Proarrhythmia assessment in treatment with hydroxychloroquine and azithromycin hospitalized elderly COVID-19 patients - our experience
The aim of our study was to characterize the repolarization disorders propensity induced by drug-drug interaction. In this observational retrospective study, we report our experience on all elderly patients with ascertained diagnosis of coronavirus disease 2019 through nasopharyngeal swab with real...
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| Format: | Article |
| Language: | English |
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PAGEPress Publications
2021-06-01
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| Series: | Geriatric Care |
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| Online Access: | https://www.pagepressjournals.org/index.php/gc/article/view/9536 |
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| author | Raffaele Costa Alberto Castagna Carlo Torchia Carmen Ruberto Viviana Vespertini Lucio Cosco Giovanni Ruotolo |
| author_facet | Raffaele Costa Alberto Castagna Carlo Torchia Carmen Ruberto Viviana Vespertini Lucio Cosco Giovanni Ruotolo |
| author_sort | Raffaele Costa |
| collection | DOAJ |
| description | The aim of our study was to characterize the repolarization disorders propensity induced by drug-drug interaction. In this observational retrospective study, we report our experience on all elderly patients with ascertained diagnosis of coronavirus disease 2019 through nasopharyngeal swab with real time-polymerase chain reaction at our Pugliese-Ciaccio hospital in Catanzaro, who received hydroxychloroquine (HCQ), with or without azithromycin (AZY). 33 hospitalized patients were examined. We calculated QT value, cQT, QT dispersion, and cQT dispersion and examined possible progression on the basal electrocardiogram (T0) and after the insertion of the drug (T1). The QT value is increased by T0 vs T1 (370±40.74 vs 420±36.91 ms; P=0.000), as well as the cQT value (408±25.40 vs 451.54±58.81; P=0.003), the QT dispersion (QTd: 36.36±14.53 vs 50.90±13.12 ms; P=0.000); the dispersion of cQTc (cQTd 46.27±18.72 vs 63.18±21.93 ms; P=0.001). The ΔQT was 37.44±44.09 while the ΔcQT was 32.01±56.47). The main determinant of QTc prolongation is the number of drug at risk of prolongation of the QT that could influence the ventricular repolarization phase. The use of HCQ in combination with AZY, in patients suffering from severe acute respiratory syndrome-related coronavirus-2, can favor the onset of serious side effects, even potentially fatal. Finally, the measures of QTd and cQTd confirmed additional electrocardiographic parameters useful in identifying patients being treated with drugs at risk of potential adverse arrhythmic events following drug interaction. |
| first_indexed | 2024-12-12T10:42:01Z |
| format | Article |
| id | doaj.art-e1ffd5e3fea44e95b4cbb79f1db76931 |
| institution | Directory Open Access Journal |
| issn | 2465-1109 2465-1397 |
| language | English |
| last_indexed | 2024-12-12T10:42:01Z |
| publishDate | 2021-06-01 |
| publisher | PAGEPress Publications |
| record_format | Article |
| series | Geriatric Care |
| spelling | doaj.art-e1ffd5e3fea44e95b4cbb79f1db769312022-12-22T00:27:02ZengPAGEPress PublicationsGeriatric Care2465-11092465-13972021-06-017210.4081/gc.2021.9536Proarrhythmia assessment in treatment with hydroxychloroquine and azithromycin hospitalized elderly COVID-19 patients - our experienceRaffaele Costa0Alberto Castagna1Carlo Torchia2Carmen Ruberto3Viviana Vespertini4Lucio Cosco5Giovanni Ruotolo6Geriatric Unit, ‘Pugliese-Ciaccio’ General Hospital, CatanzaroPrimary Care Department, Azienda Sanitaria Provinciale di CatanzaroGeriatric Unit, ‘Pugliese-Ciaccio’ General Hospital, CatanzaroGeriatric Unit, ‘Pugliese-Ciaccio’ General Hospital, CatanzaroInfectious Diseases Unit, ‘Pugliese-Ciaccio’ General Hospital, CatanzaroInfectious Diseases Unit, ‘Pugliese-Ciaccio’ General Hospital, CatanzaroGeriatric Unit, ‘Pugliese-Ciaccio’ General Hospital, CatanzaroThe aim of our study was to characterize the repolarization disorders propensity induced by drug-drug interaction. In this observational retrospective study, we report our experience on all elderly patients with ascertained diagnosis of coronavirus disease 2019 through nasopharyngeal swab with real time-polymerase chain reaction at our Pugliese-Ciaccio hospital in Catanzaro, who received hydroxychloroquine (HCQ), with or without azithromycin (AZY). 33 hospitalized patients were examined. We calculated QT value, cQT, QT dispersion, and cQT dispersion and examined possible progression on the basal electrocardiogram (T0) and after the insertion of the drug (T1). The QT value is increased by T0 vs T1 (370±40.74 vs 420±36.91 ms; P=0.000), as well as the cQT value (408±25.40 vs 451.54±58.81; P=0.003), the QT dispersion (QTd: 36.36±14.53 vs 50.90±13.12 ms; P=0.000); the dispersion of cQTc (cQTd 46.27±18.72 vs 63.18±21.93 ms; P=0.001). The ΔQT was 37.44±44.09 while the ΔcQT was 32.01±56.47). The main determinant of QTc prolongation is the number of drug at risk of prolongation of the QT that could influence the ventricular repolarization phase. The use of HCQ in combination with AZY, in patients suffering from severe acute respiratory syndrome-related coronavirus-2, can favor the onset of serious side effects, even potentially fatal. Finally, the measures of QTd and cQTd confirmed additional electrocardiographic parameters useful in identifying patients being treated with drugs at risk of potential adverse arrhythmic events following drug interaction.https://www.pagepressjournals.org/index.php/gc/article/view/9536QT assessmenthydroxychloroquineazithromycinCOVID-19. |
| spellingShingle | Raffaele Costa Alberto Castagna Carlo Torchia Carmen Ruberto Viviana Vespertini Lucio Cosco Giovanni Ruotolo Proarrhythmia assessment in treatment with hydroxychloroquine and azithromycin hospitalized elderly COVID-19 patients - our experience Geriatric Care QT assessment hydroxychloroquine azithromycin COVID-19. |
| title | Proarrhythmia assessment in treatment with hydroxychloroquine and azithromycin hospitalized elderly COVID-19 patients - our experience |
| title_full | Proarrhythmia assessment in treatment with hydroxychloroquine and azithromycin hospitalized elderly COVID-19 patients - our experience |
| title_fullStr | Proarrhythmia assessment in treatment with hydroxychloroquine and azithromycin hospitalized elderly COVID-19 patients - our experience |
| title_full_unstemmed | Proarrhythmia assessment in treatment with hydroxychloroquine and azithromycin hospitalized elderly COVID-19 patients - our experience |
| title_short | Proarrhythmia assessment in treatment with hydroxychloroquine and azithromycin hospitalized elderly COVID-19 patients - our experience |
| title_sort | proarrhythmia assessment in treatment with hydroxychloroquine and azithromycin hospitalized elderly covid 19 patients our experience |
| topic | QT assessment hydroxychloroquine azithromycin COVID-19. |
| url | https://www.pagepressjournals.org/index.php/gc/article/view/9536 |
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