Effect of Triple Combination Therapy With Lopinavir-Ritonavir, Azithromycin, and Hydroxychloroquine on QT Interval and Arrhythmic Risk in Hospitalized COVID-19 Patients
| Autor: | Emilio Attena, Raffaele Verde, Pierpaolo Di Micco, Gerardo Nigro, Rosa Mocerino, Vincenzo Russo, Francesco Santelli, Andreina Carbone, Filiberto Fausto Mottola, Luigi Nunziata, Sergio Severino, Nicoletta Verde |
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| Přispěvatelé: | Russo, V., Carbone, A., Mottola, F. F., Mocerino, R., Verde, R., Attena, E., Verde, N., Di Micco, P., Nunziata, L., Santelli, F., Nigro, G., Severino, S. |
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
0301 basic medicine
congenital hereditary and neonatal diseases and abnormalities medicine.medical_specialty Side effect Lopinavir/ritonavir arrhythmia QT interval arrhythmias coronavirus disease 2019 lopinavir/ritonavir QTc prolongation SARS-CoV2 torsades des pointes 03 medical and health sciences 0302 clinical medicine Internal medicine Heart rate medicine Pharmacology (medical) cardiovascular diseases Original Research Pharmacology business.industry Incidence (epidemiology) lcsh:RM1-950 Prolongation Hydroxychloroquine Lopinavir lcsh:Therapeutics. Pharmacology 030104 developmental biology 030220 oncology & carcinogenesis cardiovascular system Cardiology Ritonavir business circulatory and respiratory physiology medicine.drug |
| Zdroj: | Frontiers in Pharmacology, Vol 11 (2020) Frontiers in Pharmacology |
| Popis: | Introduction: no data are provided about the effect of triple combination therapy with Lopinavir/Ritonavir (LPN/RTN), hydroxychloroquine (HQ) and azithromycin (AZT) on corrected QT (QTc) interval and arrhythmic risk, in COVID-19 patients. This study aims to describe the incidence of extreme QTc interval prolongation among COVID-19 patients on this experimental treatment and to identify the clinical features associated with extreme QTc prolongation. Materials and methods: data of 87 COVID-19 patients, treated with triple combination including LPN/RTN, HQ and AZT, were analyzed. QT interval was obtained by the tangent method and corrected for heart rate using Bazett’s formula. Extreme QTc interval prolongation was considered an absolute QTc interval ≥ 500 ms or an increase in QTc intervals of 60 milliseconds or greater (ΔQTc ≥ 60 milliseconds) compared with baseline. Results: Hypertension (66.7%) and diabetes (25.3%) were the most prevalent cardiovascular comorbidities. 20 patients (23%) showed extreme QTc interval prolongation; No clinical, electrocardiographic or pharmacological characteristics have been associated to extreme QTc prolongation, except the history of ischemic stroke (P= 0,007). One torsade de pointes (TdP) in patient with QTc extreme prolongation (QTc: 560 ms) after 5 days of therapy was recorded. Conclusions: We observed a high incidence of extreme QTc interval prolongation among COVID- 19 patients on triple combination therapy. The incidence of malignant arrhythmias seems to be low, a careful electrocardiographic monitoring would be advisable. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
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