tetano
Editor, Senior Moderator
Neth Heart J. 2020 Apr 29. doi: 10.1007/s12471-020-01429-7. [Epub ahead of print]
Chloroquine-induced QTc prolongation in COVID-19 patients.
van den Broek MPH[SUP]1[/SUP], M?hlmann JE[SUP]2[/SUP], Abeln BGS[SUP]3[/SUP], Liebregts M[SUP]3[/SUP], van Dijk VF[SUP]3[/SUP], van de Garde EMW[SUP]2,[/SUP][SUP]4[/SUP].
Author information
Abstract
BACKGROUND:
In the battle against the SARS-CoV‑2 pandemic, chloroquine has emerged as a new potential therapeutic option for the treatment of infected patients. A safety consideration for the application of chloroquine is its QTc-prolonging potential. Thus far, no data are available on the QTc-prolonging potential of chloroquine in COVID-19 patients.
OBJECTIVE:
To assess the degree of chloroquine-induced QTc prolongation in hospitalised COVID-19 patients.
METHODS:
A baseline electrocardiogram (ECG) and ECGs recorded during chloroquine treatment were retrospectively collected in patients suspected of having COVID-19. The QTc interval was calculated by computerised and manual interpretation. Baseline and follow-up QTc intervals were compared using the paired samples t-test.
RESULTS:
A total of 95 patients had a baseline ECG recording and at least one ECG recording during chloroquine therapy. Chloroquine treatment resulted in a mean QTc prolongation of 35 ms (95% CI 28-43 ms) using computerised interpretation and 34 ms (95% CI 25-43 ms) using manual interpretation. No torsade de pointes was observed during chloroquine treatment. After manual review, 22 patients (23%) had a QTc interval exceeding 500 ms during chloroquine treatment. None of these patients had a prolonged QTc interval prior to the initiation of chloroquine treatment.
CONCLUSIONS:
Chloroquine significantly prolongs the QTc interval in a clinically relevant matter. This highlights the need for ECG monitoring when prescribing chloroquine to COVID-19 patients.
KEYWORDS:
COVID-19; Chloroquine; Coronavirus; Electrocardiogram; QT prolongation; SARS-CoV‑2
PMID:32350818DOI:10.1007/s12471-020-01429-7
Chloroquine-induced QTc prolongation in COVID-19 patients.
van den Broek MPH[SUP]1[/SUP], M?hlmann JE[SUP]2[/SUP], Abeln BGS[SUP]3[/SUP], Liebregts M[SUP]3[/SUP], van Dijk VF[SUP]3[/SUP], van de Garde EMW[SUP]2,[/SUP][SUP]4[/SUP].
Author information
Abstract
BACKGROUND:
In the battle against the SARS-CoV‑2 pandemic, chloroquine has emerged as a new potential therapeutic option for the treatment of infected patients. A safety consideration for the application of chloroquine is its QTc-prolonging potential. Thus far, no data are available on the QTc-prolonging potential of chloroquine in COVID-19 patients.
OBJECTIVE:
To assess the degree of chloroquine-induced QTc prolongation in hospitalised COVID-19 patients.
METHODS:
A baseline electrocardiogram (ECG) and ECGs recorded during chloroquine treatment were retrospectively collected in patients suspected of having COVID-19. The QTc interval was calculated by computerised and manual interpretation. Baseline and follow-up QTc intervals were compared using the paired samples t-test.
RESULTS:
A total of 95 patients had a baseline ECG recording and at least one ECG recording during chloroquine therapy. Chloroquine treatment resulted in a mean QTc prolongation of 35 ms (95% CI 28-43 ms) using computerised interpretation and 34 ms (95% CI 25-43 ms) using manual interpretation. No torsade de pointes was observed during chloroquine treatment. After manual review, 22 patients (23%) had a QTc interval exceeding 500 ms during chloroquine treatment. None of these patients had a prolonged QTc interval prior to the initiation of chloroquine treatment.
CONCLUSIONS:
Chloroquine significantly prolongs the QTc interval in a clinically relevant matter. This highlights the need for ECG monitoring when prescribing chloroquine to COVID-19 patients.
KEYWORDS:
COVID-19; Chloroquine; Coronavirus; Electrocardiogram; QT prolongation; SARS-CoV‑2
PMID:32350818DOI:10.1007/s12471-020-01429-7