A Comparision of QT Interval Prolongation in Covid 19 Patients Treated with Hydroxycholoquin Alone and in Combination with Azithromycin
Gauhar Rahman, Mohammad Yaqoob Khan, Zahabia Manzoor, Imrana Nawaz, Gul Mehnaz, Kashif Ali Samin
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ABSTRACT
Objective: The aim of this study is to compare the
incidence of increase QT interval among COVID 19 patients treated with
hydroxychloroquin alone and combination with azithromycin.
Study Design: Retrospective Cohort Study
Place and Duration: It is a multicenter study and conducted
in cardiology departments of Farooq Hospital, Lahore, Govt Zakir Khan Shaheed
Hospital Matta Swat and Category A Hospital, Batkhela Malakand for duration
from March 2020 to February 2021.
Methods: Total 100 Covid-19 patients of both genders
were enrolled in this study. Patients details demographics age, sex and body
mass index were recorded after taking informed written consent. Patients were
divided into two groups. Group I had 50 patients and received hydroxychloroquin
and group II (50 patients) received hydroxychloroquin with azithromycin.
Outcomes among both groups were assessed in terms of increase QT interval.
Complete data was analyzed by SPSS 24.0 version.
Results: There were 32 (64%) males and 18 (36%)
females in group I while in group II 30 (60%) males and 20 (40%) females. Mean
age in group I was 57.65±9.87 years with mean BMI 28.18±4.23 kg/m2
and in group II mean age was 61.09±6.26 years with mean BMI 29.18±6.53 kg/m2.
Hypertension was the most common co-morbidity found in 60%and 56% in group I
and II followed by diabetes 26% and 28% among both groups. Prolong QTc was
found among 10 (20%) cases in group I and in Group II 15 (30%) patients.
Significantly QTc was increase in group II from 443.18±26.23 to 475.13±29.36
while in group I QTc increases from 442.37±33.25 to 468.09±26.37 ms. Among 15
cases in combination group 9 patients had change QTc of >500
milliseconds and 2 cases had QTc of > delta 60 ms while in monotherapy
group 4 cases had change QTc of 500 milliseconds and 1 had > delta 60
milliseconds.
Conclusion: We concluded in this study that
prolonged QTc and change of QTc was significantly higher in COVID 19 patients
who received treatment with combination of hydroxychloroquin and azithromycin
as compared to the patients who received hydroxychloroquin only.
Keywords: COVID 19, QTc
interval, Hydroxychloroquin, Azithromycin