Prolonged QT Interval in SARS-CoV-2 Infection: Prevalence and Prognosis
Background: The prognostic value of a prolonged QT interval in SARS-Cov2 infection is not well known. Objective: To determine whether the presence of a prolonged QT on admission is an independent factor for mortality in SARS-Cov2 hospitalized patients. Methods: Single-center cohort of 623 consecutiv...
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doaj-bd1013da68b04e1c889ee74ef7e930662020-11-25T03:18:46ZengMDPI AGJournal of Clinical Medicine2077-03832020-08-0192712271210.3390/jcm9092712Prolonged QT Interval in SARS-CoV-2 Infection: Prevalence and PrognosisNúria Farré0Diana Mojón1Marc Llagostera2Laia C. Belarte-Tornero3Alicia Calvo-Fernández4Ermengol Vallés5Alejandro Negrete6Marcos García-Guimaraes7Yolanda Bartolomé8Camino Fernández9Ana B. García-Duran10Jaume Marrugat11Beatriz Vaquerizo12Department of Cardiology, Hospital del Mar, 08003 Barcelona, SpainDepartment of Cardiology, Hospital del Mar, 08003 Barcelona, SpainDepartment of Cardiology, Hospital del Mar, 08003 Barcelona, SpainDepartment of Cardiology, Hospital del Mar, 08003 Barcelona, SpainDepartment of Cardiology, Hospital del Mar, 08003 Barcelona, SpainDepartment of Cardiology, Hospital del Mar, 08003 Barcelona, SpainDepartment of Cardiology, Hospital del Mar, 08003 Barcelona, SpainDepartment of Cardiology, Hospital del Mar, 08003 Barcelona, SpainDepartment of Cardiology, Hospital del Mar, 08003 Barcelona, SpainDepartment of Cardiology, Hospital del Mar, 08003 Barcelona, SpainDepartment of Cardiology, Hospital del Mar, 08003 Barcelona, SpainREGICOR (Registre Gironí del Cor) Study Group, IMIM (Hospital del Mar Medical Research Institute), 08003 Barcelona, SpainDepartment of Cardiology, Hospital del Mar, 08003 Barcelona, SpainBackground: The prognostic value of a prolonged QT interval in SARS-Cov2 infection is not well known. Objective: To determine whether the presence of a prolonged QT on admission is an independent factor for mortality in SARS-Cov2 hospitalized patients. Methods: Single-center cohort of 623 consecutive patients with positive polymerase-chain-reaction test (PCR) to SARS Cov2, recruited from 27 February to 7 April 2020. An electrocardiogram was taken on these patients within the first 48 h after diagnosis and before the administration of any medication with a known effect on QT interval. A prolonged QT interval was defined as a corrected QT (QTc) interval >480 milliseconds. Patients were followed up with until 10 May 2020. Results: Sixty-one patients (9.8%) had prolonged QTc and only 3.2% had a baseline QTc > 500 milliseconds. Patients with prolonged QTc were older, had more comorbidities, and higher levels of immune-inflammatory markers. There were no episodes of ventricular tachycardia or ventricular fibrillation during hospitalization. All-cause death was higher in patients with prolonged QTc (41.0% vs. 8.7%, <i>p</i> < 0.001, multivariable HR 2.68 (1.58–4.55), <i>p</i> < 0.001). Conclusions: Almost 10% of patients with COVID-19 infection have a prolonged QTc interval on admission. A prolonged QTc was independently associated with a higher mortality even after adjustment for age, comorbidities, and treatment with hydroxychloroquine and azithromycin. An electrocardiogram should be included on admission to identify high-risk SARS-CoV-2 patients.https://www.mdpi.com/2077-0383/9/9/2712QT intervalCOVID-19hydroxychloroquineazithromycinprognosisdeath |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Núria Farré Diana Mojón Marc Llagostera Laia C. Belarte-Tornero Alicia Calvo-Fernández Ermengol Vallés Alejandro Negrete Marcos García-Guimaraes Yolanda Bartolomé Camino Fernández Ana B. García-Duran Jaume Marrugat Beatriz Vaquerizo |
spellingShingle |
Núria Farré Diana Mojón Marc Llagostera Laia C. Belarte-Tornero Alicia Calvo-Fernández Ermengol Vallés Alejandro Negrete Marcos García-Guimaraes Yolanda Bartolomé Camino Fernández Ana B. García-Duran Jaume Marrugat Beatriz Vaquerizo Prolonged QT Interval in SARS-CoV-2 Infection: Prevalence and Prognosis Journal of Clinical Medicine QT interval COVID-19 hydroxychloroquine azithromycin prognosis death |
author_facet |
Núria Farré Diana Mojón Marc Llagostera Laia C. Belarte-Tornero Alicia Calvo-Fernández Ermengol Vallés Alejandro Negrete Marcos García-Guimaraes Yolanda Bartolomé Camino Fernández Ana B. García-Duran Jaume Marrugat Beatriz Vaquerizo |
author_sort |
Núria Farré |
title |
Prolonged QT Interval in SARS-CoV-2 Infection: Prevalence and Prognosis |
title_short |
Prolonged QT Interval in SARS-CoV-2 Infection: Prevalence and Prognosis |
title_full |
Prolonged QT Interval in SARS-CoV-2 Infection: Prevalence and Prognosis |
title_fullStr |
Prolonged QT Interval in SARS-CoV-2 Infection: Prevalence and Prognosis |
title_full_unstemmed |
Prolonged QT Interval in SARS-CoV-2 Infection: Prevalence and Prognosis |
title_sort |
prolonged qt interval in sars-cov-2 infection: prevalence and prognosis |
publisher |
MDPI AG |
series |
Journal of Clinical Medicine |
issn |
2077-0383 |
publishDate |
2020-08-01 |
description |
Background: The prognostic value of a prolonged QT interval in SARS-Cov2 infection is not well known. Objective: To determine whether the presence of a prolonged QT on admission is an independent factor for mortality in SARS-Cov2 hospitalized patients. Methods: Single-center cohort of 623 consecutive patients with positive polymerase-chain-reaction test (PCR) to SARS Cov2, recruited from 27 February to 7 April 2020. An electrocardiogram was taken on these patients within the first 48 h after diagnosis and before the administration of any medication with a known effect on QT interval. A prolonged QT interval was defined as a corrected QT (QTc) interval >480 milliseconds. Patients were followed up with until 10 May 2020. Results: Sixty-one patients (9.8%) had prolonged QTc and only 3.2% had a baseline QTc > 500 milliseconds. Patients with prolonged QTc were older, had more comorbidities, and higher levels of immune-inflammatory markers. There were no episodes of ventricular tachycardia or ventricular fibrillation during hospitalization. All-cause death was higher in patients with prolonged QTc (41.0% vs. 8.7%, <i>p</i> < 0.001, multivariable HR 2.68 (1.58–4.55), <i>p</i> < 0.001). Conclusions: Almost 10% of patients with COVID-19 infection have a prolonged QTc interval on admission. A prolonged QTc was independently associated with a higher mortality even after adjustment for age, comorbidities, and treatment with hydroxychloroquine and azithromycin. An electrocardiogram should be included on admission to identify high-risk SARS-CoV-2 patients. |
topic |
QT interval COVID-19 hydroxychloroquine azithromycin prognosis death |
url |
https://www.mdpi.com/2077-0383/9/9/2712 |
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