We have detected that you are using an Ad Blocker. PracticeUpdate is free to end users but we rely on advertising to fund our site. Please consider supporting PracticeUpdate by whitelisting us in your ad blocker.
We have sent a message to the email address you have provided, . If this email is not correct, please update your settings with your correct address.
The email address you provided during registration, , does not appear to be valid. Please update your settings with a valid address before to continue using PracticeUpdate.
Welcome to PracticeUpdate! We hope you are enjoying access to a selection of our top-read and most recent articles. Please register today for a free account and gain full access to all of our expert-selected content.
You can find your saved items on your dashboard, in the "saved" tab.
You've recommended your first item
Your recommendations help us improve our content suggestions for you and other PracticeUpdate members.
You've subscribed to your first topic alert
What does that mean?
Each day, we'll check to see if new items have been published to the topics you're subscribed to, and we'll send you one email with all of the new items from that day.
We'll keep all topic alert notifications available on your dashboard for 30 days, to make sure you don't miss anything.
Lastly, whenever you have unread items in the topics you've subscribed to, the "Alerts" icon will light up in the main menu. Just click on the bell to see your five most-recent, unread notifications.
There is a lack of safety data related to the use of hydroxychloroquine alone or in combination with azithromycin to treat COVID-19. This retrospective case series examined outcomes in 40 patients with laboratory-confirmed COVID-19 who were admitted to the ICU and who received hydroxychloroquine alone (55%) or in combination with azithromycin (45%). After administration of antiviral therapy, 93% of patients experienced an increase in QTc and 36% experienced prolonged QTc after 2 to 5 days of treatment. No patients experienced ventricular arrhythmias. Antiviral treatment was terminated early in 25% and 17.5% of patients due to acute renal failure and ECG abnormalities, respectively.
Although limited by the retrospective nature of the study and small sample size, these data suggest that hydroxychloroquine with or without azithromycin should be used with caution for the treatment of patients with COVID-19 because serious complications may develop. The authors suggest that this treatment should only be used when patients can be closely monitored.
This abstract is available on the publisher's site.
The novel coronavirus disease 2019 (COVID-19) outbreak is an ongoing situation caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Studies in patients with mild to moderate COVID-19 symptoms have suggested benefits of hydroxychloroquine alone or in combination with azithromycin against SARS-CoV-2 and raised hope for treating the disease. As a result, these treatments are increasingly used off-label for patients with COVID-19, including for those in intensive care units (ICUs). However, both medications are known to induce QT prolongation via a human Ether-à-go-go–related gene potassium channel blockade, which can promote life-threatening ventricular arrhythmias. Safety data for these treatments are largely lacking for patients with COVID-19. This is even more relevant for critically ill patients who are particularly exposed to electrolyte imbalance and/or drugs leading to an increased risk of QT prolongation.Therefore, we aimed to examine the safety of hydroxychloroquine with or without azithromycin regarding QT interval in ICU patients with COVID-19.
Assessment of QT Intervals in a Case Series of Patients With Coronavirus Disease 2019 (COVID-19) Infection Treated With Hydroxychloroquine Alone or in Combination With Azithromycin in an Intensive Care Unit
JAMA Cardiol 2020 May 01;[EPub Ahead of Print], F Bessière, H Roccia, A Delinière, R Charrière, P Chevalier, L Argaud, M Cour