Prevalência de arritmias em pacientes com Sars-cov-2 tratados com hidroxicloroquina e azitromicina / Prevalence of arrhytmias in patients with Sars-cov-2 treated with hydroxychloroquine and azithromycin

Beatriz Gomes Dalla Justina, Caroline Marques de Aquino, Diana Neves Ladeia, Eduarda Faria do Nascimento, Gustavo Mariano Rodrigues Santos, Israel Souza da Silva Ramos, Ludmila Limpias Terrazas Binkowski, Pedro Duarte Moreira Andrade, Rodrigo Silas Lara Ferreira, Vinícius Catto Vaz

Abstract


INTRODUÇÃO: Este estudo tem como objetivo realizar uma revisão de narrativa a respeito da correlação entre o prolongamento do intervalo QT e desenvolvimento de Torsade de Pointes (TdP) em pacientes previamente diagnosticados com a COVID-19 e medicados com Hidroxicloroquina e Azitromicina. METODOLOGIA:  Foram realizadas buscas nas bases de dados PubMed/ MedLine utilizando-se os seguintes descritores: ‘’COVID-19”, ‘’hidroxicloroquine’’, “azithromycin”, “QTc interval”, ‘’arrhythmias’’ e ‘’cardiac’’ com ênfase nos resultados de até 1 ano. RESULTADOS: Um total de trinta e três artigos de periódicos internacionais foram selecionados, totalizando uma amostra de 1191 pacientes confirmados com COVID-19 e tratados com Hidroxicloroquina associado com Azitromicina. Estes pacientes que fizeram uso de HCQ em monoterapia desenvolveram menos anormalidades cardíacas e QTc > 500ms em comparação aos tratados com a combinação desses fármacos. DISCUSSÃO: O estudo identificou um prolongamento excessivo do intervalo qtc nos pacientes em uso combinado da medicação, além de algumas arritmias associadas, principalmente FA e TdP. No entanto, é necessária uma investigação mais ampla, com estudos que demonstrem eficácia no combate ao vírus sem o surgimento de efeitos deletérios. CONCLUSÃO: O desenvolvimento de TdP através do uso de Hidroxicloroquina + Azitromicina foi raro. Entretanto, foi significativo o número de pacientes que apresentaram prolongamento do intervalo QT, em particular aqueles que já possuíam alguma comorbidade.

Keywords


COVID-19, Torsade de Pointes, Hidroxicloroquina, Azitromicina, Intervalo QT.

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DOI: https://doi.org/10.34119/bjhrv3n4-344

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