmed COVID-19 in 150 Spanish hospitals (SEMI-COVID-19 Registry) from March 1, 2020, to April 30, 2021. NC was defined as patients admitted for non-COVID-19 diseases with a positive SARS-CoV-2 test on the fifth day of hospitalization or later. The primary outcome was 30-day in-hospital mortality (IHM). The secondary outcome was other COVID-19-related complications. A multivariable logistic regression analysis was performed. Results: Of the 23,219 patients hospitalized with COVID-19, 1,104 (4.8%) were NC. Compared to CAC patients, NC patients were older (median 76 vs. 69 years; p < 0.001), had more comorbidities (median Charlson Comorbidity Index 5 vs. 3; p < 0.001), were less symptomatic (p < 0.001), and had normal chest X-rays more frequently (30.8% vs. 12.5%, p < 0.001). After adjusting for sex, age, dependence, COVID-19 wave, and comorbidities, NC was associated with lower risk of moderate/severe acute respiratory distress syndrome (ARDS) (adjusted odds ratio [aOR]: 0.72; 95% confidence interval [CI]: 0.59–0.87; p < 0.001) and higher risk of acute heart failure (aOR: 1.40; 1.12–1.72; p = 0.003), sepsis (aOR: 1.73; 1.33–2.54; p < 0.001), and readmission (aOR: 1.35; 1.03–1.83; p = 0.028). NC was associated with a higher case fatality rate (39.1% vs. 19.2%) in all age groups. IHM was significantly higher among NC patients (aOR: 2.07; 1.81–2.68; p < 0.001). Risk factors for increased IHM in NC patients were age, moderate/severe dependence, malignancy, dyspnea, moderate/severe ARDS, multiple organ dysfunction syndrome, and shock; odynophagia was associated with lower IHM. Conclusions: NC is associated with greater mortality and complications compared to CAC. Hospital strategies to prevent NC must be strengthened.

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Section: Discussionmentioning

confidence: 99%

Nosocomial COVID-19: A Nationwide Spanish Study

Ramos‐Rincón¹,

López-Sampalo²,

Cobos-Palacios³

et al. 2023

Gerontology

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“…40 Another study in SARS-CoV-2 patients reported an increase of 13 (IQR 9 -16) ms. 41 Other studies reported QTcF-prolongation after hydroxychloroquine treatment only in a minority of their cases. 44,45 E.g., an average increase of the QTcF-interval of 1.8% was observed in a cohort of 219 hospitalized and ambulatory SARS-CoV-2 patients who were treated with a total dose of 2800 mg hydroxychloroquine, although combined with other antiviral drugs. 40 In another cohort of 111 hospitalized SARS-…”

Section: Discussionmentioning

confidence: 99%

Effect of hydroxychloroquine on the cardiac ventricular repolarization: A randomized clinical trial

Maarse

Graff

Kanters

et al. 2021

Brit J Clinical Pharma

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What is already known about this subject? Hydroxychloroquine has been used as anti-malarial and anti-rheumatic drug for decades, with only very few reports of cardiac death after use of this drug.The current SARS-Cov-2 pandemic has raised renewed attention on hydroxychloroquine. Concerns were raised on the pro-arrhythmic effects of hydroxychloroquine, that are presumably caused by blockage of the cardiac hERG channel. This study analyzed the effect of hydroxychloroquine, dosed in a regular regimen for SARS-CoV-2 patients, on the ventricular repolarization in a concentration-effect analysis. What does this study add? There were no significant associations between hydroxychloroquine concentration and ECG characteristics, including QTcF-interval and T-wave morphology, measured with a Morphology Combination Score (MCS). Based on this analysis, hydroxychloroquine does not significantly affect the QTcFinterval and does not significantly increase the risk of arrhythmias in the studied dosing regimen and population. This outcome can be explained by the maximal plasma concentration of this dosing regimen, that is not high enough to exert hERG channel inhibition.

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“…A detailed description of the studies included in the two groups is provided in Data S1 12–194 . The literature search yielded a total of 826 citations.…”

Section: Data Extractionmentioning

confidence: 99%

Prevalence of overweight and obesity and their effect on COVID‐19 severity and hospitalization among younger than 50 years versus older than 50 years population: A systematic review and meta‐analysis

et al. 2023

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SummaryCohort studies have shown that both overweight and obesity have their impact by increasing hospitalization with COVID‐19. We conducted a systematic literature search in PubMed, Google Scholar, and MedRxiv databases following the PRISMA guidelines. Statistical analyses were performed using STATA software version 16 MP (Stata Corp, College Station, TX, USA) and Med Calc software version 22.009(Med Calc software Ltd, Ostend, Belgium). The primary outcome was to measure the prevalence of overweight and obesity and their impact on the risk of hospitalization among COVID‐19 patients under and above 50 years of age. In total, 184 studies involving 2,365,377 patients were included. The prevalence of overweight was highest among those younger than 50 years of age over those older than 50 years of age, (26.33% vs. 30.46%), but there was no difference in obesity (36.30% vs. 36.02%). Overall, the pooled prevalence of overweight and obesity among hospitalized COVID‐19 patients was 31.0% and 36.26%, respectively. Compared with normal weight, the odds of hospitalization with overweight (odds ratio [OR] 2.186, 95% confidence interval [CI] [1.19, 3.99], p < 0.01) and obesity (OR 3.069, 95% CI [1.67, 5.61], p < 0.001) in those younger than 50 years and obesity (OR 3.977, 95% CI [2.75, 5.73], p < 0.001) in the older than 50 years age group were significantly high. The increased prevalence of overweight and obesity among the under 50 years age group and obesity among the older than 50 years age group significantly increased the rate of COVID‐19 infections, severity and hospitalization.

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QTc prolongation among hydroxychloroquine sulphate‐treated COVID‐19 patients: An observational study

Cited by 11 publications

References 24 publications

Nosocomial COVID-19: A Nationwide Spanish Study

Nosocomial COVID-19: A Nationwide Spanish Study

Effect of hydroxychloroquine on the cardiac ventricular repolarization: A randomized clinical trial

Prevalence of overweight and obesity and their effect on COVID‐19 severity and hospitalization among younger than 50 years versus older than 50 years population: A systematic review and meta‐analysis

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