%0 Journal Article %1 hsia2020prolongation %A Hsia, B C %A Greige, N %A Quiroz, J A %A Khokhar, A S %A Daily, J %A Di Biase, L %A Ferrick, K J %A Fisher, J D %A Krumerman, A %D 2020 %J J Interv Card Electrophysiol %K (h)cq QTc azm covid-19 %R 10.1007/s10840-020-00822-x %T QT prolongation in a diverse, urban population of COVID-19 patients treated with hydroxychloroquine, chloroquine, or azithromycin %U https://pubmed.ncbi.nlm.nih.gov/32654098/ %X Hydroxychloroquine, chloroquine, and azithromycin have been used for treatment of COVID-19, but may cause QT prolongation. Minority populations are disproportionately impacted by COVID-19. This study evaluates the risk of QT prolongation and subsequent outcomes after administration of these medications in largely underrepresented minority COVID-19 patients.We conducted an observational study on hospitalized COVID-19 patients in the Montefiore Health System (Bronx, NY). We examined electrocardiograms (ECG) pre/post-medication initiation to evaluate QTc, HR, QRS duration, and presence of other arrhythmias.One hundred five patients (mean age 67 years; 44.8% F) were analyzed. The median time from the first dose of any treatment to post-medication ECG was 2 days (IQR: 1-3). QTc in men increased from baseline (440 vs 455 ms, p  500 ms was significantly increased after treatment (16.2% vs. 4.8%, p  500 ms or an increase of 60 ms had a higher frequency of death (47.6% vs. 22.6%, p = 0.02) with an odds ratio of 3.1 (95% CI: 1.1-8.7). Adjusting for race/ethnicity yielded no significant associations.Hydroxychloroquine, chloroquine, and/or azithromycin were associated with QTc prolongation but did not result in fatal arrhythmias. Our findings suggest that any harm is unlikely to outweigh potential benefits of treatment. Careful risk-benefit analyses for individual patients should guide the use of these medications. Randomized control trials are necessary to evaluate their efficacies.

@article{hsia2020prolongation, abstract = {Hydroxychloroquine, chloroquine, and azithromycin have been used for treatment of COVID-19, but may cause QT prolongation. Minority populations are disproportionately impacted by COVID-19. This study evaluates the risk of QT prolongation and subsequent outcomes after administration of these medications in largely underrepresented minority COVID-19 patients.We conducted an observational study on hospitalized COVID-19 patients in the Montefiore Health System (Bronx, NY). We examined electrocardiograms (ECG) pre/post-medication initiation to evaluate QTc, HR, QRS duration, and presence of other arrhythmias.One hundred five patients (mean age 67 years; 44.8% F) were analyzed. The median time from the first dose of any treatment to post-medication ECG was 2 days (IQR: 1-3). QTc in men increased from baseline (440 vs 455 ms, p  500 ms was significantly increased after treatment (16.2% vs. 4.8%, p  500 ms or an increase of 60 ms had a higher frequency of death (47.6% vs. 22.6%, p = 0.02) with an odds ratio of 3.1 (95% CI: 1.1-8.7). Adjusting for race/ethnicity yielded no significant associations.Hydroxychloroquine, chloroquine, and/or azithromycin were associated with QTc prolongation but did not result in fatal arrhythmias. Our findings suggest that any harm is unlikely to outweigh potential benefits of treatment. Careful risk-benefit analyses for individual patients should guide the use of these medications. Randomized control trials are necessary to evaluate their efficacies.}, added-at = {2020-08-08T18:20:10.000+0200}, author = {Hsia, B C and Greige, N and Quiroz, J A and Khokhar, A S and Daily, J and Di Biase, L and Ferrick, K J and Fisher, J D and Krumerman, A}, biburl = {https://www.bibsonomy.org/bibtex/2de5a14ea9ddf4519d10ed25de08c284e/fordham1}, description = {QT prolongation in a diverse, urban population of COVID-19 patients treated with hydroxychloroquine, chloroquine, or azithromycin - PubMed}, doi = {10.1007/s10840-020-00822-x}, interhash = {ae555f879dd557d9aa08a92224c8592c}, intrahash = {de5a14ea9ddf4519d10ed25de08c284e}, journal = {J Interv Card Electrophysiol}, keywords = {(h)cq QTc azm covid-19}, month = jul, pmid = {32654098}, timestamp = {2020-08-08T18:20:10.000+0200}, title = {QT prolongation in a diverse, urban population of COVID-19 patients treated with hydroxychloroquine, chloroquine, or azithromycin}, url = {https://pubmed.ncbi.nlm.nih.gov/32654098/}, year = 2020 }