J Clin Med Res

Journal of Clinical Medicine Research, ISSN 1918-3003 print, 1918-3011 online, Open Access

Article copyright, the authors; Journal compilation copyright, J Clin Med Res and Elmer Press Inc

Journal website https://www.jocmr.org

Original Article

Volume 12, Number 9, September 2020, pages 604-611

Effects of Short-Term Hydroxychloroquine Plus Moxifloxacin Therapy on Corrected QT Interval and Tp-e Interval in Patients With COVID-19

**Table 1.** Demographic Features and Comorbidities of Patients on Admission (N = 76)
Baseline characteristics	N (%)
^aChronic lung disease was defined as chronic obstructive pulmonary disease, asthma, or chronic bronchitis.
Sex
Female	44 (58%)
Male	32 (42%)
Age (years)	61.7 ± 14.8
Smoking	11 (15%)
Comorbidities
Heart failure	13 (17%)
Hypertension	41 (54%)
Coronary artery disease	21 (28%)
Cerebrovascular disease	2 (2%)
Diabetes mellitus	26 (34%)
Chronic lung disease^a	21 (28%)
Atrial fibrillation	2 (2%)
Malignancy	1 (1%)
Chronic kidney disease	5 (7%)
Death without cardiac arrhythmia	5 (7%)

Table 1. Demographic Features and Comorbidities of Patients on Admission (N = 76)

Baseline characteristics

N (%)

^aChronic lung disease was defined as chronic obstructive pulmonary disease, asthma, or chronic bronchitis.

Sex

Female

44 (58%)

Male

32 (42%)

Age (years)

61.7 ± 14.8

Smoking

11 (15%)

Comorbidities

Heart failure

13 (17%)

Hypertension

41 (54%)

Coronary artery disease

21 (28%)

Cerebrovascular disease

2 (2%)

Diabetes mellitus

26 (34%)

Chronic lung disease^a

21 (28%)

Atrial fibrillation

2 (2%)

Malignancy

1 (1%)

Chronic kidney disease

5 (7%)

Death without cardiac arrhythmia

5 (7%)

**Table 2.** Laboratory Findings of Patients on Admission to Hospital (N = 76)
ΔQTc: change in corrected QT interval; BP: blood pressure.
Hemoglobin, g/dL	12.9 ± 1.8
Platelet count, (× 10³/µL)	215 (180 - 258)
White blood cell count, (× 10³/µL)	9.1 ±3.8
Neutrophil cell count, (× 10³/µL)	6.4 ± 3.4
Lymphocyte cell count, (× 10³/µL)	1.9 ± 0.9
Serum creatinine, mg/dL	0.85 (0.72 - 1.07)
Alanine aminotransferase, U/L	22 (16 - 34)
Lactate dehydrogenase, U/L	321.6 ± 114.4
Serum potassium, mEq/L	4.3 ± 0.2
Serum sodium, mEq/L	136.2 ± 2.4
C-reactive protein, mg/dL	3.2 (0.6 - 8.5)
Ferritin, ng/mL	118 (52 - 220)
D-dimer, µg/L	907 (698 - 1,130)
Troponin I, ng/mL	0.01 (0.01 - 0.03)
Activated partial thromboplastin time, s	32.7 ± 5.0
Prothrombin time, s	1.2 ± 0.3
Ph	7.37 ± 0.06
ΔQTc, ms	15 (3 - 38)
Tisdale score	7.3 ± 1.1
Systolic BP, mm Hg	130.1 ± 14.1
Diastolic BP, mm Hg	80 (70 - 85)

Table 2. Laboratory Findings of Patients on Admission to Hospital (N = 76)

ΔQTc: change in corrected QT interval; BP: blood pressure.

Hemoglobin, g/dL

12.9 ± 1.8

Platelet count, (× 10³/µL)

215 (180 - 258)

White blood cell count, (× 10³/µL)

9.1 ±3.8

Neutrophil cell count, (× 10³/µL)

6.4 ± 3.4

Lymphocyte cell count, (× 10³/µL)

1.9 ± 0.9

Serum creatinine, mg/dL

0.85 (0.72 - 1.07)

Alanine aminotransferase, U/L

22 (16 - 34)

Lactate dehydrogenase, U/L

321.6 ± 114.4

Serum potassium, mEq/L

4.3 ± 0.2

Serum sodium, mEq/L

136.2 ± 2.4

C-reactive protein, mg/dL

3.2 (0.6 - 8.5)

Ferritin, ng/mL

118 (52 - 220)

D-dimer, µg/L

907 (698 - 1,130)

Troponin I, ng/mL

0.01 (0.01 - 0.03)

Activated partial thromboplastin time, s

32.7 ± 5.0

Prothrombin time, s

1.2 ± 0.3

7.37 ± 0.06

ΔQTc, ms

15 (3 - 38)

Tisdale score

7.3 ± 1.1

Systolic BP, mm Hg

130.1 ± 14.1

Diastolic BP, mm Hg

80 (70 - 85)

**Table 3.** Electrocardiographic Parameters of the Study Group (N = 76)
	2nd day	5th day	P
QTc: corrected QT; Tp-e: transmural dispersion of repolarization; cTp-e: corrected transmural dispersion of repolarization.
Heart rate (beats/min)	78 (72 - 90)	80 (73 - 90)	0.127
QT interval (ms)	370.8 ± 32.5	381.0 ± 29.3	0.001
QTc interval (ms)	424 (403 - 436)	442 (420 - 468)	< 0.001
Tp-e interval (ms)	60 (55 - 70)	65 (57 - 75)	< 0.001
cTp-e interval (ms)	72.2 ± 12.9	75.4 ± 12.7	< 0.001
Tp-e/QT ratio	0.17 ± 0.03	0.17 ± 0.02	0.03
Tp-e/QTc ratio	0.17 ± 0.03	0.17 ± 0.03	0.228

Table 3. Electrocardiographic Parameters of the Study Group (N = 76)

2nd day

5th day

QTc: corrected QT; Tp-e: transmural dispersion of repolarization; cTp-e: corrected transmural dispersion of repolarization.

Heart rate (beats/min)

78 (72 - 90)

80 (73 - 90)

0.127

QT interval (ms)

370.8 ± 32.5

381.0 ± 29.3

0.001

QTc interval (ms)

424 (403 - 436)

442 (420 - 468)

< 0.001

Tp-e interval (ms)

60 (55 - 70)

65 (57 - 75)

< 0.001

cTp-e interval (ms)

72.2 ± 12.9

75.4 ± 12.7

< 0.001

Tp-e/QT ratio

0.17 ± 0.03

0.17 ± 0.02

0.03

Tp-e/QTc ratio

0.17 ± 0.03

0.228

**Table 4.** Increased Ventricular Arrhythmia Risk and Adverse Events in Study Population (N = 76)
	N	%	Mean ± SD
QTc: corrected QT; Tp-e: transmural dispersion of repolarization; cTp-e: corrected transmural dispersion of repolarization; SD: standard deviation.
5th day with QTc interval > 500 ms	4	5	516.3 ± 13.2
Increase in the QTc interval of > 60 ms	10	8	70.4 ± 12.4
Tp-e interval ≥ 110 ms	0	0	-
cTp-e interval ≥ 110 ms	0	0	-
Tp-e/QT ratio > 0.23	3	4	0.24 ± 0.07
Tp-e/QTc ratio > 0.23	0	0	-
Atrial arrhythmia	0	0	-
Torsades de pointes	0	0	-
Nonsustained ventricular tachycardia	0	0	-
Sustained ventricular tachycardia	0	0	-

Table 4. Increased Ventricular Arrhythmia Risk and Adverse Events in Study Population (N = 76)

Mean ± SD

QTc: corrected QT; Tp-e: transmural dispersion of repolarization; cTp-e: corrected transmural dispersion of repolarization; SD: standard deviation.

5th day with QTc interval > 500 ms

516.3 ± 13.2

Increase in the QTc interval of > 60 ms

70.4 ± 12.4

Tp-e interval ≥ 110 ms

cTp-e interval ≥ 110 ms

Tp-e/QT ratio > 0.23

0.24 ± 0.07

Tp-e/QTc ratio > 0.23

Atrial arrhythmia

Torsades de pointes

Nonsustained ventricular tachycardia

Sustained ventricular tachycardia

**Table 5.** Correlations Between the Fifth Day Electrocardiography and Clinical Parameters
	QTc interval	cTp-e interval	Tp-e/QTc ratio
*P < 0.05. WBC: white blood cell count; CRP: C-reactive protein.
Age, (years)	0.305	0.007*	-0.118	0.310	-0.003	0.978
WBC, 10³/µL	-0.003	0.977	-0.071	0.543	-0.080	0.493
Neutrophil, 10³/µL	0.013	0.914	-0.080	0.492	-0.094	0.418
Lymphocyte, 10³/µL	-0.062	0.594	-0.053	0.648	-0.038	0.745
Platelet, 10³/µL	0.180	0.190	-0.092	0.427	-0.162	0.162
Ferritin, ng/mL	0.045	0.701	0.150	0.196	0.146	0.209
D-dimer, µg/L	0.213	0.064	0.347	0.002*	0.339	0.003*
Troponin I, ng/mL	0.318	0.005*	0.106	0.441	-0.079	0.567
CRP, mg/L	0.016	0.891	0.001	0.991	0.002	0.985

Table 5. Correlations Between the Fifth Day Electrocardiography and Clinical Parameters

QTc interval

cTp-e interval

Tp-e/QTc ratio

*P < 0.05. WBC: white blood cell count; CRP: C-reactive protein.

Age, (years)

0.305

0.007*

-0.118

0.310

-0.003

0.978

WBC, 10³/µL

-0.003

0.977

-0.071

0.543

-0.080

0.493

Neutrophil, 10³/µL

0.013

0.914

-0.080

0.492

-0.094

0.418

Lymphocyte, 10³/µL

-0.062

0.594

-0.053

0.648

-0.038

0.745

Platelet, 10³/µL

0.180

0.190

-0.092

0.427

-0.162

0.162

Ferritin, ng/mL

0.045

0.701

0.150

0.196

0.146

0.209

D-dimer, µg/L

0.213

0.064

0.347

0.002*

0.339

0.003*

Troponin I, ng/mL

0.318

0.005*

0.106

0.441

-0.079

0.567

CRP, mg/L

0.016

0.891

0.001

0.991

0.002

0.985