Abstract:
Introduction: Several existing medications are being repurposed for treatment of COVID-19, including chloroquine
and hydroxychloroquine. The use of these medications has been associated with QT prolongation. Their use in patients
with COVID-19, magnifies the risk for development of heart arrhythmias.
Purpose: The aim of this bibliographic research was to perform an analysis of existing clinical reports regarding effects
of chloroquine and hydroxychloroquine used in patients with COVID-19 on myocardial repolarization, effects which
can be measured on ECG as dispersion of QT interval and manifested clinically as heart arrhythmias.
Material and methods: A three‐step approach was employed. Firstly, a search of clinical reports in HINARI and
PubMed using key words COVID-19 and QT dispersion was performed. Secondarily, selected articles were limited to
the English language and human studies. Finally, full texts of all the selected articles were reviewed in details and
points relevant to QT dispersion related to use of drugs were extracted. A number of 11 articles was selected for final
analysis. Full information regarding age of patients, dosage of drugs used, information about changes in QTc, clinical
outcomes were found in 7 articles, which analysis is presented in the table 1 and 2.
Conclusions:
Medications used in COVID-19 patients have the potential to affect electrophysiology of the heart and can be associated with QT dispersion on ECG. Giving importance to these ECG markers may have a significant contribution in decreasing drug-related arrhythmias
in this group of patients.
Chloroquine and hydroxychloroquine particularly when combined with azithromycin increase the QTc in patients.
QTc prolongation is used as a surrogate of risk for torsades de pointes, but the relationship is imperfect. Risk generally increases when the QTc exceeds 500 ms.
The amount of QTc increase varies with drug dose, drug combination, sex, underlying heart disease in addition to COVID-19.
Description:
Chair of Physiopathology and clinical physiopathology, Chair of anesthesiology and intensive care nr. 1 ”Valeriu Ghereg”, State University of Medicine and Pharmacy “Nicolae Testemitanu”, Chisinau, Republic of Moldova, Congresul consacrat aniversării a 75-a de la fondarea Universității de Stat de Medicină și Farmacie „Nicolae Testemițanu” din Republica Moldova, Ziua internațională a științei pentru pace și dezvoltare
