Oğuz AKKUŞ, Tayibe BAL, Hasibullah YAGOOBİ, Özkan BEKLER, Gamze AKKUŞ, Mehmet ÇABALAK

Hastanede yatan COVID-19 hastalarında elektrokardiyografik bulgular ve hidroksiklorokin + azitromisin tedavisinin kardiyak güvenliği

Amaç: Bu çalışma ile COVID-19 hastalarında 12-derivasyonlu elektrokardiyografinin (EKG) standart değerlendirmesine ek olarak yeni aritmi belirteçlerini ve tedavi etkisininin araştırılması amaçlanmıştır. Gereç ve Yöntem: Toplam 51 COVID-19 hastasının 12-derivasyonlu EKG si tedavi öncesi, tedavinin 2. ve 5. günlerinde geriye dönük olarak değerlendirildi. Hastalar COVID-19’a yönelik hidroksiklorokin (HCQ) + azitromisin veya sadece HCQ tedavisi aldı. Ciddi COVID-19 hastaları, pnömoni bulgularına ek olarak SpO230/dk olarak tanımlandı. Bulgular: Hastaların %68,6’ı HCQ + azitromisin kombinasyon tedavisi alırken, %31,4 hasta sadece azitromisin tedavisi aldı. Tedavinin 2. gününde, kombinasyon tedavisi alanlarda ve sadece azitromisin alanlarda sadece kalp hızı istatistiksel olarak anlamlı değişken olarak bulundu. Tedavinin 5. gününde kalp hızına ek olarak ve cTpe değerleri her iki tedavi rejiminde istatistiksel olarak anlamlı olarak bulundu. Tedavi süresince her iki tedavi rejiminde Tpe düzeyleri istatistiksel anlamlı olarak artmasına rağmen, rölatif artış oranları istatistiksel olarak gruplar arası benzer bulundu. Sonuç: Çalışma sonuçlarımız, kısa süreli hastanede yatan COVID-19 hastalarında kullandığımız HCQ/ azitromisin tedavisinin kabul edilebilir düzeyde kardiyak etki profiline sahip olduğunu göstermektedir.

Electrocardiographic findings and cardiac safety of hydroxychloroquine+azithromycin in hospitalized patients with COVID-19

Purpose: The aim of this study was to determine the novel arrhythmia markers (Tpe, cTpe, cTpe/cQT) in addition to standard evaluation of 12-derived electrocardiography (ECG) and effects of therapy in patients with COVID-19. Materials and Methods: We evaluated 12-derived ECG in 51 patients with COVID-19 at the pre-treatment stage and on the 2nd and 5th days of the treatment, retrospectively. Patients were treated by either hydroxychloroquine (HCQ) + azithromycin or HCQ alone. Severe COVID-19 patients were defined with the presence of clinical signs and symptoms of pneumonia plus SpO2 30 breathe/minute. Results: While 68.6% of patients received HCQ + azithromycin combination therapy, 31.4% of patients received HCQ monotherapy. On the 2nd day of the treatment, heart rate was the only statistically significant variable either on the treatment of HCQ + azithromycin or HCQ alone. On the 5th day of treatment, in addition to the heart rate, Tpe and cTpe levels were also statistically significant among the whole treatment regimens. Although Tpe statistically significantly increased in both treatment strategies during treatment, increasing relative Tpe ratios were similar between both of the treatment strategies. Conclusion: The results of our study suggests that those off-label drugs (HCQ/azithromycin) have an acceptable cardiac safety profile in COVID-19 disease during short hospitalization.

Keywords:

Arrhythmia, corrected QT, COVID-19, Tpeak- Tend interval,

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