Currently, there are no FDA-approved treatments available, the anti-malarial drug, hydroxychloroquine, has emerged as a potential therapy for pneumonia linked to COVID-19.
But in a new study, researchers found evidence that patients who used hydroxychloroquine for COVID-19 were at a higher risk of electrical changes to the heart and irregular heartbeats.
The combination of hydroxychloroquine with antibiotic drug azithromycin was linked to even greater changes compared to hydroxychloroquine alone.
The researchers say that while hydroxychloroquine and azithromycin are generally well-tolerated drugs, increased usage in the context of COVID-19 may increase the side effects.
This is especially concerning given that that patients with heart co-morbidities are more likely to be affected by COVID-19 and that the virus itself may damage the heart.
The research was conducted by a team at Beth Israel Deaconess Medical Center (BIDMC).
According to the team, hydroxychloroquine and azithromycin each can cause an electrical disturbance in the heart known as a QTc prolongation, indicated by a longer space between specific peaks on an electrocardiogram.
QTc prolongation denotes that the heart muscle is taking milliseconds longer than normal to recharge between beats.
The delay can cause cardiac arrhythmias, which in turn increases the likelihood of cardiac arrest, stroke, or death.
In this study, the team tested 90 adults with COVID-19 who were hospitalized at BIDMC between March 1 and April 7, 2020, and received at least one day of hydroxychloroquine.
More than half of these patients also had high blood pressure, and more than 30% had diabetes.
The team found 7 patients (19%) who received hydroxychloroquine alone developed prolonged QTc of 500 milliseconds or more, and three patients had a change in QTc of 60 milliseconds or more.
Of the 53 patients who also received azithromycin, 21% had prolonged QTc of 500 milliseconds or more, and 13% experienced a change in QTc of 60 milliseconds or more.
Previous studies suggested hydroxychloroquine may be effective against SARS-CoV-1, a fatal but hard-to-transmit respiratory virus related to the coronavirus that causes COVID-19.
More recently, a small study of patients with COVID-19 appeared to benefit from the anti-malarial drug. Subsequent research, however, has failed to confirm either finding.
In light of their data, the team urges caution and careful consideration before administering hydroxychloroquine as a treatment for COVID-19.
The lead author of the study is Nicholas J. Mercuro, PharmD, a pharmacy specialist in infectious diseases at BIDMC.
The study is published in JAMA Cardiology.
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