Hydroxychloroquine cardiotoxicity: a case-control study comparing patients with COVID-19 and patients with systemic lupus erythematosus

Mancuso, Silvia; Spinelli, Francesca Romana; Agati, Luciano; Ciardi, Maria Rosa; Garufi, Cristina; Natalucci, Francesco; Molteni, Emanuele; Truglia, S.; Riccieri, Valeria; Priori, Roberta; Mastroianni, Claudio Maria; Conti, Fabrizio

doi:10.55563/clinexprheumatol/7ullgb

Cited by 4 publications

(3 citation statements)

References 21 publications

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“…HCQ alone led to more pronounced QTc prolongation than combinations with azithromycin, where the QTc was notably lower. [11][12][13] This could be influenced by the younger average age of our participants (51 years) compared to those in studies by Mancuso et al [14] (70.5 years) and Rosenberg et al [15] (over 60 years), suggesting a potential impact of age and baseline cardiac health on drug metabolism and the pharmacokinetics of HCQ.…”

Section: Comparative Analysis Of Treatment Regimensmentioning

confidence: 61%

The evaluation of the short-term and long-term hydroxychloroquine therapy on ECG parameters

Uyar,

Kök,

Ayan

et al. 2024

Medicine

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Amidst the COVID-19 pandemic, hydroxychloroquine (HCQ) was widely administered despite limited data on its safety and efficacy. This study assesses the acute and chronic impacts of HCQ on electrocardiography (ECG) parameters alongside the effects of azithromycin and levofloxacin coadministration in patients with COVID-19. A comprehensive analysis was conducted on 109 COVID-19 patients receiving HCQ, with or without Azithromycin and/or Levofloxacin, and 51 long-term HCQ-treated Sjogren’s syndrome (SS) patients. ECG parameters, including QTc interval, were meticulously evaluated against a control group of 109 COVID-19 patients without HCQ treatment. HCQ monotherapy, in combination with Levofloxacin, significantly prolonged the QTc interval in COVID-19 patients compared to controls. Notably, the combination of HCQ and Azithromycin demonstrated a mitigated impact on QTc prolongation. Long-term HCQ use in SS patients did not significantly affect QTc intervals, illustrating a distinct safety profile from short-term use in COVID-19 treatment. HCQ’s impact on QTc prolongation is influenced by therapeutic context, coadministered drugs, and patient demographics. The findings underscore the necessity of cautious HCQ use, particularly in acute settings like COVID-19, where monitoring and consideration of drug interactions and patient-specific factors are critical.

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Section: Comparative Analysis Of Treatment Regimensmentioning

confidence: 61%

The evaluation of the short-term and long-term hydroxychloroquine therapy on ECG parameters

Uyar,

Kök,

Ayan

et al. 2024

Medicine

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“…Furthermore, concerns about risk for QT prolongation and increased rate of arrythmias which were noticed in patients with COVID-19 who were treated with antimalarials during the early phase of the pandemic finally resulted in abandonment of HCQ. Mancuso et al reported a QTc prolongation in 17% of COVID-19 patients treated with HCQ[ 99 ], a finding typically not seen in SLE patients chronically treated with the drug [ 100 , 101 ].…”

Section: Covid-19 In Patients With Slementioning

confidence: 99%

Systemic Lupus Erythematosus and COVID-19

et al. 2023

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Purpose of Review To describe the current state of knowledge regarding COVID-19 in patients with systemic lupus erythematosus (SLE). We focus on (i) SARS-CoV-2 vaccination uptake, immunogenicity and safety, and (ii) outcomes of COVID-19 in patients with SLE and pertinent risk factors for adverse sequelae. Recent Findings Notwithstanding the potential concern of patients about possible post-vaccination side-effects, the safety of anti-SARS-CoV-2 vaccines in patients with SLE has been undisputedly confirmed in numerous studies. Humoral immunogenicity is generally attained in SLE, although affected by the use of background immunosuppressive drugs, especially rituximab. The latter has also clearly been implicated with adverse COVID-19 outcomes in SLE, including need for hospitalization, mechanical ventilation and death. Summary Although the wide adoption of vaccination has significantly improved COVID-19 outcomes, patients with SLE continue to pose challenges during the pandemic, mainly owing to administered immunosuppressive medications.

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“…Furthermore, the use of antiviral drugs could also cause an increase in the QTc interval for up to 72 h after treatment, with the prolongation of the QTc interval observed in 36.3% of patients [5]. Some studies have also suggested that a combined arrhythmogenic effect of the SARS-CoV-2 infection and hydroxychloroquine could account for the excess of QTc prolongation and fatal arrhythmias previously described in some COVID-19 patients [6].…”

Section: Introductionmentioning

confidence: 99%

Telemedicine in the Era of a Pandemic: Usefulness of a Novel Three-Lead ECG

Babic,

Veljkovic,

Lakcevic

et al. 2023

Diagnostics

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The 12-lead electrocardiogram (ECG) is a first-line diagnostic tool for patients with cardiac symptoms. As observed during the COVID-19 pandemic, the ECG is essential to the initial patient evaluation. The novel KardioPal three-lead-based ECG reconstructive technology provides a potential alternative to a standard ECG, reducing the response time and cost of treatment and improving patient comfort. Our study aimed to evaluate the diagnostic accuracy of a reconstructed 12-lead ECG obtained by the KardioPal technology, comparing it with the standard 12-lead ECG, and to assess the feasibility and time required to obtain a reconstructed ECG in a real-life scenario. A prospective, nonrandomized, single-center, adjudicator-blinded trial was conducted on 102 patients during the COVID-19 pandemic at the Dedinje Cardiovascular Institute in Belgrade. The KardioPal system demonstrated a high feasibility rate (99%), with high specificity (96.3%), sensitivity (95.8%), and diagnostic accuracy (96.1%) for obtaining clinically relevant matching of reconstructed 12-lead compared to the standard 12-lead ECG recording. This novel technology provided a significant reduction in ECG acquisition time and the need for personnel and space for obtaining ECG recordings, thereby reducing the risk of viral transmission and the burden on an already overwhelmed healthcare system such as the one experienced during the COVID-19 pandemic.

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Hydroxychloroquine cardiotoxicity: a case-control study comparing patients with COVID-19 and patients with systemic lupus erythematosus

Cited by 4 publications

References 21 publications

The evaluation of the short-term and long-term hydroxychloroquine therapy on ECG parameters

The evaluation of the short-term and long-term hydroxychloroquine therapy on ECG parameters

Systemic Lupus Erythematosus and COVID-19

Telemedicine in the Era of a Pandemic: Usefulness of a Novel Three-Lead ECG

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