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\begin{document}

\title{Therapeutic challenges of the modern era: QT prolongation management in
COVID-19 hospitalised patients}



\author[1]{Ailís Pollock}%
\author[2]{Rajesh  Kumar}%
\author[3]{Patrick  Devitt}%
\author[4]{Clíona Ní  Cheallaigh}%
\author[3]{Berry Kennedy}%
\author[5]{Caroline  Daly}%
\author[5]{Brian  Kent}%
\affil[1]{Beaumont Hospital}%
\affil[2]{St. James's Hsopital}%
\affil[3]{St. James's Hospital}%
\affil[4]{St. James's Hospital }%
\affil[5]{St James's Hospital}%


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  \date{May 27, 2024}


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\begin{abstract}
Introduction: Hydroxychloroquine, with or without Azithromycin, was used
as a treatment strategy for COVID-19 in March and April 2020. The use of
Hydroxychloroquine (HCQ), with or without Azithromycin, may increase the
risk of QT prolongation. This study was performed to assess the
incidence and degree of QT prolongation in hospitalised COVID-19
patients treated with HCQ, and the association with morbidity and
mortality. Methods and Results: Single centre retrospective
observational study. Baseline corrected QT interval (QTc), peak QTc and
change in QTc ([?]QTc) were calculated for all patients. Known or
suspected risk factors for QT prolongation were assessed. All patients
were followed up for QT prolongation, length of stay, incidence of ICU
admission and 30 day all-cause mortality. Sixty-two patients were
included (mean age 67 years; 33.9\% female). QT prolongation occurred in
62.9\% of patients given HCQ, with [?]QTc [?]60msec or acquired QTc [?]500msec
in 14.5\% of patients. The mean [?]QTc was 28.4msec. QT prolongation was
associated with increased mortality (OR 11.0; 95\% CI 1.3 -- 90.9;
P=0.03). Conclusions: There was a high incidence of QT prolongation in
patients who received HCQ as part of a COVID-19 treatment regimen. We
observed an increased risk of death in patients with QT prolongation, as
well as an increased incidence of ICU admission and longer length of
stay in hospital. We recommend particular attention be paid to the risk
of QT prolongation with novel treatment strategies for COVID-19. Further
research is warranted on the effect of QT prolongation on clinical
outcomes in COVID-19.%
\end{abstract}%



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