Abstract
Introduction: Hydroxychloroquine, one of the challenging drugs used for COVID-19, has shown to be beneficial in some studies, although concerns about the side effects of the drug have limited its use. Several electrocardiogram changes have been described in these patients which could be exacerbated using hydroxychloroquine, especially QT-prolongation. Struggles to identify the population at risk of side effects of these drugs result in few scoring systems, one of which is the Tisdale score that showed to have successfully predicted the at-risk population.
Objectives: In this study, we aimed to assess the degree of QT prolongation provoked by hydroxychloroquine, either alone or in combination with azithromycin in association with the treatment outcomes based on their Tisdale score.
Patients and Methods: We conducted a historical cohort study on 659 patients with COVID-19 at Khorshid hospital, Isfahan, Iran from March to April 2020. Tisdale risk score was used for predicting high-risk patients for QT corrected (QTc) interval prolongation.
Results: Mean (SD) of baseline QTc was 390.66 (14.65), 390.74 (16.52), 389.67 (19.51), 390.68 (17.35) for patients who received hydroxychloroquine, hydroxychloroquine plus azithromycin, Kaletra, respectively. QTc was not increased significantly after starting treatment in each group.
Conclusion: Despite that none of our patients have a high Tisdale score, our findings showed the predictive value of this score for treatment outcomes. Individuals with medium Tisdale scores showed much worse outcomes and in-hospital mortality. Tisdale score could be employed as a valuable tool to predict the COVID-19 patients’ prognosis after treatment with QT-prolonging drugs.