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Case Reports
. 2020 Oct;45(5):1190-1193.
doi: 10.1111/jcpt.13183. Epub 2020 Jul 21.

QTc prolongation during antiviral therapy in two COVID-19 patients

Suyan Zhu  1 , Jian Wang  2 , Yong Wang  2 , Jinguo Chu  3 , Yao Liu  1 , Xueqin Chen  4 , Xiaomin Chen  2
Affiliations
Case Reports

QTc prolongation during antiviral therapy in two COVID-19 patients

Suyan Zhu et al. J Clin Pharm Ther. 2020 Oct.

Abstract

What is known and objective: Acquired long QT syndrome secondary to drug-induced QT prolongation and torsades de pointes has been reported for antiviral drugs. However, no studies have reported an association between corrected QT (QTc) prolongation and antiviral therapy in patients with novel coronavirus disease (COVID-19).

Case description: We present two cases from our institution in which patients with COVID-19 experienced QTc prolongation during treatment with antiviral therapy. Lopinavir/ritonavir, together with gender and drug-drug interactions, may have contributed to the induction of QTc prolongation in those patients.

What is new and conclusion: Co-administration of QT-prolonging medications and drugs interfering with the metabolism of those medications must be considered in patients with COVID-19. Careful analysis of electrocardiograms for QTc duration should be performed at baseline and during antiviral therapy to identify individuals at high risk of arrhythmias.

Keywords: COVID-19; QTc interval prolongation; drug interactions; lopinavir/ritonavir.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
EGCs of Case 1.Left: ECG on February 12, QTc interval 482 ms. Right: ECG on February 16, QTc interval 410 ms
Figure 2
Figure 2
EGCs of Case 2. Left: ECG on February 12, QTc interval 467 ms. Right: ECG on February 15, QTc interval 422 ms
Figure 3
Figure 3
Timeline of medication administration, electrolyte levels and QTc intervals during hospitalization. Upper: Case 1. Lower: Case 2
See this image and copyright information in PMC

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