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All Journal Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Jurnal Pendidikan Kedokteran Indonesia: The Indonesian Journal of Medical Education Indonesian Journal of Pharmacology and Therapy
Gumilang, Rizki Amalia
Academic Hospital, Universitas Gadjah Mada/ Department Of Cardiology And Vascular Medicine, Faculty Of Medicine, Public Health And Nursing, Universitas Gadjah Mada/Dr. Sardjito General Hospital, Yogyakarta
Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health

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Journal : Indonesian Journal of Pharmacology and Therapy

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Safety monitoring of chloroquine and hydroxychloroquine in COVID-19 patients in Indonesia on QT prolongation: hospital based monitoring study Jarir At Thobari; Togi Junice Hutadjulu; Tri Asti Isnariani; Umi Sa'adatun Nikmah; Lukman Ade Chandra; Pompini Agustina Sitompul; Anggoro Budi Hartopo; Rizki Amalia Gumilang; Luhur Pribadi; Deva Bachtiar; Anwar Santoso
Indonesian Journal of Pharmacology and Therapy Vol 4 No 1 (2023)
Publisher : Indonesian Pharmacologist Association or Ikatan Farmakologi Indonesia (IKAFI) and Faculty of Medicine, Public Health, and Nursing Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (287.561 KB) | DOI: 10.22146/ijpther.7148

Abstract

Chloroquine (CQ) and Hydroxychloroquine (HCQ) are the challenging drugs used for COVID-19. Several studies show its beneficial, however, both medications can prolong the QTc interval and increase the risk of patients for torsades de pointes and death. The Tisdale score is identified to have successfully predicted the at-risk population of side effects of these drugs. This study aim to evaluate the QT prolongation caused by the administration of chloroquine and hydroxychloroquine in COVID-19 patients and the association with the treatment outcomes based on their Tisdale score. We conducted an observational study on 213 hospitalized patients with confirmed or suspect COVID-19 in 6 referral hospitals in Indonesia. All baseline demographic such as age and gender, RT-PCR test result, severity of disease, history of cardiovascular disease (myocardial infarction, heart failure, hypertension), serum kalium level at baseline, and the use of medication associated with risk QTc interval prolongation were collected. The Tisdale risk score was used for predicting high-risk patients for QT corrected (QTc) interval prolongation. Out of 213 patients who were treated with CQ/HCQ, there were 60 (28.2%) patients had QTc interval prolongation, included 43 patients (20.2%) who had normal QTc interval at baseline and at the end of treatment had prolong interval; or 17 patients (8.0%) who had QTc interval more than 470 msec at baseline and QTc interval prolongation was worsen at the end of treatment. Several factors, including age more than 50 years, COVID-19 confirm PCR, and had comorbidity heart failure, were statistically significant associated with QTc interval prolongation. The high-risk score of Tisdale score have increased risk significantly on QTc interval prolongation (RR: 2.15, 95%CI 1.07-4.32) and associated with risk of death (RR: 3.50, 95%CI 1.34-9.13) compared to low-risk score. Our findings showed that the treatment of CQ/HCQ in COVID-19 patients is associated with QTc prolongation. The Tisdale score can be used as a valuable tool to predict the COVID-19 patients’ outcome after treatment of these QTc-prolonging drugs.
Co-Authors Anggoro Budi Hartopo Anis Fuad Anwar Santoso Budi Yuli Setianto Deva Bachtiar Gharini, Putrika Prastuti Ratna Jarir At Thobari Luhur Pribadi Lukman Ade Chandra Nahar Taufiq Orisativa Kokasih Pompini Agustina Sitompul Shofuro Hasana Togi Junice Hutadjulu Tri Asti Isnariani Umi Sa'adatun Nikmah Vita Arfiana Nurul Fatimah