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. 2020 Aug 21;9(9):2712.
doi: 10.3390/jcm9092712.

Prolonged QT Interval in SARS-CoV-2 Infection: Prevalence and Prognosis

Núria Farré  1   2   3 , Diana Mojón  1 , Marc Llagostera  1 , Laia C Belarte-Tornero  1   2   3 , Alicia Calvo-Fernández  1   2 , Ermengol Vallés  1   2   3 , Alejandro Negrete  1 , Marcos García-Guimaraes  1 , Yolanda Bartolomé  1 , Camino Fernández  1 , Ana B García-Duran  1 , Jaume Marrugat  4   5 , Beatriz Vaquerizo  1   2   3
Affiliations

Prolonged QT Interval in SARS-CoV-2 Infection: Prevalence and Prognosis

Núria Farré et al. J Clin Med. .

Abstract

Background: The prognostic value of a prolonged QT interval in SARS-Cov2 infection is not well known.

Objective: To determine whether the presence of a prolonged QT on admission is an independent factor for mortality in SARS-Cov2 hospitalized patients.

Methods: Single-center cohort of 623 consecutive patients with positive polymerase-chain-reaction test (PCR) to SARS Cov2, recruited from 27 February to 7 April 2020. An electrocardiogram was taken on these patients within the first 48 h after diagnosis and before the administration of any medication with a known effect on QT interval. A prolonged QT interval was defined as a corrected QT (QTc) interval >480 milliseconds. Patients were followed up with until 10 May 2020.

Results: Sixty-one patients (9.8%) had prolonged QTc and only 3.2% had a baseline QTc > 500 milliseconds. Patients with prolonged QTc were older, had more comorbidities, and higher levels of immune-inflammatory markers. There were no episodes of ventricular tachycardia or ventricular fibrillation during hospitalization. All-cause death was higher in patients with prolonged QTc (41.0% vs. 8.7%, p < 0.001, multivariable HR 2.68 (1.58-4.55), p < 0.001).

Conclusions: Almost 10% of patients with COVID-19 infection have a prolonged QTc interval on admission. A prolonged QTc was independently associated with a higher mortality even after adjustment for age, comorbidities, and treatment with hydroxychloroquine and azithromycin. An electrocardiogram should be included on admission to identify high-risk SARS-CoV-2 patients.

Keywords: COVID-19; QT interval; azithromycin; death; hydroxychloroquine; prognosis.

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Conflict of interest statement

N.F. reports grants and consultancy fees from Novartis, Bayer, Rovi, and AstraZeneca; J.M. reports grants and consultancy fees from AstraZeneca, Sanofi, Shire, Gilead, Daichii-Sankyo, Genincode, and Ferrer. The other authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Flowchart of patient selection.
Figure 2
Figure 2
Kaplan–Meier 30-day survival curves for mortality by QTc during the time from medical contact.
See this image and copyright information in PMC

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