Key result
Hydroxychloroquine therapy in pediatric COVID-19 is linked to 0 cases of significant QTc prolongation.
Why the study?
Hydroxychloroquine and azithromycin can cause corrected QT prolongation, but experience evaluating QT intervals with their concurrent use in children with coronavirus disease 2019 was limited.
Does hydroxychloroquine with concurrent azithromycin cause QT prolongation in hospitalised children positive for coronavirus disease 2019?
Cohort (n=21)
No
Does hydroxychloroquine with concurrent azithromycin cause QT prolongation in hospitalised children positive for coronavirus disease 2019?
The combined use of hydroxychloroquine and azithromycin did not cause QT prolongation in a small cohort of non-severe pediatric COVID-19 patients.
Supports cardiac safety of hydroxychloroquine-azithromycin in non-severe pediatric COVID-19; hypothesis-generating and requires randomized confirmation.
INTRODUCTION AND AIM: Hydroxychloroquine alone or in combination with azithromycin has been increasingly used for patients with coronavirus disease 2019, in both children and adults. Drugs are generally well tolerated in clinical practice; however, both can cause corrected QT prolongation. We aimed to report our experience of QT interval evaluation associated with the use of hydroxychloroquine with concurrent azithromycin among children testing positive for coronavirus disease 2019. METHODS: Our single-centre; retrospective, study evaluated children with coronavirus disease 2019 disease admitted to the Pediatric Department at Sancaktepe Training and Research Hospital Istanbul, Turkey from 10 March, 2020 to 10 April, 2020. The data including demographics, clinical symptoms, co-morbid diseases, laboratory, radiological findings as well as electrocardiographs of the patients were obtained from our records. Electrocardiograms were evaluated before, one day after and at the termination of the treatment. RESULTS: 21 patients aged 9 to 18 years were evaluated. The median age was 170 months (range 112-214), 51.1% of them were girls and 48.9% were boys. Their laboratory results did not reveal any abnormalities. None of them needed intensive care. We did not detect QT prolongation during or at the termination of the treatment. CONCLUSION: We did not detect QT prolongation during or at the termination of the treatment in our patients due to the fact that they were not severely affected by the disease. Patients were treated in our inpatient clinic and none of them required intensive care. Laboratory results were also insignificant. Furthermore, they did not need other medications.
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Tunçer et al. (2020) conducted a cohort in COVID-19 (n=21). Hydroxychloroquine with or without azithromycin vs. Pre-treatment baseline was evaluated on Development of prolonged corrected QT interval to 500 milliseconds or more, or change in QTc greater than 60 milliseconds. Treatment with hydroxychloroquine with or without azithromycin in hospitalized children with COVID-19 did not result in any cases of QTc prolongation to 500 milliseconds or more, or an increase of 60 milliseconds or more.
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