Ventricular repolarization indexes in patients treated with hydroxychloroquine – azithromycin combination for COVID-19

Günay, Şeyda; Caliskan, Serhat; Sığırlı, Deniz; Şahin, Emre Ertan

doi:10.4149/bll_2020_134

Cited by 1 publication

(1 citation statement)

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“…The effects of combined use of hydroxychloroquine and azithromycin therapy on QT interval were studied earlier [12], but the effects of this therapy on QRS duration and dispersion have not yet been investigated. The aim of our study was to investigate the effects of hydroxychloroquine and azithromycin combination therapy on changes in QRS duration and dispersion values before and after the treatment in patients diagnosed with COVID-19 who had no known history of cardiovascular diseases.…”

Section: Introductionmentioning

confidence: 99%

The effects of combined hydroxychloroquine and azithromycin therapy on QRS wave in COVID-19 patients

Kocak¹,

Cosgun²,

KARAMANLIOĞLU³

et al. 2022

Journal of Surgery and Medicine

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Background/Aim: Hydroxychloroquine and azithromycin are frequently used for the treatment of coronavirus disease 2019 . The use of these medications increases the risk of adverse cardiovascular events. The aim of our study was to investigate the effects of these drugs on the arrhythmogenic electrocardiographic (ECG) markers, QRS duration, and QRS dispersion, and also to evaluate gender differences with respect to these effects. Methods: Between March and June 2020, 107 (54 males, 53 females) patients admitted to our hospital's isolation ward with COVID-19 diagnosis with no history, risk factors, or clinical findings of cardiovascular diseases were included in this prospective cohort study. All participants had a mild illness, and none of them required intensive care unit admission. ECGs of the patients were recorded before starting treatment with combined hydroxychloroquine and azithromycin, and a second ECG was recorded on the next morning following the last dose of the treatment. All ECGs were evaluated by two blinded cardiologists in terms of QRS duration and dispersion. Results: Among study participants, QRS duration was significantly prolonged after treatment with hydroxychloroquine and azithromycin (81.14 (9.11) versus 85.5 (10.48) ms [P < 0.01]), and the same pattern was observed with QRS dispersion (36.67 (9.54) versus 40.18 (9.35) ms [P < 0.01]). When gender differences were evaluated, male patients also showed significant changes in both QRS duration (82.65 (8.04) versus 87.31 (10.7) ms [P < 0.01]), and dispersion (36.93 (8.61) versus 41.31 (9.63) ms [P < 0.01]), while in females the difference was statistically insignificant for both QRS duration (79.06 (10.18) versus 82.8 (9.79) ms [P = 0.056]), and dispersion (36.31 (10.83) versus 38.62 (8.86) ms [P = 0.23]). Conclusions: The combined use of hydroxychloroquine and azithromycin led to an increase in both QRS duration and dispersion in all patients. These changes were more significant in males than in female patients. No clinical effects of these ECG changes were observed in the short-term, and further studies are needed to investigate the possible clinical implications of these drugs during longer follow-up periods.

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Section: Introductionmentioning

confidence: 99%