031
QT interval monitoring for inpatient treated with hydroxychloroquine/azithromycin association in the context of SARS-CoV-2 pandemic

https://doi.org/10.1016/j.acvdsp.2020.10.229Get rights and content
Under an Elsevier user license
open archive

Background

There are ongoing clinical trials on the efficacy of several therapeutic strategies for the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Among them, the association between hydroxychloroquine (HCQ) and azithromycin (AZT) is under evaluation. Both drugs have a known torsadogenic potential, but QT prolongation induced by this association for inpatient is unknown.

Objective

To assess QT monitoring of inpatient treated with the association HCQ/AZT for SARS-CoV-2.

Methods

Before therapy initiation, a baseline 12 lead-ECG was electronically sent to our cardiology department for QT analysis (automatic measurement, and Bazett/Fridericia calculation with manual measurement), and after two days of treatment. An institutional protocol (Pasteur University Hospital, Nice) was validated, and allowed HCQ/AZT initiation only if baseline QTc ≥ 480ms and potassium level > 4.0 mmol/L.

Results

From March 24th to April 19th, 71 patients were included (mean age 62 ± 14 years, male 66%). Three patients out of 71 (4.2%) were not eligible for drug initiation (QTc ≥ 500ms), and the treatment had to be stopped because of significant QTc prolongation in 2 out of 68 patients (2.9%): concurrent QT-prolonging medication polypharmacy in both patients. Baseline mean QTc was 418 ± 30 ms and lengthened to 442 ± 46 ms after 48 hours of combined therapy (Fig. 1). The agreement coefficient between automatic measurement of QT interval and manual measurements (variability below 5%) was calculated at 57%.

Conclusion

A combined therapy, using HCQ/AZT for inpatient SARS-CoV-2, required a close ECG monitoring. This association had to be interrupted in 2.9% of the patients treated.

Cited by (0)