[QTc interval prolongation in patients infected with SARS-CoV-2 and treated with antiviral drugs]. / Evolución del intervalo QTc en pacientes con infección SARS-CoV-2 tratados con fármacos antivirales.
An Pediatr (Engl Ed)
; 2021 Apr 20.
Article
em Es
| MEDLINE
| ID: mdl-34183281
ABSTRACT
INTRODUCTION:
Many antiviral agents, such as hydroxychloroquine, have been used to treat COVID-19, without being broadly accepted. QTc prolongation is a worrisome adverse effect, scarcely studied in pediatrics. PATIENTS ANDMETHODS:
Pediatric patients affected from COVID-19 who received antivirals were matched (12) with controls not infected nor exposed. Electrocardiograms were prospectively analyzed at baseline, during the first 72 h in treatment and after 72 h.RESULTS:
Eleven (22.9%) out of 48 patients admitted due to COVID-19 (March-July 2020) received antiviral therapy. All had underlying diseases congenital heart disease (4/11; 36.4%) and immunosuppression (3/11; 27.3%) stand out. 5/11 (45.5%) received treatment at baseline with a potential effect on QTc. There where no differences observed in the baseline QTc between cases and controls 414.8 ms (49.2) vs. 416.5 ms (29.4) (p = 0.716). Baseline long QT was observed in 2/11 cases and 2/22. Among cases, 10/11 (90.9%) received hydroxychloroquine, mainly associated with azithromycin (8/11; 72.7%), 3 received lopinavir/ritonavir and one remdesivir. The median increase in QTc after 72 h under treatment was 28.9 ms (IQR 48.7) (p = 0.062). 4/11 (36.4%) patients had a long QTc at 72 h, resulting in 3 patients ≥500 ms; treatment was stopped in one (QTc 510 ms) but ventricular arrhythmias were not documented.CONCLUSIONS:
The use of antivirals caused an increase on the QTc interval after 72 h of treatment, being the QTc long in 36.3% of the patients, although no arrhythmic events were observed. The use of hydroxychloroquine and antivirals requires active QTc monitoring and it is recommended to discontinue treatment if QTc >500 ms.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Idioma:
Es
Revista:
An Pediatr (Engl Ed)
Ano de publicação:
2021
Tipo de documento:
Article