QT interval measurement with portable device during COVID-19 outbreak
| Autor: | Luis Álvarez Acosta, Marx Rivera Zambrano, Virginia Barreto Cáceres, Diego Valdivia Miranda, Alejandro Iriarte Plasencia, Nerea Torres González, Julio Salvador Hernández Afonso |
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| Rok vydání: | 2020 |
| Předmět: |
QT interval
lcsh:Diseases of the circulatory (Cardiovascular) system medicine.medical_specialty Portable device Side effect Azithromycin 030204 cardiovascular system & hematology Sudden death Article 03 medical and health sciences 0302 clinical medicine Internal medicine medicine cardiovascular diseases 030212 general & internal medicine SARS-CoV-2 business.industry COVID-19 Drug-induced QT prolongation Hydroxychloroquine Lopinavir lcsh:RC666-701 Cardiology Ritonavir Cardiology and Cardiovascular Medicine business medicine.drug |
| Zdroj: | International Journal of Cardiology. Heart & Vasculature IJC Heart & Vasculature International Journal of Cardiology: Heart & Vasculature, Vol 30, Iss, Pp 100644-(2020) |
| ISSN: | 2352-9067 |
| DOI: | 10.1016/j.ijcha.2020.100644 |
| Popis: | Highlights • Hydroxychloroquine and azithromycin significantly prolong QT interval. • COVID-19 causes high levels of ferritin, D-dimer and C-reactive protein. • Troponin elevation seems to be uncommon in COVID-19 patients. • A protocol for electrocardiographic control may reduce the risk of sudden death. • Portable devices reduce contact to perform electrocardiogram in isolated patients. Coronavirus Disease 2019 continues to spread and to date, no definitive treatment is available. Overcrowded and under-resourced healthcare centres have had to design different strategies to treat these patients, what includes the control of the electrocardiogram (ECG), as some drugs that have been used to treat this disease may prolong the QT interval as a side effect. During the COVID-19 outbreak, we designed a protocol for monitoring the QT interval using a portable device with Bluetooth connectivity. After a validation study with 50 patients, we found a very good correlation between the QT interval measured both with this device and with the conventional body surface ECG. In this article, we provide a brief overview of the protocol and then analyse the QT changes observed in a group of patients during their hospitalization and treatment for SARS-CoV-2 infection. 81 patients with confirmed SARS-CoV-2 infection were enrolled in the protocol (age 63.4 SD 17.2 years; 70.3% men), while being treated with lopinavir/ritonavir, azithromycin and hydroxychloroquine, both individually or combined. Ten patients developed long drug-related QT interval, and the QT prolongation was statically significant for all treatment schemes. All patients with drug induced QT prolongation corrected the QT interval following the indications of the protocol, and no patients died of arrhythmic causes after its implementation. In our experience, a protocol for the electrocardiographic monitoring of these patients minimizes the risk of iatrogenic QT interval prolongation and consequently reduces sudden death events, and for that purpose, portable devices like the one used in this protocol may constitute a useful tool to minimize the contact with such patients. |
| Databáze: | OpenAIRE |
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