Comparison of hydroxychloroquine plus moxifloxacin versus hydroxychloroquine alone on corrected QT interval prolongation in COVID-19 patients

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dc.contributor.authorYavuz V.
dc.contributor.authorOzyurtlu F.
dc.contributor.authorCetin N.
dc.date.accessioned2024-07-22T08:06:27Z
dc.date.available2024-07-22T08:06:27Z
dc.date.issued2021
dc.description.abstractBackground: Hydroxychloroquine (HCQ) alone or with some antibiotic and antiviral agents is used off label in the treatment of Coronavirus Disease 2019 (COVID-19). It seems that the most important safety problem about these medications are their cardiac side effects. Although there are data on arrhythmogenic events associated with the use of HCQ alone, such as corrected QT (QTc) prolongation, Torsade de pointes (TdP) or bradycardia, there are insufficient data on its combination with moxifloxacin (MOX). Objective: The aim of our study is to analyze the effect of HCQ alone or in combination with the use of MOX on QTc interval, heart rate, and arrhythmic events in patients with a diagnosis of COVID-19. Methods: This is a single center cohort study of non-intensive care unit (ICU) patients hospitalized with clinical signs consistent with pneumonia and at least one positive COVID-19 nasopharyngeal polymerase chain reaction test result. QTc intervals and heart rates in patients whose treatment consisted of HCQ alone or its separate combination with MOX at baseline and post-treatment were calculated and compared. Results: 312 patients were included (median age of 42 [IQR: 31.25–57.75] years, 54.16% male). Patients were divided into two groups based on their in-hospital treatment strategy as follows: HCQ alone (n: 166, 53.20%) or HCQ + MOX (n: 146, 46.79%). As compared to baseline, QTc intervals were significantly increased in all patients after treatment (406.00 [388.00–422.00] ms vs 418.00 [401.00–435.00] ms, p< 0.001). When the baseline QTc intervals were evaluated, there was no statistically significant difference between HCQ alone and HCQ + MOX groups (403.00 [384.50–419.00] ms vs. 409.50 [390.00–425.00] ms, p: 0.086). After treatment period, QTc intervals were significantly higher in HCQ + MOX group compared to the group in which patients only used HCQ (413.00 [398.00–430.00] ms vs. 426.50 [405.00–441.00] ms, p< 0.001). We found a significant decrease in heart rate in both groups after treatment period. From 79.00 (70.00–88.00) bpm to 70.00 (63.00–79.00) bpm in HCQ alone group (p< 0.001) and from 80.00 (70.00–88.00) bpm to 70.50 (63.00–78.75) bpm in HCQ + MOX group (p< 0.001). On the other hand, no statistically significant difference was observed between the groups in terms of heart rates either before or after the treatment. Conclusion: In this cohort study, patients who received HCQ for the treatment of COVID-19 were at high risk of QTc prolongation, and concurrent treatment with MOX was associated with greater changes in QTc. However, none of patients experienced malignant ventricular arrhythmia or death during treatment. Clinicians should carefully weigh risks and benefits with close monitoring of QTc if considering treatment with HCQ especially concomitant use with MOX. Further prospective studies are needed to determine the exact implications of these drugs on arrhythmias in patients with COVID-19. © 2021, ČKS.
dc.identifier.DOI-ID10.33678/COR.2021.053
dc.identifier.issn00108650
dc.identifier.urihttp://akademikarsiv.cbu.edu.tr:4000/handle/123456789/13536
dc.language.isoEnglish
dc.publisherCzech Society of Cardiology Z.S
dc.rightsAll Open Access; Gold Open Access
dc.subjectbiological marker
dc.subjectC reactive protein
dc.subjectelectrolyte solution
dc.subjecthydroxychloroquine
dc.subjectmoxifloxacin
dc.subjectadult
dc.subjectArticle
dc.subjectchronic obstructive lung disease
dc.subjectcohort analysis
dc.subjectcomorbidity assessment
dc.subjectcontrolled study
dc.subjectcoronary artery disease
dc.subjectcoronavirus disease 2019
dc.subjectdiabetes mellitus
dc.subjectdrug dose reduction
dc.subjectdrug effect
dc.subjectelectrocardiogram
dc.subjectelectrocardiography monitoring
dc.subjectelectrolyte disturbance
dc.subjectfemale
dc.subjectheart failure
dc.subjectheart rate
dc.subjectheart rhythm
dc.subjecthospital patient
dc.subjecthuman
dc.subjecthypertension
dc.subjectlung insufficiency
dc.subjectmajor clinical study
dc.subjectmale
dc.subjectnasopharyngeal swab
dc.subjectobservational study
dc.subjectpolymerase chain reaction
dc.subjectprevalence
dc.subjectQT prolongation
dc.subjectQTc interval
dc.subjectretrospective study
dc.subjectsecondary infection
dc.subjecttreatment outcome
dc.titleComparison of hydroxychloroquine plus moxifloxacin versus hydroxychloroquine alone on corrected QT interval prolongation in COVID-19 patients
dc.typeArticle

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