Key result
Hydroxychloroquine use requires careful multiparametric risk assessment and ECG monitoring for QTc prolongation, particularly in frail elderly patients with comorbidities and polypharmacy.
Why the study?
Hydroxychloroquine can cause potentially harmful QTc prolongation, especially in elderly patients with frailty syndrome, comorbidities, and polypharmacotherapy.
Does hydroxychloroquine increase the risk of QTc prolongation and arrhythmias in elderly frail patients?
Does hydroxychloroquine increase the risk of QTc prolongation and arrhythmias in elderly frail patients?
In elderly frail patients receiving hydroxychloroquine, traditional Comprehensive Geriatric Assessment should be combined with a multiparametric risk score for QTc prolongation to reduce arrhythmic risk.
Alerts to QTc risks with hydroxychloroquine in frail elderly; leaves open optimal monitoring strategies pending higher-level evidence.
Hydroxychloroquine is an antimalarial drug also known for its anti-inflammatory and antiviral effects, which have raised the interest of many researchers for its potential use in COVID-19 patients. It is known that this drug, being able to influence the cardiac repolarization phase with QTc interval prolongation, can be potentially harmful, chiefly in elderly subjects with frailty syndrome, several comorbidities and polypharmacotherapy. Therefore, although electrocardiogram monitoring of QTc prolongation is the focal point for reducing the arrhythmic risk of these patients, in order to identify the most exposed patients, the traditional Comprehensive Geriatric Assessment should be combined with a multiparametric risk score for QTc prolongation.
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Castagna et al. (2020) conducted a review in COVID-19 and QTc prolongation. Hydroxychloroquine was evaluated. Hydroxychloroquine use requires careful multiparametric risk assessment and ECG monitoring for QTc prolongation, particularly in frail elderly patients with comorbidities and polypharmacy.
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