QTc interval prolongation and life-threatening arrhythmias during hospitalization in patients with COVID-19. Results from a multi-center prospective registry.
October 24, 2020
Santoro F., Monitillo F., Raimondo P., et al.
Clinical Infectious Diseases
Some of the drugs currently used for Coronavirus disease (COVID-19) may have interaction with myocardial cells, and may results in QTc interval prolongation and torsade de pointes. Aim of the study was therefore to evaluate potential predictors of QTc-interval prolongation and incidence of life threating arrhythmias in COVID-19 patients admitted with normal QTc-interval that started therapy during hospitalization.We report one of the first multi-center registry on 154 consecutive patients with a diagnosis of COVID-19 from February 25 to March 30 2020, admitted into four hospitals in Italy and Germany. All patients underwent standard 12-lead ECGs were serially recorded within 12 hours after admission and then repeated after 7 and 14 days. We found that: 1) After 7 days of hospitalization 14 % of patients developed prolongation of QTc interval, dual antiviral therapy, age and basal heart rate were an independent predictor of pQT; 2) Life threatening arrhythmias have an incidence of 3.6% and may present after a median of 9 days of hospitalization with cardiac arrest and non-sustained VT; 3) Life threatening arrhythmias were featured by poor outcome with 50% of mortality. The study evaluated a relatively low number of patients. Dual antiviral therapy, age and basal heart rate were the only independent predictors of QT prolongation at 7 days. In the present study we found that a combination of antivirals may predict prolonged QTc interval, however due to the heterogenous antivirals combination, no conclusion can be provided.
Santoro F., Monitillo F., Raimondo P., Lopizzo A. QTc interval prolongation and life-threatening arrhythmias during hospitalization in patients with COVID-19. Results from a multi-center prospective registry. Clinical Infectious Diseases 2020, ciaa1578.