Maneikis Kazimieras, Ringeleviciute Ugne, Bacevicius Justinas, Dieninyte-Misiune Egle, Burokaite Emilija, Kazbaraite Gintare, Monika Janusaite Marta, Dapkeviciute Austeja, Zucenka Andrius, Peceliunas Valdas, Kryzauskaite Lina, Kasiulevicius Vytautas, Ringaitiene Donata, Zablockiene Birute, Zvirblis Tadas, Marinskis Germanas, Jancoriene Ligita, Griskevicius Laimonas
Hematology, Oncology and Transfusion Medicine Centre, Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania.
Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania.
Int J Cardiol Heart Vasc. 2020 Dec 11;32:100685. doi: 10.1016/j.ijcha.2020.100685. eCollection 2021 Feb.
To assess cardiac safety in COVID-19 patients treated with the combination of Hydroxychloroquine and Azithromycin using arrhythmia risk management plan.
We retrospectively examined arrhythmia safety of treatment with Hydroxychloroquine and Azithromycin in the setting of pre-defined arrhythmia risk management plan. The data was analyzed using R statistical package version 4.0.0. A two-tailed p-value<0.05 was considered significant. 81 patients were included from March 23rd to May 10th 2020. The median age was 59 years, 58.0% were female. The majority of the study population (82.7%) had comorbidities, 98.8% had radiological signs of pneumonia. Fourteen patients (17.3%) experienced QTc ≥ 480 ms and 16 patients (19.8%) had an increase of QTc ≥ 60 ms. Seven patients (8.6%) had QTc prolongation of ≥ 500 ms. The treatment was discontinued in 4 patients (4.9%). None of the patients developed ventricular tachycardia. The risk factors significantly associated with QTc ≥ 500 ms were hypokalemia (p = 0.032) and use of diuretics during the treatment (p = 0.020). Three patients (3.7%) died, the cause of death was bacterial superinfection with septic shock in two patients, and disseminated intravascular coagulation with multiple organ failure in one patient. None of these deaths were associated with cardiac arrhythmias.
We recorded a low incidence of QTc prolongation ≥ 500 ms and no ventricular tachycardia events in COVID-19 patients treated with Hydroxychloroquine and Azithromycin using cardiac arrhythmia risk management plan.
使用心律失常风险管理计划评估接受羟氯喹和阿奇霉素联合治疗的新冠肺炎患者的心脏安全性。
我们在预先定义的心律失常风险管理计划背景下，回顾性研究了羟氯喹和阿奇霉素治疗的心律失常安全性。使用R统计软件包版本4.0.0对数据进行分析。双侧p值<0.05被认为具有统计学意义。纳入了2020年3月23日至5月10日的81例患者。中位年龄为59岁，58.0%为女性。大多数研究人群（82.7%）患有合并症，98.8%有肺炎的影像学表现。14例患者（17.3%）QTc≥480毫秒，16例患者（19.8%）QTc增加≥60毫秒。7例患者（8.6%）QTc延长≥500毫秒。4例患者（4.9%）停止治疗。无一例患者发生室性心动过速。与QTc≥500毫秒显著相关的危险因素是低钾血症（p=0.032）和治疗期间使用利尿剂（p=0.020）。3例患者（3.7%）死亡，2例患者的死亡原因是细菌重叠感染伴感染性休克，1例患者是弥散性血管内凝血伴多器官衰竭。这些死亡均与心律失常无关。
我们记录到，在使用心律失常风险管理计划接受羟氯喹和阿奇霉素治疗的新冠肺炎患者中，QTc延长≥500毫秒的发生率较低且无室性心动过速事件发生。
