Relationship between index of cardio-electrophysiological balance and hydroxychloroquine in patients with COVID-19

Abstract

Background: Hydroxychloroquine (HCQ) treatment is frequently prescribed for coronavirus disease 2019 (COVID-19). Electrocardiographic (ECG) monitorization is recommended because HCQ causes QT interval prolongation. The index of cardioelectrophysiological balance (iCEB), calculated as the ratio of QT interval / QRS duration. In recent years, iCEB has been described as an important marker for dysrhthmias. Decreased or increased iCEB is related with lethal ventricular arrhythmias. Aim of the study: In our research, we purposed to investigate the relationship between iCEB and HCQ in patients with COVID-19. Methods: 200 patients (males, 84 ; females, 116 ; 60.4 ± 13.8 years) with PCR positive and chest tomography findings compatible with COVID-19 pneumonia were registered in the research. Demographic, clinical, and laboratory data for all patients were collected. ECG was recorded from all patients on admission to COVID-19 clinic, in oral treatment with HCQ (200 mg, twice daily) for at least 5 days. iCEB (QT/QRS) was calculated from the 12-lead electrocardiogram. Results: The mean age of the patients was 60.4 ± 13.8 years. Compared to admission ECG, ECG on day 5 showed significant increases in heart rate, QT interval, corrected QT (QTc) interval, and iCEB. Conclusions: Our results suggested that iCEB is related with HCQ treatment in patients with COVID-19. Previous studies have show that high iCEB is related with torsade de Pointes (TdP), ventricular tachycardia.

Keywords

• ECG
• Electrodiagnosis
• Hydroxychloroquine
• arrhythmia
• COVID-19.

References

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