Impact of Hydroxychloroquine Treatment of COVID-19 on Cardiac Conduction: The Beat Goes On

Objectives: Our study aimed to investigate the frequency of malignant cardiac arrhythmias in hospitalized patients receiving hydroxychloroquine alone and those a combination with azithromycin, as well quantitative extent QT prolongation within Tisdale Risk Score (TRS) categories. Background: There have been over 33 million cases SARS-CoV-2 (COVID-19) resulting 600,000 deaths United States. As current COVID-19 pandemic continues, numerous medications administered attempt treat afflicted by disease. While has use for decades rheumatologic infectious disease processes, it does potential cardiotoxicity related drug-induced prolongation. Drug-induced an increased risk arrhythmogenicity, potentially progressing into torsades de pointes (TdP) patient mortality. The relationship between TdP is complex inexact, but there remains optimism regarding these treatment despite limited data on their true efficacy. Methods: We retrospectively identified 75 who were admitted underwent 5 days. protocol was defined initial dose 400 mg BID first day, followed daily next 4 Baseline demographics, medications, medical histories, lab values, ECG intervals, Categories collected all patients. Results: Seventy-four (98.7%) completed full course hydroxychloroquine. 41 males (54.7%) 34 females (45.3%). Average length stay 8.9 days (95% CI: 7.5, 10.2). One could not complete due inability swallow medication tablets. no reports new arrythmias or incidence during study. Seventy-two (96%) taking at least 2 prolonging medications. average corrected intervals follows: day 1 admission 421.62 milliseconds (n = 66, 95% 412.19, 431.05), 431.50 ms 30, 416.34, 446.66), 3 433.48 23, 413.34, 453.61), 427.59 17, 400.83, 454.35), 444.28 18, 428.43, 460.12). interval prolonged 22.66 from (p 0.03) overall population. Conclusion: experienced arrhythmogenicity Torsades Pointes statistically significant increase QTc after received 5-day COVID-19.