Drug-induced QTc interval prolongation in PCR-positive non-ICU COVID-19 patients with diverse findings on chest computed tomography
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2021
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Abstract
Background: Some of the drugs used for the treatment of coronavirus disease (COVID-19) can increase the risk of corrected QT (QTc) interval prolongation, which may trigger arrhythmia or even death. Due to the low sensitivity of the reverse transcriptase-polymerase chain reaction (RT-PCR) test, chest computed tomography (CT) imaging is being used for COVID-19 diagnostic correlation and to evaluate whether there is pneumonic involvement in the lung. Objective: In this study, we aimed to investigate the correlation between lung changes on CT and QTc interval changes on ECG in non-ICU patients with COVID-19 who have a positive PCR test when using drugs that can prolong the QTc interval. Methods: This was a single-centre retrospective cohort study of hospitalized non-ICU patients. The study included 344 patients (56.1% men) with a mean age of 46.34 ± 17.68 years. The patients were divided into four groups according to their chest CT results: those having typical, atypical, indeterminate, or no pneumonic involvement. The mean QTc intervals and heart rates calculated from electrocardiograms (ECG) during admission to the hospital and after the treatment were compared. Results: No significant differences were found between the groups’ age, gender, and body mass index (BMI). In addition, no significant differences were found between the groups’ mean QTc interval values at admission (P:.127) or after the treatment (P:.205). The groups’ heart rate values were also similar, with no significant differences in the mean heart rate on admission (P:.648) and post-treatment (P:.229) ECGs. Conclusion: This study has demonstrated findings of COVID-19 infection based on chest CT does not correlate with QT interval prolongation in non-ICU COVID-19 patients. There is a need for additional larger studies investigating the effect of chest CT findings on QT interval prolongation and bradycardia in COVID-19 patients. © 2021 John Wiley & Sons Ltd
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Adult , Azithromycin , COVID-19 , Electrocardiography , Female , Humans , Hydroxychloroquine , Male , Middle Aged , Pharmaceutical Preparations , Polymerase Chain Reaction , Retrospective Studies , SARS-CoV-2 , Tomography , Tomography, X-Ray Computed , alanine aminotransferase , aspartate aminotransferase , azithromycin , C reactive protein , calcium , dipeptidyl carboxypeptidase inhibitor , favipiravir , hydroxychloroquine , magnesium , moxifloxacin , potassium , azithromycin , drug , hydroxychloroquine , acute heart infarction , adult , Article , bradycardia , calcium blood level , chronic kidney failure , computer assisted tomography , coronavirus disease 2019 , electrocardiography , erythrocyte transfusion , female , heart failure , heart rate , heart ventricle fibrillation , human , hypertension , intensive care unit , length of stay , loading drug dose , major clinical study , male , middle aged , mortality rate , pneumonia , polymerase chain reaction , prevalence , QT prolongation , QTc interval , retrospective study , reverse transcription polymerase chain reaction , scoring system , sinus node , sinus rhythm , ST segment elevation , virus load , polymerase chain reaction , tomography , x-ray computed tomography