First known case of a potentially deadly heart rhythm disturbance induced by chloroquine therapy for COVID-19 reported

Clinicians should carefully monitor patients treated with chloroquine therapy, particularly elderly women and others at higher risk for heart rhythm abnormalities, investigators caution in the journal Heart Rhythm
19-Jun-2020 12:35 PM EDT, by Elsevier

Newswise — Philadelphia, June 18, 2020 - A patient who met many of the published safety guidelines for chloroquine therapy against COVID-19 was observed to have a very abnormal ECG pattern after treatment began, leading to multiple episodes of torsade de pointes (TdP), a life-threatening arrhythmia in which the lower chambers of the heart beat out of sync with the upper chambers. Her condition was resolved after chloroquine was discontinued, investigators report in Heart Rhythm, the official journal of the Heart Rhythm Society, the Cardiac Electrophysiology Society, and the Pediatric & Congenital Electrophysiology Society, published by Elsevier.

Chloroquine and hydroxychloroquine are commonly used to treat malaria and some rheumatic diseases. Their use as a treatment for COVID-19 has been widely debated in medical journals and the popular press. The authors of this case report present the first description of TdP due to chloroquine treatment in a patient with COVID-19.

Lead investigator Yishay Szekely, MD, Department of Cardiology, Sourasky Tel Aviv Medical Center and Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel, observes, "On the one hand, these drugs are known to cause prolongation of a specific ECG interval called QT interval. On the other hand, there is no evidence of sudden, unexplained death when they are used to treat malaria. And by the same token, neither the American nor the European rheumatology societies recommend electrocardiographic (ECG) surveillance for patients who receive long-term treatment with hydroxychloroquine."

The patient, an 84 year-old women with a history of breast cancer and controlled hypertension was admitted to the hospital with COVID-19. Her medications included letrozole, prescribed for breast cancer, and memantine, prescribed for Alzheimer's disease. An ECG found her corrected QT (QTc) interval was 462 milliseconds, borderline high but still below the 500-millisecond limit suggested by safety guidelines for chloroquine treatment. Her condition worsened and chloroquine therapy was introduced. After five days of treatment, there was no change to her clinical status, however, a follow-up ECG showed signs of an extremely elongated QTc interval of 627 milliseconds. Chloroquine was discontinued, as were other drugs known or suspected of causing QT-prolongation, including memantine and letrozole.

The patient was placed on a continuous ECG monitor and given potassium supplements to prevent arrhythmias. Six hours later episodes of TdP were noted on her ECG. She received treatment that led to an immediate resolution of the ventricular arrhythmias, and her QT interval gradually normalized. She was released after two weeks.

Dr. Szekely notes that the memantine the patient was taking likely contributed to the proarrhythmic effects of chloroquine. However, her QTc interval spiked only after chloroquine was introduced. "This clearly points to chloroquine as the culprit drug of her TdP." The breast cancer medication letrozole is actually considered safer from a QT interval point of view than other medications used to treat breast cancer.

"Chloroquine therapy is not free of risk in patients with COVID-19, particularly in those with high risk features for QT prolongation and TdP," says Dr. Szekely. "Given its questionable efficacy in the treatment of COVID-19 and risk of QT interval prolongation and torsade de pointes, chloroquine treatment must be considered thoroughly and reviewed on a regular basis."

###

SEE ORIGINAL STUDY



Filters close

Showing results

110 of 5845
Released: 17-Jun-2021 4:15 PM EDT
UNC Researchers Lead Study of Diabetes Treatment of COVID-19 Patients
University of North Carolina School of Medicine

Diabetes is one of the comorbidities most strongly associated with severe COVID-19 in the US, and data from early in the pandemic suggested individuals with type 2 diabetes faced twice the risk of death from COVID-19 and a greater risk of requiring hospitalization and intensive care. A new study shows best treatment options.

Released: 17-Jun-2021 4:10 PM EDT
Vaccination, Previous Infection, Protect Against COVID-19 gamma/P.1 Variant in Animal Model
University of Wisconsin-Madison

In a new study using variant virus recovered from one of the original travelers, researchers in the U.S. and Japan have found that vaccination with an mRNA vaccine induces antibody responses that would protect humans from infection with the gamma/P.1 variant.

Newswise:Video Embedded virtual-event-for-june-17-11am-edt-covid-19-vaccines-and-male-fertility
VIDEO
Released: 17-Jun-2021 3:20 PM EDT
VIDEO AVAILABLE: Vaccines and Male Fertility Event for June 17, 2021
Newswise

This upcoming JAMA-published study examined whether the COVID-19 vaccine impacts male fertility.

Released: 17-Jun-2021 1:30 PM EDT
Hackensack Meridian Doctors, Student Help Establish Way to Prioritize Surgeries During COVID-19 lockdown
Hackensack Meridian Health

The MeNTS method of prioritizing surgeries during the height of pandemic, developed by University of Chicago, helped procedures continue during time of need

Released: 17-Jun-2021 12:55 PM EDT
‘Nanodecoy’ Therapy Binds and Neutralizes SARS-CoV-2 Virus
North Carolina State University

Nanodecoys made from human lung spheroid cells (LSCs) can bind to and neutralize SARS-CoV-2, promoting viral clearance and reducing lung injury in a macaque model of COVID-19.

access_time Embargo lifts in 2 days
Embargo will expire: 21-Jun-2021 11:00 AM EDT Released to reporters: 17-Jun-2021 12:10 PM EDT

A reporter's PressPass is required to access this story until the embargo expires on 21-Jun-2021 11:00 AM EDT The Newswise PressPass gives verified journalists access to embargoed stories. Please log in to complete a presspass application. If you have not yet registered, please Register. When you fill out the registration form, please identify yourself as a reporter in order to advance to the presspass application form.

Newswise: Blood Cancer Patients with COVID-19 Fare Better with Convalescent Plasma
Released: 17-Jun-2021 11:55 AM EDT
Blood Cancer Patients with COVID-19 Fare Better with Convalescent Plasma
Washington University in St. Louis

A large, retrospective, multicenter study involving Washington University School of Medicine in St. Louis indicates that convalescent plasma from recovered COVID-19 patients can dramatically improve likelihood of survival among blood cancer patients hospitalized with the virus. The therapy involves transfusing plasma — the pale yellow liquid in blood that is rich in antibodies — from people who have recovered from COVID-19 into patients who have leukemia, lymphoma or other blood cancers and are hospitalized with the viral infection.

Released: 17-Jun-2021 11:05 AM EDT
Stress during pandemic linked to poor sleep
Washington State University

Many people likely lost sleep over COVID-19. A study of twins led by Washington State University researchers found that stress, anxiety and depression during the first few weeks of the pandemic were associated with less and lower quality sleep.

Newswise:Video Embedded university-of-miami-miller-school-study-shows-covid-19-mrna-vaccines-do-not-impact-male-fertility
VIDEO
Released: 17-Jun-2021 11:00 AM EDT
University of Miami Miller School Study Shows COVID-19 mRNA Vaccines Do Not Impact Male Fertility
University of Miami Health System, Miller School of Medicine

The Pfizer and Moderna mRNA COVID-19 vaccines is safe for male reproduction, according to a new study by University of Miami Miller School of Medicine researchers published in JAMA , the most widely circulated general medical journal in the world.

15-Jun-2021 1:20 PM EDT
Higher COVID-19 Mortality Among Black Patients Linked to Unequal Hospital Quality
Perelman School of Medicine at the University of Pennsylvania

If Black patients were admitted to the same hospitals that serve a majority of White patients, researchers showed their risk of death would drop by 10 percent


Showing results

110 of 5845

close
1.44161