Key result
Chloroquine is linked to ~35 ms QTc prolongation in hospitalized COVID-19 patients.
Why the study?
Chloroquine emerged as a potential therapy for SARS-CoV-2, but data were lacking on its QTc-prolonging potential in COVID-19 patients.
Does chloroquine treatment prolong the QTc interval in hospitalised COVID-19 patients?
Cohort (n=95)
No
Does chloroquine treatment prolong the QTc interval in hospitalised COVID-19 patients?
Mean Difference: 35 (95% CI 28–43)
Absolute Event Rate: 479% vs 444%
Chloroquine causes clinically relevant QTc prolongation in COVID-19 patients, highlighting the necessity for ECG monitoring during its use.
Chloroquine-associated QTc prolongation may support ECG monitoring in hospitalized COVID-19 patients; leaves open arrhythmic risk and outcomes in randomized settings.
BACKGROUND: In the battle against the SARS-CoV‑2 pandemic, chloroquine has emerged as a new potential therapeutic option for the treatment of infected patients. A safety consideration for the application of chloroquine is its QTc-prolonging potential. Thus far, no data are available on the QTc-prolonging potential of chloroquine in COVID-19 patients. OBJECTIVE: To assess the degree of chloroquine-induced QTc prolongation in hospitalised COVID-19 patients. METHODS: A baseline electrocardiogram (ECG) and ECGs recorded during chloroquine treatment were retrospectively collected in patients suspected of having COVID-19. The QTc interval was calculated by computerised and manual interpretation. Baseline and follow-up QTc intervals were compared using the paired samples t-test. RESULTS: A total of 95 patients had a baseline ECG recording and at least one ECG recording during chloroquine therapy. Chloroquine treatment resulted in a mean QTc prolongation of 35 ms (95% CI 28-43 ms) using computerised interpretation and 34 ms (95% CI 25-43 ms) using manual interpretation. No torsade de pointes was observed during chloroquine treatment. After manual review, 22 patients (23%) had a QTc interval exceeding 500 ms during chloroquine treatment. None of these patients had a prolonged QTc interval prior to the initiation of chloroquine treatment. CONCLUSIONS: Chloroquine significantly prolongs the QTc interval in a clinically relevant matter. This highlights the need for ECG monitoring when prescribing chloroquine to COVID-19 patients.
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Broek et al. (2020) conducted a cohort in COVID-19 (n=95). Chloroquine vs. Baseline (pre-treatment) was evaluated on Mean QTc prolongation (computer interpreted) (MD 35 ms, 95% CI 28-43). Chloroquine treatment in hospitalized COVID-19 patients significantly prolonged the QTc interval by a mean of 35 ms, with 23% of patients developing a QTc exceeding 500 ms.
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