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Effect of triple antimicrobial therapy on electrocardiography parameters in patients with mild-to-moderate coronavirus disease 2019.
Anatol J Cardiol. 2021 03; 25(3):184-190.AJ

Abstract

OBJECTIVE

The effects of treatment of coronavirus disease 2019 (COVID-19) with a triple combination composed of hydroxychloroquine, an an-tiviral, and an antibiotic on electrocardiography (ECG) parameters in patients with mild-to-moderate symptoms are not wholly understood. We aimed to explore the changes in ECG parameters after treatment with triple combination therapy in patients with mild-to-moderate symptomatic COVID-19.

METHODS

This retrospective, single-center case series analyzed 91 patients with mild-to-moderate symptomatic COVID-19 at Ankara Gazi Mus-tafa Kemal State Hospital of Ankara City, Turkey, from April 1, 2020, to April 30, 2020. Forty-three patients were treated with hydroxychloroquine+oseltamivir+azithromycin (Group 1) and 48 patients were treated with hydroxychloroquine+oseltamivir+levofloxacin (Group 2). Heart rate, P wave duration, P wave dispersion, PR interval, QRS duration, corrected QT interval (QTc), QTc dispersion (QTD), delta QTc, Tp-e, Tp-e dispersion, and Tp-e/QTc ratio were all calculated from the baseline and posttreatment 12-lead ECG recordings.

RESULTS

The QTc, QRS duration, Tp-e, PR interval, and P wave duration were significantly increased after treatment (p<0.001; p<0.001; p<0.001; p=0.001; p=0.001). The posttreatment C-reactive protein level was significantly lower than at baseline in Group 1 (p=0.014). At admission, 30% of patients had QT prolongation, and 4.3% of them had a QT duration >500 ms. Both Group 1 and Group 2 showed significant prolongation of the QTc interval (Group 1; p<0.001 vs. Group 2; p<0.001), QRS duration (Group 1; p=0.006 vs. Group 2; p=0.014), Tp-e (Group 1; p=0.036 vs. Group 2; p<0.001), and PR interval (Group 1; p=0.002 vs. Group2; p=0.05). The QTD was significantly decreased in Group 1 (p<0.001). None of the patients experienced any overt ventricular arrhythmia.

CONCLUSION

To the best of our knowledge, this study is the first to investigate QT prolongation in a population of COVID-19 patients treated with triple combination therapy. We found that there was a significant decrease in the QTD after the treatment in patients who were taking triple therapy including azithromycin.

Authors+Show Affiliations

Department of Cardiology, Gazi Mustafa Kemal State Hospital; Ankara-Turkey.Department of Cardiology, Faculty of Medicine, Ankara University; Ankara-Turkey.Department of Cardiology, Faculty of Medicine, Gazi University; Ankara-Turkey.

Pub Type(s)

Journal Article
Observational Study

Language

eng

PubMed ID

33690133

Citation

Uğurlu Ilgın, Burcu, et al. "Effect of Triple Antimicrobial Therapy On Electrocardiography Parameters in Patients With Mild-to-moderate Coronavirus Disease 2019." Anatolian Journal of Cardiology, vol. 25, no. 3, 2021, pp. 184-190.
Uğurlu Ilgın B, Akbulut Koyuncu İM, Kızıltunç E. Effect of triple antimicrobial therapy on electrocardiography parameters in patients with mild-to-moderate coronavirus disease 2019. Anatol J Cardiol. 2021;25(3):184-190.
Uğurlu Ilgın, B., Akbulut Koyuncu, İ. M., & Kızıltunç, E. (2021). Effect of triple antimicrobial therapy on electrocardiography parameters in patients with mild-to-moderate coronavirus disease 2019. Anatolian Journal of Cardiology, 25(3), 184-190. https://doi.org/10.14744/AnatolJCardiol.2020.79138
Uğurlu Ilgın B, Akbulut Koyuncu İM, Kızıltunç E. Effect of Triple Antimicrobial Therapy On Electrocardiography Parameters in Patients With Mild-to-moderate Coronavirus Disease 2019. Anatol J Cardiol. 2021;25(3):184-190. PubMed PMID: 33690133.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effect of triple antimicrobial therapy on electrocardiography parameters in patients with mild-to-moderate coronavirus disease 2019. AU - Uğurlu Ilgın,Burcu, AU - Akbulut Koyuncu,İrem Müge, AU - Kızıltunç,Emrullah, PY - 2021/3/10/entrez PY - 2021/3/11/pubmed PY - 2021/3/19/medline SP - 184 EP - 190 JF - Anatolian journal of cardiology JO - Anatol J Cardiol VL - 25 IS - 3 N2 - OBJECTIVE: The effects of treatment of coronavirus disease 2019 (COVID-19) with a triple combination composed of hydroxychloroquine, an an-tiviral, and an antibiotic on electrocardiography (ECG) parameters in patients with mild-to-moderate symptoms are not wholly understood. We aimed to explore the changes in ECG parameters after treatment with triple combination therapy in patients with mild-to-moderate symptomatic COVID-19. METHODS: This retrospective, single-center case series analyzed 91 patients with mild-to-moderate symptomatic COVID-19 at Ankara Gazi Mus-tafa Kemal State Hospital of Ankara City, Turkey, from April 1, 2020, to April 30, 2020. Forty-three patients were treated with hydroxychloroquine+oseltamivir+azithromycin (Group 1) and 48 patients were treated with hydroxychloroquine+oseltamivir+levofloxacin (Group 2). Heart rate, P wave duration, P wave dispersion, PR interval, QRS duration, corrected QT interval (QTc), QTc dispersion (QTD), delta QTc, Tp-e, Tp-e dispersion, and Tp-e/QTc ratio were all calculated from the baseline and posttreatment 12-lead ECG recordings. RESULTS: The QTc, QRS duration, Tp-e, PR interval, and P wave duration were significantly increased after treatment (p<0.001; p<0.001; p<0.001; p=0.001; p=0.001). The posttreatment C-reactive protein level was significantly lower than at baseline in Group 1 (p=0.014). At admission, 30% of patients had QT prolongation, and 4.3% of them had a QT duration >500 ms. Both Group 1 and Group 2 showed significant prolongation of the QTc interval (Group 1; p<0.001 vs. Group 2; p<0.001), QRS duration (Group 1; p=0.006 vs. Group 2; p=0.014), Tp-e (Group 1; p=0.036 vs. Group 2; p<0.001), and PR interval (Group 1; p=0.002 vs. Group2; p=0.05). The QTD was significantly decreased in Group 1 (p<0.001). None of the patients experienced any overt ventricular arrhythmia. CONCLUSION: To the best of our knowledge, this study is the first to investigate QT prolongation in a population of COVID-19 patients treated with triple combination therapy. We found that there was a significant decrease in the QTD after the treatment in patients who were taking triple therapy including azithromycin. SN - 2149-2271 UR - https://www.unboundmedicine.com/medline/citation/33690133/Effect_of_triple_antimicrobial_therapy_on_electrocardiography_parameters_in_patients_with_mild-to-moderate_coronavirus_disease_2019. L2 - http://www.anatoljcardiol.com/linkout/?PMID=33690133 DB - PRIME DP - Unbound Medicine ER -