Effects of Hydroxychloroquine Treatment on QTc Interval in COVID-19 Positive Patients with Schizophrenia

Year 2025, Volume: 35 Issue: 2, 382 - 387, 30.04.2025

Beyazit Garip , Şükran Tekin

https://doi.org/10.54005/geneltip.1557225

Abstract

Abstract
Background
Hydroxychloroquine (HCQ) treatment in COVID-19 positive schizophrenia patients was among the most debated topics at the start of the pandemic. Although the efficacy of HCQ remains controversial, its adverse effects, such as QTc prolongation, have raised major concerns due to the potential for life-threatening cardiac arrhythmias. The present study aims to explore the potential side effect of QTc prolongation when HCQ is used concurrently with antipsychotic medications.

Method
We conducted a retrospective case analysis in patients admitted to the inpatient psychiatric unit for COVID-19 positive psychiatric conditions (n=25). Electrocardiographic data and antipsychotic dosage management were analyzed retrospectively during the follow-up period. QTc interval longer than 500 ms was considered a pathological threshold

Results
QTc intervals exceeded the upper limit on the 3rd and 5th days of HCQ treatment, as well as on the first day after discontinuing HCQ, compared to QTc intervals recorded at initial hospital admission (p < 0.05). Analyzing the data by gender revealed a significant difference in QTc intervals only in women on the 2nd and 3rd days of HCQ treatment (p < 0.05). Cases of prolonged QTc did not share any common features regarding drug use, clinical diagnosis, or concomitant diseases.

Conclusion
The potential QTc prolongation associated with HCQ has emerged as a risk factor for ventricular fibrillation and death. When HCQ treatment is combined with antipsychotics, patients must be monitored more closely to prevent potentially life-threatening cardiac side effects.

Keywords

Hydroxychloroquine, QTc Interval, Schizophrenia, COVID-19, Antipsychotics

Project Number

773

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