Kocaeli Med J. 2021; 10(1): 12-21 | DOI: 10.5505/ktd.2021.67984

The Impact of Hydroxychloroquine with or without Azithromycin Treatment on T-peak to T-end Time in Patients Hospitalized with Coronavirus Disease (COVID-19)

Ferhat Iþýk¹, Ümit Ýnci¹, Abdurrahman Akyüz¹, Burhan Aslan¹, Murat Çap¹, Ýlyas Kaya¹, Mehmet Þahin Adýyaman¹, Önder Bilge¹, Rojhat Altindag¹, Derya Deniz Altýntaþ², Bernas Altýntaþ^1
1University of Health Sciences, Gazi Yaþargil Training and Research Hospital, Department of Cardiology, Diyarbakýr, Turkey
²University of Health Sciences, Gazi Yaþargil Training and Research Hospital, Department of Radiology, Diyarbakýr, Turkey

INTRODUCTION: The aim of our study is to investigate the effects of hydroxychloroquine (HCQ) with azithromycin (AZR) treatment versus HCQ alone on T-end to T-peak (TpTe) time in COVID-19 patients.
METHODS: Two hundred-five consecutive patients hospitalized with the diagnosis of COVID-19 were included in our study. Patients were divided into two groups according to the HCQ alone and HCQ+AZR combination treatments administered. These two groups were compared according to the demographic features, admission and follow-up laboratory parameters, admission and 3rd day electrocardiographic (ECG) parameters.
RESULTS: The median age of all patients was 44 (31-59) and 53% of them were male. QRS interval, QT interval, QTc interval, QT dispersion, QTc dispersion,TpTe time and TpTe/QTc ratio were significantly higher in the 3rd day ECGs than admission ECGs. In the HCQ group, QT dispersion and QTc dispersion at admission ECG were significantly higher than in the HCQ + AZR group. On the 3rd day ECG parameters of the two groups were similar. We determined the predicting factors of the TpTe time on the 3rd day ‘s ECG using linear regression analysis. These were the HCQ+ AZR combination treatment [regression coefficient (RE) 0.097 and 95% CI 0.960, 4.109, p = 0.040], female gender (RE -0.119 and 95% CI -4.552, -0.440, p = 0.018), and TpTe time at admission ECG (RE 0.741 and 95% CI 0.637, 0.840, p < 0.001).
DISCUSSION AND CONCLUSION: HCQ + AZR combination treatment was found to be an independent predictor in the prolongation of the TpTe time, compared to the HCQ alone treatment.

Keywords: COVID-19, hydroxychloroquine, azithromycin, TpTe time

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COVÝD-19 Tanýsý ile Yatýrýlan Hastalarda Hidroksiklorokin ve/veya Azitromisin Tedavisinin T tepe-T bitiþ Süresi Üzerine Olan Etkisi

Ferhat Iþýk¹, Ümit Ýnci¹, Abdurrahman Akyüz¹, Burhan Aslan¹, Murat Çap¹, Ýlyas Kaya¹, Mehmet Þahin Adýyaman¹, Önder Bilge¹, Rojhat Altindag¹, Derya Deniz Altýntaþ², Bernas Altýntaþ^1
1Saðlýk Bilimleri Üniversitesi, Gazi Yaþargil Eðitim ve Araþtýrma Hastanesi, Kardiyoloji Bölümü, Diyarbakýr, Türkiye
²Saðlýk Bilimleri Üniversitesi, Gazi Yaþargil Eðitim ve Araþtýrma Hastanesi, Radyoloji Bölümü, Diyarbakýr, Türkiye

GÝRÝÞ ve AMAÇ: Çalýþmamýzýn amacý COVÝD-19 hastalarýnda hidroksiklorokin (HQC) ve azitromisin (AZR) tedavisinin, sadece hidroksiklorokin (HCQ) alan hastalara göre T tepe-T bitiþ (TpTe) süresi üzerine etkilerini araþtýrmaktýr.
YÖNTEM ve GEREÇLER: Çalýþmamýza 6 Nisan-30 Nisan 2020 tarihleri arasýnda COVÝD-19 tanýsý ile yatýrýlan ardýþýk 205 hasta alýndý. Hastalar, yalnýz HQC verilen ve HQC+AZR kombinasyonu verilenler diye iki gruba ayrýldý. Ýki grup demografik özellikleri, baþvuru ve 3.gün laboratuar parametreleri ve 3.gün elektrokardiografi (EKG) bulgularýna göre karþýlaþtýrýldý. Ayrýca tüm hastalarýn baþvuru ve 3.gün EKG’leri karþýlaþtýrýldý.
BULGULAR: Tüm hastalarýn median yaþ ortalamasý 44 (31-59) olup, % 53’ü erkek hastalardý. Hastalarýn baþvuru EKG’sine göre 3.gün EKG’ lerinde; QRS süresi, QT süresi, QTc süresi, QT dispersiyonu, QTc dispersiyonu, TpTe süresi ve TpTe/QTc oraný anlamlý olarak daha fazlaydý. HQC grubunda HQC+AZR grubuna göre, baþvuru EKG'lerinde QT dispersiyonu ve QTc dispersiyonu anlamlý olarak daha fazlaydý. Ýki grubun 3. gün EKG parametreleri ise benzerdi. Lineer regresyon analizi yöntemini kullanarak 3.gün EKG'lerindeki TpTe deðerleri için bazý prediktörler tespit ettik. Bunlar; HCQ+AZR kombinasyonunun kullanýlmasý [regression coefficient (RE) 0.097 and 95% CI 0.960, 4.109, p = 0.040], kadýn cinsiyet (RE -0.119 and 95% CI -4.552, -0.440, p = 0.018) ve baþvuru EKG'sindeki TpTe süresi (RE 0.741 and 95% CI 0.637, 0.840, p < 0.001) idi.
TARTIÞMA ve SONUÇ: Çalýþmamýz sonucunda, HQC+AZR kombinasyon tedavisinin HQC grubuna karþý TpTe süresinin uzamasýnda baðýmsýz bir prediktör olduðu görülmüþtür.

Anahtar Kelimeler: COVÝD-19, hidroksiklorokin, azitromisin, TpTe süresi

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