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QTc Interval Prolonged in Some Hospitalized With COVID-19

WEDNESDAY, April 28, 2021 -- COVID-19 infection is associated with significant mean QTc prolongation at days 2 and 5 of hospitalization, according to a study published online April 23 in JAMA Network Open.

Geoffrey A. Rubin, M.D., from the Vagelos College of Physicians and Surgeons at Columbia University in New York City, and colleagues conducted a cohort study involving 3,050 patients aged 18 years and older who underwent severe acute respiratory syndrome coronavirus 2 testing and had electrocardiograms (ECGs) from March 1 through May 1, 2020.

Overall, 965 patients had more than two ECGs and were included in the study; 76.0 and 24.0 percent were with and without COVID-19, respectively. The researchers found that by two-day and five-day multivariable models, COVID-19 infection was associated with significant mean QTc prolongation from baseline. Compared with COVID-19-negative status, COVID-19 infection was independently associated with a modeled mean 27.32 millisecond increase in QTc at five days. Compared with patients without COVID-19, more patients with COVID-19 not receiving hydroxychloroquine and azithromycin had QTc of 500 milliseconds or greater (25.0 versus 10.8 percent). In a multivariable analysis, QTc prolongation was seen in association with age 80 years and older versus younger than 50 years, severe chronic kidney disease versus no chronic kidney disease, elevated high-sensitivity troponin levels, and elevated lactate dehydrogenase levels.

"COVID-19 infection was independently associated with longer modeled QTc intervals from baseline, and patients at higher risk were 80 years or older, had elevated high-sensitivity troponin, or had significant kidney dysfunction," the authors write.

Several authors disclosed financial ties to the biopharmaceutical and medical device industries.

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