A New Index in the Follow-Up of Arrhythmia of Coronavirus Disease-2019 (COVID-19) Patients Receiving Hydroxychloroquine and Azithromycin Therapy; Index of Cardiac Electrophysiological Balance

Abstract

Objective: Index of cardiac electrophysiological balance (iCEB) is a relatively new electrocardiographic (ECG) parameter that shows the balance between ventricular depolarization and repolarization, thus providing more information than other conventional ECG parameters such as QT and corrected QT (cQT) intervals. This study aimed to evaluate the condition of iCEB with the treatment of hydroxychloroquine and azithromycin used in COVID-19 patients. Method: The study was designed as cross-sectional and descriptive. Sixty three (52 male, 28.4 ± 10.7 years) COVID-19 patients with mild symptoms who received hydroxychloroquine and azithromycin treatment between 30 March and 30 June 2020 were included in the study. iCEB and corrected iCEB (iCEBc) values were calculated by dividing the respective QT and cQT intervals by the QRS duration. Results: In the study group, the mean PR, QRS, QT and cQT intervals were similar between groups. While heart rate was significantly higher before treatment, iCEB and iCEBc increased significantly after treatment. Conclusions: Our study did not observe a significant difference in QT and cQT intervals with hydroxychloroquine and azithromycin treatment in COVID-19. Still, there was a significant increase in the iCEB and iCEBc. We believe that the cardiac electrophysiological balance index can be used to monitor arrhythmias in patients undergoing short-term treatment at COVID -19.