药物致 QTc 间期延长在 PCR 阳性非 ICU COVID-19 患者中的表现，这些患者的胸部计算机断层扫描结果存在多样性。
Drug-induced QTc interval prolongation in PCR-positive non-ICU COVID-19 patients with diverse findings on chest computed tomography.
机构信息
Department of Cardiology, Grandmedical Hospital, Manisa, Turkey.
Department of Cardiology, Celal Bayar University, Manisa, Turkey.
出版信息
Int J Clin Pract. 2021 Oct;75(10):e14583. doi: 10.1111/ijcp.14583. Epub 2021 Jul 12.
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.
背景
一些用于治疗冠状病毒病（COVID-19）的药物可能会增加校正 QT（QTc）间期延长的风险，从而引发心律失常甚至死亡。由于逆转录酶-聚合酶链反应（RT-PCR）检测的敏感性较低，胸部计算机断层扫描（CT）成像正被用于 COVID-19 的诊断相关性，并评估肺部是否有肺部受累。
目的
本研究旨在探讨使用可延长 QTc 间期的药物治疗 COVID-19 患者时，非 ICU 患者的肺部 CT 变化与心电图（ECG）QTc 间期变化之间的相关性，且这些患者的 PCR 检测结果为阳性。
方法
这是一项单中心回顾性队列研究，纳入了 344 名（56.1%为男性）住院非 ICU 患者，平均年龄为 46.34±17.68 岁。根据胸部 CT 结果，将患者分为四组：典型、非典型、不确定或无肺部受累。比较患者入院时和治疗后的心电图（ECG）平均 QTc 间期和心率。
结果
各组的年龄、性别和体重指数（BMI）无显著差异。此外，各组入院时（P=.127）和治疗后（P=.205）的平均 QTc 间期值无显著差异。各组的心率值也相似，入院时（P=.648）和治疗后（P=.229）ECG 的平均心率无显著差异。
结论
本研究表明，基于胸部 CT 的 COVID-19 感染发现与非 ICU COVID-19 患者的 QTc 间期延长无关。需要进行更多的大型研究来探讨胸部 CT 发现对 COVID-19 患者 QTc 间期延长和心动过缓的影响。
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