scholarly journals QT Prolongation in Critically Ill Patients With SARS-CoV-2 Infection

2022 ◽  
Vol 27 ◽  
pp. 107424842110694
Author(s):  
Wasim S. El Nekidy ◽  
Khalid Almuti ◽  
Hazem ElRefaei ◽  
Bassam Atallah ◽  
Lana M. Mohammad ◽  
...  
Keyword(s):  
Risk Factors ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Qt Interval ◽  
Interval Prolongation ◽  
Qtc Prolongation ◽  
Factors Associated ◽  
Qt Interval Prolongation ◽  
History Of ◽  
Clinically Significant

Background: Several reports linked the use of repurposed drugs such as hydroxychloroquine (HCQ), azithromycin, lopinavir/ritonavir, and favipiravir with QT interval prolongation in patients with SARS-CoV2 infection. Little is known about the risk factors for QT interval prolongation in this population. We sought to describe the prevalence and identify the main risk factors associated with clinically significant corrected QT (QTc) prolongation in this population. Methods: We conducted a retrospective analysis of critically ill patients who were admitted to our intensive care unit (ICU), had at least one electrocardiogram performed during their ICU stay, and tested positive for SARs-CoV-2. Clinically significant QTc interval prolongation was defined as QTc >500 milliseconds (ms). Results: Out of the 111 critically ill patients with SARS-CoV-2 infection, QTc was significantly prolonged in 47 cases (42.3%). Patients with a clinically significant QTc prolongation had significantly higher proportions of history of cardiac diseases/surgery (22 [46.8%] vs. 10 [15.6%], P < .001), hypokalemia (10 [21.3] vs. 5 [7.8%], P = .04), and male gender (95% vs. 82.8%, P = .036) than patients with QTc ≤500 ms, respectively. A total of 46 patients (41.4%) received HCQ, 28 (25.2%) received lopinavir/ritonavir, and 5 (4.5%) received azithromycin. Multivariate logistic regression analysis showed that a history of cardiac disease was the only independent factor associated with clinically significant QTc prolongation ( P = .004 for the likelihood-ratio test). Conclusion: The prevalence of clinically significant QTc prolongation in critically ill patients with SARS-CoV-2 infection was high and independent of drugs used. Larger prospective observational studies are warranted to elucidate independent risk factors associated with clinically significant QTc prolongation in this study population.

scholarly journals Predictors of QT Interval Prolongation in Critically-ill Patients with SARS-CoV-2 Infection Treated with Hydroxychloroquine

2020 ◽  
Author(s):  
Frederico Scuotto ◽  
Rogério Marra ◽  
Lilian Leite de Almeida ◽  
Mariana Santa Rita Soares ◽  
Gabriela Kurita Silva ◽  
...  
Keyword(s):  
Critically Ill ◽  
Critically Ill Patients ◽  
Qt Interval ◽  
Clinical Aspects ◽  
Multivariable Logistic Regression Analysis ◽  
Qtc Interval ◽  
Interval Prolongation ◽  
Qt Interval Prolongation ◽  
The Mean ◽  
Interval Enlargement

AbstractBackgroundHydroxychloroquine (HCQ) has been described as a potential treatment for SARS-CoV-2 infection. However, there are safety concerns regarding its QT interval and pro-arrhythmic effects.ObjectiveThis trial aimed to determine the predictors of QT interval prolongation and pro-arrhythmic effects in patients hospitalized for SARS-CoV-2 infection and receiving HCQ.MethodsWe performed a retrospective observational study of 45 critically-ill patients hospitalized because of SARS-CoV-2 infection and treated with 800 mg of HCQ at day 1 and 400 mg on days 2–5. Clinical aspects and outcomes, basal and final corrected QT (QTc) interval, and the incidence of arrhythmias and arrhythmogenic death were observed. Independent predictors of QTc prolongation were identified using multivariable logistic regression analysis. QT interval prolongation was considered substantial at final QTc ≥ 480 ms.ResultsThe mean age was 60.9 ± 16.67 years and 28 (62.2%) patients were men. Basal QTc was 442 ± 28 ms, and the final QTc interval was 458 ± 34 ms, for a mean QTc interval variation of 15 ± 11 ms. There was no arrhythmogenic death. The need for hemodialysis remained a statistically significant predictor of QT interval enlargement (odds ratio, 10.34; 95% confidence interval, 1.04 – 102.18; p = 0.045).ConclusionsHCQ promotes mild to moderate QT interval prolongation. The risk of QT interval prolongation is higher among patients with acute renal failure requiring hemodialysis.

scholarly journals Etiology, incidence, and outcomes of patient–ventilator asynchrony in critically-ill patients undergoing invasive mechanical ventilation

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Yongfang Zhou ◽  
Steven R. Holets ◽  
Man Li ◽  
Gustavo A. Cortes-Puentes ◽  
Todd J. Meyer ◽  
...  
Keyword(s):  
Risk Factors ◽  
Mechanical Ventilation ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Invasive Mechanical Ventilation ◽  
Surgical Intensive Care ◽  
Mechanically Ventilated ◽  
History Of ◽  
Training Background ◽  
The Relationship

AbstractPatient–ventilator asynchrony (PVA) is commonly encountered during mechanical ventilation of critically ill patients. Estimates of PVA incidence vary widely. Type, risk factors, and consequences of PVA remain unclear. We aimed to measure the incidence and identify types of PVA, characterize risk factors for development, and explore the relationship between PVA and outcome among critically ill, mechanically ventilated adult patients admitted to medical, surgical, and medical-surgical intensive care units in a large academic institution staffed with varying provider training background. A single center, retrospective cohort study of all adult critically ill patients undergoing invasive mechanical ventilation for ≥ 12 h. A total of 676 patients who underwent 696 episodes of mechanical ventilation were included. Overall PVA occurred in 170 (24%) episodes. Double triggering 92(13%) was most common, followed by flow starvation 73(10%). A history of smoking, and pneumonia, sepsis, or ARDS were risk factors for overall PVA and double triggering (all P < 0.05). Compared with volume targeted ventilation, pressure targeted ventilation decreased the occurrence of events (all P < 0.01). During volume controlled synchronized intermittent mandatory ventilation and pressure targeted ventilation, ventilator settings were associated with the incidence of overall PVA. The number of overall PVA, as well as double triggering and flow starvation specifically, were associated with worse outcomes and fewer hospital-free days (all P < 0.01). Double triggering and flow starvation are the most common PVA among critically ill, mechanically ventilated patients. Overall incidence as well as double triggering and flow starvation PVA specifically, portend worse outcome.

scholarly journals Risk factors associated with Acinetobacter baumannii septicemia and its mortality rates in critically ill patients

Critical Care ◽  
2013 ◽  
Vol 17 (S2) ◽  
Author(s):  
K Kontopoulou ◽  
K Tsepanis ◽  
I Sgouropoulos ◽  
A Triantafyllidou ◽  
D Socratous ◽  
...  
Keyword(s):  
Risk Factors ◽  
Acinetobacter Baumannii ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Mortality Rates ◽  
Factors Associated

scholarly journals Absence of relevant QT interval prolongation in not critically ill COVID-19 patients

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Juan Jiménez-Jáimez ◽  
Rosa Macías-Ruiz ◽  
Francisco Bermúdez-Jiménez ◽  
Ricardo Rubini-Costa ◽  
Jessica Ramírez-Taboada ◽  
...  
Keyword(s):  
Critically Ill ◽  
Qt Interval ◽  
Treatment Initiation ◽  
Qtc Interval ◽  
Risk Markers ◽  
Interval Prolongation ◽  
Qt Interval Prolongation ◽  
Qtc Interval Prolongation ◽  
Ambulatory Patients ◽  
Reported Data

AbstractSARS-CoV-2 is a rapidly evolving pandemic causing great morbimortality. Medical therapy with hydroxicloroquine, azitromycin and protease inhibitors is being empirically used, with reported data of QTc interval prolongation. Our aim is to assess QT interval behaviour in a not critically ill and not monitored cohort of patients. We evaluated admitted and ambulatory patients with COVID-19 patients with 12 lead electrocardiogram at 48 h after treatment initiation. Other clinical and analytical variables were collected. Statistical analysis was performed to assess the magnitude of the QT interval prolongation under treatment and to identify clinical, analytical and electrocardiographic risk markers of QT prolongation independent predictors. We included 219 patients (mean age of 63.6 ± 17.4 years, 48.9% were women and 16.4% were outpatients. The median baseline QTc was 416 ms (IQR 404–433), and after treatment QTc was prolonged to 423 ms (405–438) (P < 0.001), with an average increase of 1.8%. Most of the patients presented a normal QTc under treatment, with only 31 cases (14.1%) showing a QTc interval > 460 ms, and just one case with QTc > 500 ms. Advanced age, longer QTc basal at the basal ECG and lower potassium levels were independent predictors of QTc interval prolongation. Ambulatory and not critically ill patients with COVID-19 treated with hydroxychloroquine, azithromycin and/or antiretrovirals develop a significant, but not relevant, QT interval prolongation.

Clinical characteristics of patients with drug-induced QT interval prolongation and torsade de pointes: identification of risk factors

2008 ◽  
Vol 98 (4) ◽  
pp. 208-212 ◽  
Author(s):  
Konstantinos P. Letsas ◽  
Michalis Efremidis ◽  
Stavros P. Kounas ◽  
Loukas K. Pappas ◽  
Gerasimos Gavrielatos ◽  
...  
Keyword(s):  
Risk Factors ◽  
Qt Interval ◽  
Clinical Characteristics ◽  
Torsade De Pointes ◽  
Interval Prolongation ◽  
Drug Induced ◽  
Qt Interval Prolongation

332 – Risk factors of qt interval prolongation in 1000 patients with schizophrenia

2008 ◽  
Vol 98 ◽  
pp. 170
Author(s):  
Y. Ozeki ◽  
K. Fujii ◽  
N. Kurimoto ◽  
K. Tsuji ◽  
N. Yamada ◽  
...  
Keyword(s):  
Risk Factors ◽  
Qt Interval ◽  
Interval Prolongation ◽  
Qt Interval Prolongation
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