#JAMAUpdate: Hydroxychloroquine linked to increased risk of
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At a time when the anti-malarial drug hydroxychloroquine (HCQ) is being touted as a 'wonder drug' to treat critical COVID-19 patients, a new US study has found evidence suggesting that patients who received hydroxychloroquine for COVID-19 were at an increased risk of electrical changes to the heart and cardiac arrhythmias.

The combination of hydroxychloroquine with azithromycin was linked to even greater changes compared to hydroxychloroquine alone, according to the researchers from Beth Israel Deaconess Medical Center (BIDMC) in the US.

In this single-centre, retrospective, observational study, the research team evaluated 90 adults with COVID-19 who were hospitalised at BIDMC between March 1 and April 7 and received at least one day of hydroxychloroquine.

More than half of these patients also had high blood pressure, and more than 30 per cent had diabetes. Seven patients (19 per cent) who received hydroxychloroquine alone developed prolonged QTc of 500 milliseconds or more, and three patients had a change in QTc of 60 milliseconds or more.

Of the 53 patients who also received azithromycin, 21 per cent had prolonged QTc of 500 milliseconds or more, and 13 per cent experienced a change in QTc of 60 milliseconds or more.

"In this study, patients who were hospitalised and receiving hydroxychloroquine for COVID-19 frequently experienced QTc prolongation and adverse drug events," said study researcher Christina F Yen.

"One participant taking the drug combination experienced a potentially lethal tachycardia called torsades de pointes, which to our knowledge has yet to be reported elsewhere in the peer-reviewed COVID-19 literature," Yen added.

Conclusively, If considering the use of hydroxychloroquine, particularly combined with azithromycin, clinicians should carefully weigh the risks and benefits, and closely monitor QTc -- particularly considering patients' co-morbidities and concomitant medication use.

Source: https://jamanetwork.com/journals/jamacardiology/fullarticle/2765631
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