Aksel Gökhan, Islam Mehmet Muzaffer, Aslan Tuncay, Eroglu Serkan Emre
Department of Emergency Medicine, University of Health Sciences, Umraniye Training and Research Hospital, Istanbul, Turkey.
Turk J Emerg Med. 2020 Jul 18;20(3):149-151. doi: 10.4103/2452-2473.290063. eCollection 2020 Jul-Sep.
Hydroxychloroquine is one of the most commonly used drugs in COVID-19 treatment. In this case report, we aimed to present a young patient whose QT interval was prolonged due to hydroxychloroquine overdose which was given for COVID-19 treatment. This is the first reported case of QT interval prolongation at a low dose of 1.600 mg in the literature. A 28-year-old male patient was admitted to the emergency department with the complaints of nausea, diarrhea, and weakness. The patient was diagnosed with COVID-19 a day prior and home isolation was recommended with hydroxychloroquine and oseltamivir P. O. treatment. His complaints started 6 h after accidentally taking 1.600 mg of hydroxychloroquine P. O. at the same time. On physical examination, the Glasgow Coma Scale was 15, and neurological, respiratory, and abdominal examinations were normal. His pulse was 54 beats/min, oxygen saturation was 99%, arterial blood pressure was 122/82 mmHg, and fever was 36.5°C. Electrocardiography (ECG) showed sinus bradycardia and corrected QT interval was calculated as 510 ms. The QT interval prolongation and bradycardia persisted, and the patient was hospitalized for follow-up and treatment. He was discharged on the 3 day of his hospitalization after the corrected QT interval was detected to be 420 ms and his bradycardia improved. Due to the potential cardiac side effects, patients who are sent to home isolation with treatment should be educated about the use, dosage, and possible side effects of this medicine, and serial ECG monitoring should be provided to patients who are hospitalized.
羟氯喹是新冠病毒疾病治疗中最常用的药物之一。在本病例报告中,我们旨在呈现一名年轻患者,其因过量服用用于新冠病毒疾病治疗的羟氯喹而出现QT间期延长。这是文献中首次报道的低剂量1600毫克时QT间期延长的病例。一名28岁男性患者因恶心、腹泻和乏力主诉入住急诊科。该患者一天前被诊断为新冠病毒疾病,建议居家隔离并口服羟氯喹和奥司他韦治疗。他在同时意外口服1600毫克羟氯喹6小时后开始出现上述症状。体格检查时,格拉斯哥昏迷量表评分为15分,神经、呼吸和腹部检查均正常。他的脉搏为54次/分钟,血氧饱和度为99%,动脉血压为122/82毫米汞柱,体温为36.5℃。心电图显示窦性心动过缓,校正QT间期计算为510毫秒。QT间期延长和心动过缓持续存在,患者住院进行随访和治疗。在检测到校正QT间期为420毫秒且心动过缓改善后,他在住院第3天出院。由于存在潜在的心脏副作用,对于接受治疗并居家隔离的患者,应就该药物的使用、剂量和可能的副作用进行教育,并对住院患者进行连续心电图监测。