• Neth Heart J · Jul 2020

    Chloroquine-induced QTc prolongation in COVID-19 patients.

    • van den BroekM P HMPHDepartment of Clinical Pharmacy, St. Antonius Hospital, Utrecht/Nieuwegein, The Netherlands. mp.van.den.broek@antoniusziekenhuis.nl., J E Möhlmann, B G S Abeln, M Liebregts, V F van Dijk, and van de GardeE M WEMWDepartment of Clinical Pharmacy, St. Antonius Hospital, Utrecht/Nieuwegein, The Netherlands.Division of Pharmacoepidemiology and Clinical Pharmacology, Department of Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands.
    • Department of Clinical Pharmacy, St. Antonius Hospital, Utrecht/Nieuwegein, The Netherlands. mp.van.den.broek@antoniusziekenhuis.nl.
    • Neth Heart J. 2020 Jul 1; 28 (7-8): 406-409.

    BackgroundIn the battle against the SARS-CoV‑2 pandemic, chloroquine has emerged as a new potential therapeutic option for the treatment of infected patients. A safety consideration for the application of chloroquine is its QTc-prolonging potential. Thus far, no data are available on the QTc-prolonging potential of chloroquine in COVID-19 patients.ObjectiveTo assess the degree of chloroquine-induced QTc prolongation in hospitalised COVID-19 patients.MethodsA baseline electrocardiogram (ECG) and ECGs recorded during chloroquine treatment were retrospectively collected in patients suspected of having COVID-19. The QTc interval was calculated by computerised and manual interpretation. Baseline and follow-up QTc intervals were compared using the paired samples t-test.ResultsA total of 95 patients had a baseline ECG recording and at least one ECG recording during chloroquine therapy. Chloroquine treatment resulted in a mean QTc prolongation of 35 ms (95% CI 28-43 ms) using computerised interpretation and 34 ms (95% CI 25-43 ms) using manual interpretation. No torsade de pointes was observed during chloroquine treatment. After manual review, 22 patients (23%) had a QTc interval exceeding 500 ms during chloroquine treatment. None of these patients had a prolonged QTc interval prior to the initiation of chloroquine treatment.ConclusionsChloroquine significantly prolongs the QTc interval in a clinically relevant matter. This highlights the need for ECG monitoring when prescribing chloroquine to COVID-19 patients.

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