Mustafa Ahmet HUYUT, Gersi ALİSHA, Betül ÇETİNTULUM HUYUT, Alida ALIYEVA

Metoprolol’ün Covid-19 Hastalarındaki Potansiyel Yararları

Amaç: Bu çalışmada, ilaca bağlı uzun QT (di-LQTc) aralığı saptanmış olan COVID-19 hastalarında aldıkları tedavilere eklenen metoprololün potansiyel yararlı etkilerini bulmayı amaçladık. Yöntem: Bu çalışma geriye dönük yapılmış bir çalışmadır. Bu çalışmadaki veriler, 1 Nisan ile 1 Haziran 2020 tarihleri arasında serviste yatırılmış, gerçek zamanlı polimeraz zincir reaksiyonu (RT-PCR) ile hastalığı doğrulanan 160 adet Covid-19 pozitif hastanın dosyaları taranarak elde edildi. Di-LQTc'li toplam 52 hastanın dosyaları taranıp metoprolol grubuna dahil edildi ve normal QTc düzeyleri olan toplam 108 hasta da metoprolol tedavisi almayan grup olarak belirlendi. Bulgular: Ortalama yaş 48.58±16.52 (% 48.75 erkek) olarak saptandı. Hastane içi ölüm oranı %3.125 (n = 5) olarak bulundu. Takip sırasında metoprolol grubunda herhangi ölümcül aritmi görülmedi. Metoprolol grubunda, metoprolol tedavisi öncesi hastalarda pik Qtc 466.50 (458.75-477.50) msn iken, taburculukta 443 (428.75-453) msn'ye düştü. İleri koşullu lojistik regresyon analizi ile, Covid-19 hastalarında bazal C-reaktif protein’in (CRP) (OR = 1.031,% 95 CI: 1.001-1.062, p = 0.043) di-LQTc'nin bağımsız prediktörü olduğunu saptadık. Sonuç: Di-LQTc'li COVID-19 hastalarının tedavi protokolüne metoprolol eklenerek uzun Qt durumunun geriye döndürülebilir olduğunu düşünmekteyiz.

Anahtar Kelimeler:

COVID-19, hidroksiklorokin, ilaca bağlı uzamış QTc, metoprolol tartarat

Metoprolol‘s Potential Beneficial Effects On Covid-19 Patients

Background: We aimed to find the potential beneficial effects of metoprolol, which was added to the treatment of COVID-19 patients with drug-induced long corrected QT (di-LQTc) interval. Materials and Methods: This study was a retrospective study. Hospitalized patient files were scanned, and the data of 160 Covid-19 positive patients who were confirmed by real-time polymerase chain reaction (RT-PCR) between April 1 and June 1, 2020, were analyzed. A total of 52 patients’ data with CoVID-19 patients with di-LQTc were scanned and collected in the metoprolol group, and a total of 108 patients’ data with CoVID-19 with normal QTc levels were collected in the non-metoprolol group. Results: The mean age was 48.58±16.52 (48.75% male). The in-hospital mortality rate was 3.125% (n=5). We did not see any malignant arrhythmias in the groups during follow-up. In the metoprolol group, the peak Qtc was 466.50 (458.75-477.50) msec in patients before metoprolol treatment, whereas it decreased to 443 (428.75-453) msec at discharge. Forward conditional logistic regression analysis demonstrated that basal C-reactive protein (CRP) (OR=1.031, 95%CI: 1.001-1.062, p=0.043) was the independent predictor of di-LQTc in Covid-19 patients. Conclusion: COVID-19 patients with di-LQTc could be treated and we thought we could reverse the QT prolongation by adding metoprolol to the treatment protocol.

Keywords:

COVID-19, drug-induced prolonged QTc, hydroxychloroquine, metoprolol tartrate,

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