Yıl: 2021 Cilt: 33 Sayı: 1 Sayfa Aralığı: 15 - 21 Metin Dili: İngilizce DOI: 10.5336/cardiosci.2020-80082 İndeks Tarihi: 17-02-2022

Impact of Adding Favipiravir to Hydroxychloroquine and Azithromycin Treatment on QTc Interval in COVID-19

Öz:
Objective: The Coronavirus disease-2019 (COVID-19) pandemic has caused the death of many people worldwide. Treatment protocol had to be developed as soon as possible so drug combinations, whose reliability has not been fully disclosed, have started to be used. In this study, we aimed to evaluate the effect of azithromycin (AZT), hydroxychloroquine (HCQ), and favipiravir (FVR) combination on the corrected QT (QTc) interval. Material and Methods: Eighty-four consecutive COVID 19 patients were enrolled in the study. All patients received AZT and HCQ, however, FVR was added to the combination in 32 patients with severe pneumonia at the beginning. ECG characteristics of all patients before treatment and on the fifth day of treatment were compared. Results: There was no significant difference between the HCQ+AZT group (n=52) and HCQ+AZT+FVR groups (n=32) in terms of baseline clinical characteristics. QTc interval significantly prolonged on the fifth day of treatment in the HCQ+AZT group (413,75±30,13; 440,27±36,11 p<0.001) and in the HCQ+AZT+FVR group (426,65±32,83; 468,22±42,13 p<0.001). When both groups were compared in terms of ΔQTc, a significant increase was observed in the HCQ+AZT+FVR group compared to the HCQ+AZT group (40(-14/175), 23(-28/213) respectively, p=0.042). In seven of the patients, QTc> 500 ms was detected after the treatment, four patients in the HCQ+AZT+FVR group and three patients in the HCQ+AZT group. Conclusion: We observed that FVR caused more prolongation in the QTc interval when used with the combination of HCQ+AZT. We recommend that patients who receive this treatment be monitored more closely for QTc.
Anahtar Kelime:

Hidroksiklorokin ve Azitromisin Tedavisine Favipiravirin Eklenmesinin COVID-19’da QTc Aralığı Üzerindeki Etkisi

Öz:
Amaç: Koronavirüs hastalığı-2019 [coronavirus disease-2019 (COVID-19)], dünya çapında birçok ölüme neden olan bir pandemiye yol açtı. Tedavi protokolünün bir an önce geliştirilmesi gerektiğinden, güvenilirliği tam olarak tanımlanmamış ilaç kombinasyonlarının kullanılmasına neden oldu. Bu çalışmada, azitromisin (AZT), hidroksiklorokin (HCQ) ve favipiravirin (FVR) kombinasyonunda düzeltilmiş QT (QTc) aralığı üzerindeki etkisini değerlendirmeyi amaçladık. Gereç ve Yöntemler: Çalışmaya, 84 ardışık COVID-19 hastası dâhil edildi. Tüm hastalara AZT ve HCQ verildi, ancak başlangıçta şiddetli pnömonili 32 hastada kombinasyona FVR eklendi. Tüm hastaların tedavi öncesi ve tedavinin 5. gününde elektrokardiyografi özellikleri karşılaştırıldı. Bulgular: HCQ+AZT grubu (n=52) ile HCQ+AZT+FVR grupları (n=32) arasında başlangıç klinik özellikleri açısından anlamlı fark yoktu. QTc aralığı, tedavinin 5. gününde HCQ+AZT grubunda (413,75±30,13 msn; 440,27±36,11 msn p<0,001) ve HCQ+AZT+FVR grubunda (426,65±32,83 msn; 468,22±42,13 msn p<0,001) anlamlı şekilde uzadı. Her 2 grup ΔQTc açısından karşılaştırıldığında, HCQ+AZT+FVR grubunda, HCQ+AZT grubuna göre anlamlı bir artış gözlendi (sırasıyla 40 (-14/175) msn, 23 (- 28/213) msn, p=0,042). Tedaviden sonra hastaların 7’sinde QTc>500 msn ölçüldü, bu hastaların 4’ü HCQ+AZT+FVR grubunda ve 3’ü HCQ+AZT grubundaydı. Sonuç: Çalışmamızda, HCQ+AZT kombinasyonu ile kullanıldığında FVR’nin, QTc aralığında daha fazla uzamaya neden olduğunu gözlemledik. Bu tedaviyi alan hastaların, QTc için daha yakından izlenmesi gerektiği kanaatindeyiz.
Anahtar Kelime:

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
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APA cerik i, ozturk cerik h, DOĞAN A, Dereli S, Bektaş O, kaya y (2021). Impact of Adding Favipiravir to Hydroxychloroquine and Azithromycin Treatment on QTc Interval in COVID-19. , 15 - 21. 10.5336/cardiosci.2020-80082
Chicago cerik idris bugra,ozturk cerik hatun,DOĞAN AHMET,Dereli Seçkin,Bektaş Osman,kaya yasemin Impact of Adding Favipiravir to Hydroxychloroquine and Azithromycin Treatment on QTc Interval in COVID-19. (2021): 15 - 21. 10.5336/cardiosci.2020-80082
MLA cerik idris bugra,ozturk cerik hatun,DOĞAN AHMET,Dereli Seçkin,Bektaş Osman,kaya yasemin Impact of Adding Favipiravir to Hydroxychloroquine and Azithromycin Treatment on QTc Interval in COVID-19. , 2021, ss.15 - 21. 10.5336/cardiosci.2020-80082
AMA cerik i,ozturk cerik h,DOĞAN A,Dereli S,Bektaş O,kaya y Impact of Adding Favipiravir to Hydroxychloroquine and Azithromycin Treatment on QTc Interval in COVID-19. . 2021; 15 - 21. 10.5336/cardiosci.2020-80082
Vancouver cerik i,ozturk cerik h,DOĞAN A,Dereli S,Bektaş O,kaya y Impact of Adding Favipiravir to Hydroxychloroquine and Azithromycin Treatment on QTc Interval in COVID-19. . 2021; 15 - 21. 10.5336/cardiosci.2020-80082
IEEE cerik i,ozturk cerik h,DOĞAN A,Dereli S,Bektaş O,kaya y "Impact of Adding Favipiravir to Hydroxychloroquine and Azithromycin Treatment on QTc Interval in COVID-19." , ss.15 - 21, 2021. 10.5336/cardiosci.2020-80082
ISNAD cerik, idris bugra vd. "Impact of Adding Favipiravir to Hydroxychloroquine and Azithromycin Treatment on QTc Interval in COVID-19". (2021), 15-21. https://doi.org/10.5336/cardiosci.2020-80082
APA cerik i, ozturk cerik h, DOĞAN A, Dereli S, Bektaş O, kaya y (2021). Impact of Adding Favipiravir to Hydroxychloroquine and Azithromycin Treatment on QTc Interval in COVID-19. Türkiye Klinikleri Cardiovascular Sciences, 33(1), 15 - 21. 10.5336/cardiosci.2020-80082
Chicago cerik idris bugra,ozturk cerik hatun,DOĞAN AHMET,Dereli Seçkin,Bektaş Osman,kaya yasemin Impact of Adding Favipiravir to Hydroxychloroquine and Azithromycin Treatment on QTc Interval in COVID-19. Türkiye Klinikleri Cardiovascular Sciences 33, no.1 (2021): 15 - 21. 10.5336/cardiosci.2020-80082
MLA cerik idris bugra,ozturk cerik hatun,DOĞAN AHMET,Dereli Seçkin,Bektaş Osman,kaya yasemin Impact of Adding Favipiravir to Hydroxychloroquine and Azithromycin Treatment on QTc Interval in COVID-19. Türkiye Klinikleri Cardiovascular Sciences, vol.33, no.1, 2021, ss.15 - 21. 10.5336/cardiosci.2020-80082
AMA cerik i,ozturk cerik h,DOĞAN A,Dereli S,Bektaş O,kaya y Impact of Adding Favipiravir to Hydroxychloroquine and Azithromycin Treatment on QTc Interval in COVID-19. Türkiye Klinikleri Cardiovascular Sciences. 2021; 33(1): 15 - 21. 10.5336/cardiosci.2020-80082
Vancouver cerik i,ozturk cerik h,DOĞAN A,Dereli S,Bektaş O,kaya y Impact of Adding Favipiravir to Hydroxychloroquine and Azithromycin Treatment on QTc Interval in COVID-19. Türkiye Klinikleri Cardiovascular Sciences. 2021; 33(1): 15 - 21. 10.5336/cardiosci.2020-80082
IEEE cerik i,ozturk cerik h,DOĞAN A,Dereli S,Bektaş O,kaya y "Impact of Adding Favipiravir to Hydroxychloroquine and Azithromycin Treatment on QTc Interval in COVID-19." Türkiye Klinikleri Cardiovascular Sciences, 33, ss.15 - 21, 2021. 10.5336/cardiosci.2020-80082
ISNAD cerik, idris bugra vd. "Impact of Adding Favipiravir to Hydroxychloroquine and Azithromycin Treatment on QTc Interval in COVID-19". Türkiye Klinikleri Cardiovascular Sciences 33/1 (2021), 15-21. https://doi.org/10.5336/cardiosci.2020-80082