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Risk of QT interval prolongation associated with use of hydroxychloroquine with or without concomitant azithromycin among hospitalized patients testing positive for coronavirus disease 2019 (COVID-19)

JAMA May 06, 2020

Mercuro NJ, Yen CF, Shim DJ, et al. - Researchers sought to determine the risk and degree of QT prolongation in cases with COVID-19 in correlation with their use of hydroxychloroquine with or without concomitant azithromycin. They assessed 90 hospitalized patients with coronavirus disease 2019 who received at least 1 day of hydroxychloroquine from March 1, 2020, through April 7, 2020, at an academic tertiary care center in Boston, Massachusetts.. Among these patients, 53 were administered concomitant azithromycin; 44 (48.9%) were female, and the mean BMI was 31.5 (6.6). Frequent QTc prolongation was observed in correlation with the use of hydroxychloroquine with or without azithromycin for treatment of COVID-19. Greater QT prolongation was observed in those taking hydroxychloroquine and azithromycin vs those taking hydroxychloroquine alone. Torsades de pointes deveoped in one patient. Based on outcomes, they recommend clinicians to cautiously weigh risks and benefits if considering hydroxychloroquine and azithromycin, with close monitoring of QTc and concomitant medication usage.

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