The effects of combined hydroxychloroquine and azithromycin therapy on QRS wave in COVID-19 patients

Abstract

Background/Aim: Hydroxychloroquine and azithromycin are frequently used for the treatment of coronavirus disease 2019 (COVID-19). The use of these medications increases the risk of adverse cardiovascular events. The aim of our study was to investigate the effects of these drugs on the arrhythmogenic electrocardiographic (ECG) markers, QRS duration, and QRS dispersion, and also to evaluate gender differences with respect to these effects. Methods: Between March and June 2020, 107 (54 males, 53 females) patients admitted to our hospital’s isolation ward with COVID-19 diagnosis with no history, risk factors, or clinical findings of cardiovascular diseases were included in this prospective cohort study. All participants had a mild illness, and none of them required intensive care unit admission. ECGs of the patients were recorded before starting treatment with combined hydroxychloroquine and azithromycin, and a second ECG was recorded on the next morning following the last dose of the treatment. All ECGs were evaluated by two blinded cardiologists in terms of QRS duration and dispersion. Results: Among study participants, QRS duration was significantly prolonged after treatment with hydroxychloroquine and azithromycin (81.14 (9.11) versus 85.5 (10.48) ms [P