Smartphone electrocardiogram for QT interval monitoring in Coronavirus Disease 2019 (COVID-19) patients treated with Hydroxychloroquine.
Identifieur interne : 000136 ( Main/Exploration ); précédent : 000135; suivant : 000137Smartphone electrocardiogram for QT interval monitoring in Coronavirus Disease 2019 (COVID-19) patients treated with Hydroxychloroquine.
Auteurs : T Y Andy Ko [Malaisie] ; L S Chen [Malaisie] ; I X Pang [Malaisie] ; H S Ling [Malaisie] ; T C Wong [Malaisie] ; L L Sia Tonnii [Malaisie] ; K T Koh [Malaisie]Source :
- The Medical journal of Malaysia [ 0300-5283 ] ; 2021.
Descripteurs français
- KwdFr :
- Adulte (MeSH), Adulte d'âge moyen (MeSH), Antienzymes (usage thérapeutique), Antiviraux (usage thérapeutique), Applications mobiles (MeSH), Association médicamenteuse (MeSH), Femelle (MeSH), Humains (MeSH), Hydroxychloroquine (usage thérapeutique), Lopinavir (usage thérapeutique), Mâle (MeSH), Ordiphone (MeSH), Ritonavir (usage thérapeutique), Sujet âgé (MeSH), Syndrome du QT long (diagnostic), Syndrome du QT long (induit chimiquement), Électrocardiographie (MeSH).
- MESH :
- diagnostic : Syndrome du QT long.
- induit chimiquement : Syndrome du QT long.
- usage thérapeutique : Antienzymes, Antiviraux, Hydroxychloroquine, Lopinavir, Ritonavir.
- Adulte, Adulte d'âge moyen, Applications mobiles, Association médicamenteuse, Femelle, Humains, Mâle, Ordiphone, Sujet âgé, Électrocardiographie.
English descriptors
- KwdEn :
- Adult (MeSH), Aged (MeSH), Antiviral Agents (therapeutic use), COVID-19 (drug therapy), Drug Combinations (MeSH), Electrocardiography (MeSH), Enzyme Inhibitors (therapeutic use), Female (MeSH), Humans (MeSH), Hydroxychloroquine (therapeutic use), Long QT Syndrome (chemically induced), Long QT Syndrome (diagnosis), Lopinavir (therapeutic use), Male (MeSH), Middle Aged (MeSH), Mobile Applications (MeSH), Ritonavir (therapeutic use), Smartphone (MeSH).
- MESH :
- chemical , therapeutic use : Antiviral Agents, Enzyme Inhibitors, Hydroxychloroquine, Lopinavir, Ritonavir.
- chemically induced : Long QT Syndrome.
- diagnosis : Long QT Syndrome.
- drug therapy : COVID-19.
- Adult, Aged, Drug Combinations, Electrocardiography, Female, Humans, Male, Middle Aged, Mobile Applications, Smartphone.
Abstract
INTRODUCTION
The global pandemic of Corona Virus Disease 2019 (COVID-19) has led to the re-purposing of medications, such as hydroxychloroquine and lopinavir-ritonavir in the treatment of the earlier phase of COVID-19 before the recognized benefit of steroids and antiviral. We aim to explore the corrected QT (QTc) interval and 'torsadogenic' potential of hydroxychloroquine and lopinavir-ritonavir utilising a combination of smartphone electrocardiogram and 12-lead electrocardiogram monitoring.
MATERIALS AND METHODS
Between 16-April-2020 to 30-April- 2020, patients with suspected or confirmed for COVID-19 indicated for in-patient treatment with hydroxychloroquine with or without lopinavir-ritonavir to the Sarawak General Hospital were monitored with KardiaMobile smartphone electrocardiogram (AliveCor®, Mountain View, CA) or standard 12-lead electrocardiogram. The baseline and serial QTc intervals were monitored till the last dose of medications or until the normalization of the QTc interval.
RESULTS
Thirty patients were treated with hydroxychloroquine, and 20 (66.7%) patients received a combination of hydroxychloroquine and lopinavir-ritonavir therapy. The maximum QTc interval was significantly prolonged compared to baseline (434.6±28.2msec vs. 458.6±47.1msec, p=0.001). The maximum QTc interval (456.1±45.7msec vs. 464.6±45.2msec, p=0.635) and the delta QTc (32.6±38.5msec vs. 26.3±35.8msec, p=0.658) were not significantly different between patients on hydroxychloroquine or a combination of hydroxychloroquine and lopinavir-ritonavir. Five (16.7%) patients had QTc of 500msec or more. Four (13.3%) patients required discontinuation of hydroxychloroquine and 3 (10.0%) patients required discontinuation of lopinavirritonavir due to QTc prolongation. However, no torsade de pointes was observed.
CONCLUSIONS
QTc monitoring using smartphone electrocardiogram was feasible in COVID-19 patients treated with hydroxychloroquine with or without lopinavir-ritonavir. The usage of hydroxychloroquine and lopinavir-ritonavir resulted in QTc prolongation, but no torsade de pointes or arrhythmogenic death was observed.
PubMed: 33742617
Affiliations:
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Malaysia.</nlm:affiliation><country xml:lang="fr">Malaisie</country><wicri:regionArea>Sarawak Heart Centre, Department of Cardiology, Sarawak</wicri:regionArea><wicri:noRegion>Sarawak</wicri:noRegion></affiliation></author><author><name sortKey="Pang, I X" sort="Pang, I X" uniqKey="Pang I" first="I X" last="Pang">I X Pang</name><affiliation wicri:level="1"><nlm:affiliation>Sarawak Heart Centre, Department of Cardiology, Sarawak, Malaysia.</nlm:affiliation><country xml:lang="fr">Malaisie</country><wicri:regionArea>Sarawak Heart Centre, Department of Cardiology, Sarawak</wicri:regionArea><wicri:noRegion>Sarawak</wicri:noRegion></affiliation></author><author><name sortKey="Ling, H S" sort="Ling, H S" uniqKey="Ling H" first="H S" last="Ling">H S Ling</name><affiliation wicri:level="1"><nlm:affiliation>Sarawak Heart Centre, Department of Cardiology, Sarawak, Malaysia.</nlm:affiliation><country xml:lang="fr">Malaisie</country><wicri:regionArea>Sarawak Heart Centre, Department of Cardiology, 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Sarawak</wicri:regionArea><wicri:noRegion>Sarawak</wicri:noRegion></affiliation></author><author><name sortKey="Koh, K T" sort="Koh, K T" uniqKey="Koh K" first="K T" last="Koh">K T Koh</name><affiliation wicri:level="1"><nlm:affiliation>Sarawak Heart Centre, Department of Cardiology, Sarawak, Malaysia.</nlm:affiliation><country xml:lang="fr">Malaisie</country><wicri:regionArea>Sarawak Heart Centre, Department of Cardiology, Sarawak</wicri:regionArea><wicri:noRegion>Sarawak</wicri:noRegion></affiliation></author></analytic><series><title level="j">The Medical journal of Malaysia</title><idno type="ISSN">0300-5283</idno><imprint><date when="2021" type="published">2021</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adult (MeSH)</term><term>Aged (MeSH)</term><term>Antiviral Agents (therapeutic use)</term><term>COVID-19 (drug therapy)</term><term>Drug Combinations (MeSH)</term><term>Electrocardiography (MeSH)</term><term>Enzyme Inhibitors (therapeutic use)</term><term>Female (MeSH)</term><term>Humans (MeSH)</term><term>Hydroxychloroquine (therapeutic use)</term><term>Long QT Syndrome (chemically induced)</term><term>Long QT Syndrome (diagnosis)</term><term>Lopinavir (therapeutic use)</term><term>Male (MeSH)</term><term>Middle Aged (MeSH)</term><term>Mobile Applications (MeSH)</term><term>Ritonavir (therapeutic use)</term><term>Smartphone (MeSH)</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Adulte (MeSH)</term><term>Adulte d'âge moyen (MeSH)</term><term>Antienzymes (usage thérapeutique)</term><term>Antiviraux (usage thérapeutique)</term><term>Applications mobiles (MeSH)</term><term>Association médicamenteuse (MeSH)</term><term>Femelle (MeSH)</term><term>Humains (MeSH)</term><term>Hydroxychloroquine (usage thérapeutique)</term><term>Lopinavir (usage thérapeutique)</term><term>Mâle (MeSH)</term><term>Ordiphone (MeSH)</term><term>Ritonavir (usage thérapeutique)</term><term>Sujet âgé (MeSH)</term><term>Syndrome du QT long (diagnostic)</term><term>Syndrome du QT long (induit chimiquement)</term><term>Électrocardiographie (MeSH)</term></keywords><keywords scheme="MESH" type="chemical" qualifier="therapeutic use" xml:lang="en"><term>Antiviral Agents</term><term>Enzyme Inhibitors</term><term>Hydroxychloroquine</term><term>Lopinavir</term><term>Ritonavir</term></keywords><keywords scheme="MESH" qualifier="chemically induced" xml:lang="en"><term>Long QT Syndrome</term></keywords><keywords scheme="MESH" qualifier="diagnosis" xml:lang="en"><term>Long QT Syndrome</term></keywords><keywords scheme="MESH" qualifier="diagnostic" xml:lang="fr"><term>Syndrome du QT long</term></keywords><keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>COVID-19</term></keywords><keywords scheme="MESH" qualifier="induit chimiquement" xml:lang="fr"><term>Syndrome du QT long</term></keywords><keywords scheme="MESH" qualifier="usage thérapeutique" xml:lang="fr"><term>Antienzymes</term><term>Antiviraux</term><term>Hydroxychloroquine</term><term>Lopinavir</term><term>Ritonavir</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adult</term><term>Aged</term><term>Drug Combinations</term><term>Electrocardiography</term><term>Female</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Mobile Applications</term><term>Smartphone</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Adulte</term><term>Adulte d'âge moyen</term><term>Applications mobiles</term><term>Association médicamenteuse</term><term>Femelle</term><term>Humains</term><term>Mâle</term><term>Ordiphone</term><term>Sujet âgé</term><term>Électrocardiographie</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><b>INTRODUCTION</b></p><p>The global pandemic of Corona Virus Disease 2019 (COVID-19) has led to the re-purposing of medications, such as hydroxychloroquine and lopinavir-ritonavir in the treatment of the earlier phase of COVID-19 before the recognized benefit of steroids and antiviral. We aim to explore the corrected QT (QTc) interval and 'torsadogenic' potential of hydroxychloroquine and lopinavir-ritonavir utilising a combination of smartphone electrocardiogram and 12-lead electrocardiogram monitoring.</p></div><div type="abstract" xml:lang="en"><p><b>MATERIALS AND METHODS</b></p><p>Between 16-April-2020 to 30-April- 2020, patients with suspected or confirmed for COVID-19 indicated for in-patient treatment with hydroxychloroquine with or without lopinavir-ritonavir to the Sarawak General Hospital were monitored with KardiaMobile smartphone electrocardiogram (AliveCor®, Mountain View, CA) or standard 12-lead electrocardiogram. The baseline and serial QTc intervals were monitored till the last dose of medications or until the normalization of the QTc interval.</p></div><div type="abstract" xml:lang="en"><p><b>RESULTS</b></p><p>Thirty patients were treated with hydroxychloroquine, and 20 (66.7%) patients received a combination of hydroxychloroquine and lopinavir-ritonavir therapy. The maximum QTc interval was significantly prolonged compared to baseline (434.6±28.2msec vs. 458.6±47.1msec, p=0.001). The maximum QTc interval (456.1±45.7msec vs. 464.6±45.2msec, p=0.635) and the delta QTc (32.6±38.5msec vs. 26.3±35.8msec, p=0.658) were not significantly different between patients on hydroxychloroquine or a combination of hydroxychloroquine and lopinavir-ritonavir. Five (16.7%) patients had QTc of 500msec or more. Four (13.3%) patients required discontinuation of hydroxychloroquine and 3 (10.0%) patients required discontinuation of lopinavirritonavir due to QTc prolongation. However, no torsade de pointes was observed.</p></div><div type="abstract" xml:lang="en"><p><b>CONCLUSIONS</b></p><p>QTc monitoring using smartphone electrocardiogram was feasible in COVID-19 patients treated with hydroxychloroquine with or without lopinavir-ritonavir. The usage of hydroxychloroquine and lopinavir-ritonavir resulted in QTc prolongation, but no torsade de pointes or arrhythmogenic death was observed.</p></div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">33742617</PMID><DateCompleted><Year>2021</Year><Month>04</Month><Day>02</Day></DateCompleted><DateRevised><Year>2021</Year><Month>04</Month><Day>02</Day></DateRevised><Article PubModel="Print"><Journal><ISSN IssnType="Print">0300-5283</ISSN><JournalIssue CitedMedium="Internet"><Volume>76</Volume><Issue>2</Issue><PubDate><Year>2021</Year><Month>03</Month></PubDate></JournalIssue><Title>The Medical journal of Malaysia</Title><ISOAbbreviation>Med J Malaysia</ISOAbbreviation></Journal><ArticleTitle>Smartphone electrocardiogram for QT interval monitoring in Coronavirus Disease 2019 (COVID-19) patients treated with Hydroxychloroquine.</ArticleTitle><Pagination><MedlinePgn>125-130</MedlinePgn></Pagination><Abstract><AbstractText Label="INTRODUCTION">The global pandemic of Corona Virus Disease 2019 (COVID-19) has led to the re-purposing of medications, such as hydroxychloroquine and lopinavir-ritonavir in the treatment of the earlier phase of COVID-19 before the recognized benefit of steroids and antiviral. We aim to explore the corrected QT (QTc) interval and 'torsadogenic' potential of hydroxychloroquine and lopinavir-ritonavir utilising a combination of smartphone electrocardiogram and 12-lead electrocardiogram monitoring.</AbstractText><AbstractText Label="MATERIALS AND METHODS">Between 16-April-2020 to 30-April- 2020, patients with suspected or confirmed for COVID-19 indicated for in-patient treatment with hydroxychloroquine with or without lopinavir-ritonavir to the Sarawak General Hospital were monitored with KardiaMobile smartphone electrocardiogram (AliveCor®, Mountain View, CA) or standard 12-lead electrocardiogram. The baseline and serial QTc intervals were monitored till the last dose of medications or until the normalization of the QTc interval.</AbstractText><AbstractText Label="RESULTS">Thirty patients were treated with hydroxychloroquine, and 20 (66.7%) patients received a combination of hydroxychloroquine and lopinavir-ritonavir therapy. The maximum QTc interval was significantly prolonged compared to baseline (434.6±28.2msec vs. 458.6±47.1msec, p=0.001). The maximum QTc interval (456.1±45.7msec vs. 464.6±45.2msec, p=0.635) and the delta QTc (32.6±38.5msec vs. 26.3±35.8msec, p=0.658) were not significantly different between patients on hydroxychloroquine or a combination of hydroxychloroquine and lopinavir-ritonavir. Five (16.7%) patients had QTc of 500msec or more. Four (13.3%) patients required discontinuation of hydroxychloroquine and 3 (10.0%) patients required discontinuation of lopinavirritonavir due to QTc prolongation. However, no torsade de pointes was observed.</AbstractText><AbstractText Label="CONCLUSIONS">QTc monitoring using smartphone electrocardiogram was feasible in COVID-19 patients treated with hydroxychloroquine with or without lopinavir-ritonavir. The usage of hydroxychloroquine and lopinavir-ritonavir resulted in QTc prolongation, but no torsade de pointes or arrhythmogenic death was observed.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Andy Ko</LastName><ForeName>T Y</ForeName><Initials>TY</Initials><AffiliationInfo><Affiliation>Sarawak General Hospital, Department of Medicine, Kuching, Sarawak, Malaysia. andyko1989@gmail.com.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Chen</LastName><ForeName>L S</ForeName><Initials>LS</Initials><AffiliationInfo><Affiliation>Sarawak Heart Centre, Department of Cardiology, Sarawak, Malaysia.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Pang</LastName><ForeName>I X</ForeName><Initials>IX</Initials><AffiliationInfo><Affiliation>Sarawak Heart Centre, Department of Cardiology, Sarawak, Malaysia.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Ling</LastName><ForeName>H S</ForeName><Initials>HS</Initials><AffiliationInfo><Affiliation>Sarawak Heart Centre, Department of Cardiology, Sarawak, Malaysia.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Wong</LastName><ForeName>T C</ForeName><Initials>TC</Initials><AffiliationInfo><Affiliation>Sarawak General Hospital, Department of Medicine, Kuching, Sarawak, Malaysia.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Sia Tonnii</LastName><ForeName>L L</ForeName><Initials>LL</Initials><AffiliationInfo><Affiliation>Sarawak General Hospital, Department of Medicine, Kuching, Sarawak, Malaysia.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Koh</LastName><ForeName>K T</ForeName><Initials>KT</Initials><AffiliationInfo><Affiliation>Sarawak Heart Centre, Department of Cardiology, Sarawak, Malaysia.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList></Article><MedlineJournalInfo><Country>Malaysia</Country><MedlineTA>Med J Malaysia</MedlineTA><NlmUniqueID>0361547</NlmUniqueID><ISSNLinking>0300-5283</ISSNLinking></MedlineJournalInfo><ChemicalList><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D000998">Antiviral Agents</NameOfSubstance></Chemical><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D004338">Drug Combinations</NameOfSubstance></Chemical><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D004791">Enzyme Inhibitors</NameOfSubstance></Chemical><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="C558899">lopinavir-ritonavir drug combination</NameOfSubstance></Chemical><Chemical><RegistryNumber>2494G1JF75</RegistryNumber><NameOfSubstance UI="D061466">Lopinavir</NameOfSubstance></Chemical><Chemical><RegistryNumber>4QWG6N8QKH</RegistryNumber><NameOfSubstance 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UI="D061466" MajorTopicYN="N">Lopinavir</DescriptorName><QualifierName UI="Q000627" MajorTopicYN="N">therapeutic use</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008875" MajorTopicYN="N">Middle Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D063731" MajorTopicYN="N">Mobile Applications</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D019438" MajorTopicYN="N">Ritonavir</DescriptorName><QualifierName UI="Q000627" MajorTopicYN="N">therapeutic use</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D000068997" MajorTopicYN="Y">Smartphone</DescriptorName></MeshHeading></MeshHeadingList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="entrez"><Year>2021</Year><Month>3</Month><Day>20</Day><Hour>12</Hour><Minute>6</Minute></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2021</Year><Month>3</Month><Day>21</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2021</Year><Month>4</Month><Day>7</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">33742617</ArticleId></ArticleIdList></PubmedData></pubmed><affiliations><list><country><li>Malaisie</li></country></list><tree><country name="Malaisie"><noRegion><name sortKey="Andy Ko, T Y" sort="Andy Ko, T Y" uniqKey="Andy Ko T" first="T Y" last="Andy Ko">T Y Andy Ko</name></noRegion><name sortKey="Chen, L S" sort="Chen, L S" uniqKey="Chen L" first="L S" last="Chen">L S Chen</name><name sortKey="Koh, K T" sort="Koh, K T" uniqKey="Koh K" first="K T" last="Koh">K T Koh</name><name sortKey="Ling, H S" sort="Ling, H S" uniqKey="Ling H" first="H S" last="Ling">H S Ling</name><name sortKey="Pang, I X" sort="Pang, I X" uniqKey="Pang I" first="I X" last="Pang">I X Pang</name><name sortKey="Sia Tonnii, L L" sort="Sia Tonnii, L L" uniqKey="Sia Tonnii L" first="L L" last="Sia Tonnii">L L Sia Tonnii</name><name sortKey="Wong, T C" sort="Wong, T C" uniqKey="Wong T" first="T C" last="Wong">T C Wong</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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