Much hyped COVID-19 treatment hydroxychloroquine may cause serious cardiac risk

Medical News: Patients with COVID-19 who were treated with a combination of hydroxychloroquine and the antibiotic azithromycin experienced altered heart rhythms on an electrocardiogram. The authors found that most patients had an altered heart rhythm and for around 1 in 10 patients it was altered enough to put them at high risk of sudden cardiac death.

Patients with COVID-19 who were on a regimen of hydroxychloroquine and azithromycin experienced electrocardiogram abnormalities, according to a Correspondence published in Nature Medicine. The authors assessed 84 patients with COVID-19 treated at a centre in New York, USA.

Recent reports have suggested that the combination of hydroxychloroquine — an anti-malarial drug — and azithromycin — an antibiotic — may help patients diagnosed with COVID-19. However, both medications have been independently shown to increase the risk of various types of cardiac rhythm abnormalities, such as QTc-interval prolongation and drug-induced torsades de pointes, and sudden cardiac death. The QTc interval is measured by an electrocardiogram and represents the time it takes for a heart to recharge between beats. A prolonged QTc interval puts a patient at risk for arrhythmia and sudden cardiac death.

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Lior Jankelson and colleagues reviewed the charts and followed the QTc interval of 84 patients with COVID-19 on a 5-day oral regiment of hydroxychloroquine and azithromycin. The patients were, on average, 63 years of age and 74% were male. After the patients were administered the drugs, the authors followed up with an electrocardiogram. They observed a prolonged QTc in most patients. The QTc was severely prolonged in 11% of the patients, which put them at high risk of arrhythmia and sudden cardiac death. Four patients in the cohort died from multiple organ failure, without evidence of arrhythmia and without severe QTc prolongation.

Jankelson and colleagues found that most patients with COVID-19 who were treated with hydroxychloroquine and azithromycin experienced QTc prolongation. This may have been exacerbated by other pre-existing conditions and the severity of the SARS-CoV-2 infection.

The authors conclude that the QTc in patients with COVID-19 who are treated with hydroxychloroquine and azithromycin should be monitored constantly, especially for patients with additional illnesses and those who are being treated with other QT-prolonging medications.

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