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. 2022 Jul;41(7):551-556.
doi: 10.1016/j.repc.2021.04.008. Epub 2022 Feb 21.

Effects of azithromycin on ventricular repolarization in children with COVID-19

Suleyman Sunkak  1 , Mustafa Argun  2 , Binnaz Celik  3 , Onur Tasci  4 , Agah Bahadir Ozturk  3 , Dogan Bahadir Inan  3 , Murat Dogan  2
Affiliations

Effects of azithromycin on ventricular repolarization in children with COVID-19

Suleyman Sunkak et al. Rev Port Cardiol. 2022 Jul.

Abstract
in English, Portuguese

Introduction: Azithromycin is used to treat pediatric COVID-19 patients. It can also prolong the QT interval in adults. This study assessed the effects of azithromycin on ventricular repolarization in children with COVID-19.

Method: The study prospectively enrolled children with COVID-19 who received azithromycin between July and August 2020. An electrocardiogram was performed before, one, three, and five days post-treatment. Using ImageJ®, the following parameters were measured: QT max, QT min, Tp-e max, and Tp-e min. The parameters QTc max, QTc min, Tp-ec max, Tp-ec min, QTcd, Tp-ecd, and the QTc/Tp-ec ratio were calculated using Bazett's formula.

Results: The study included 105 pediatric patients (mean age 9.8±5.3 years). The pretreatment heart rate was higher than after treatment (before 92 [79-108]/min vs. Day 1 82 [69-108)]/min vs. Day 3 80 [68-92.2]/min vs. Day 5 81 [70-92]/min; p=0.05).

Conclusion: Azithromycin does not affect the ventricular repolarization parameters on ECG in pediatric COVID-19 cases.

Introdução: A azitromicina (AZ) é utilizada no tratamento da COVID-19 em pediatria. Como este fármaco pode prolongar o intervalo QT nos adultos, este estudo avaliou os efeitos da AZ na repolarização ventricular de crianças com COVID-19.

Método: Este estudo prospetivo incluiu crianças com COVID-19 que foram tratadas com AZ em julho-agosto 2020. Foi efetuado um eletrocardiograma (ECG) antes e um, 3 e 5 dias após o tratamento. Utilizando ImageJ ®, foram medidos os parâmetros seguintes: QT max, QT min, Tp-e max, e Tp-e min. Os parâmetros QTc min, Tp-ec max, Tp-ec min, QTcd, Tp-ecd e QTc/Tp-ec ratio foram calculados utilizando a fórmula Bazett.

Resultados: O estudo incluiu 105 doentes pediátricos (idade média 9,8±5,3 anos). A frequência cardíaca no pré-tratamento foi mais elevada do que após o tratamento (antes 92 [79–108]/min versus dia 1 82 [69–108)]/min versus dia 3 80 [68–92,2]/min versus dia 5 81 [70–92]/min; p=0,05).

Conclusão: A AZ não afeta os parâmetros de repolarização ventricular no ECG nos casos pediátricos da COVID-19.

Keywords: Azithromycin; COVID-19; Paediatrics; QT dispersion; QT interval; Tp-e dispersion; Tp-e interval.

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