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The novel coronavirus disease 2019 (COVID-19) outbreak is an ongoing situation caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).1 Studies in patients with mild to moderate COVID-19 symptoms have suggested benefits of hydroxychloroquine alone or in combination with azithromycin against SARS-CoV-2 and raised hope for treating the disease.2 As a result, these treatments are increasingly used off-label for patients with COVID-19, including for those in intensive care units (ICUs).2,3 However, both medications are known to induce QT prolongation via a human Ether-à-go-go–related gene potassium channel blockade, which can promote life-threatening ventricular arrhythmias.4,5 Safety data for these treatments are largely lacking for patients with COVID-19. This is even more relevant for critically ill patients who are particularly exposed to electrolyte imbalance and/or drugs leading to an increased risk of QT prolongation.6 Therefore, we aimed to examine the safety of hydroxychloroquine with or without azithromycin regarding QT interval in ICU patients with COVID-19.
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Accepted for Publication: April 14, 2020
Corresponding Author: Martin Cour, MD, PhD, Médecine Intensive-Réanimation, Hôpital Edouard Herriot, 5, Place d’Arsonval, 69437 Lyon Cedex 03, France (firstname.lastname@example.org).
Author Contributions: Drs Bessière and Cour had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.
Concept and design: Bessiere, Roccia, Chevalier, Argaud, Cour.
Acquisition, analysis, or interpretation of data: Bessiere, Roccia, Deliniere, Charriere, Chevalier, Cour.
Drafting of the manuscript: Bessiere, Roccia, Chevalier, Cour.
Critical revision of the manuscript for important intellectual content: Bessiere, Roccia, Deliniere, Charriere, Argaud, Cour.
Statistical analysis: Bessiere, Cour.
Supervision: Bessiere, Deliniere, Chevalier, Argaud, Cour.
Conflict of Interest Disclosures: Dr Bessière reports grants and personal fees from Abbott, Boston Scientific, Medtronic, Biosense, and Volta Medical outside the submitted work. Dr Chevalier reports grants from Abbott, Boston Scientific, and Medtronic outside the submitted work. No other disclosures were reported.
Published Online: May 1, 2020. doi:10.1001/jamacardio.2020.1787
Correction: This article was corrected on June 24, 2020, to fix errors in the Conflict of Interest Disclosures.
Additional Contributions: We thank Verena Landel, DRCI, Hospices Civils de Lyon, for her help in manuscript preparation. She was not compensated for her contributions.
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