Prolongation of QT interval due to hydroxychloroquine overdose used in COVID-19 treatment

Gökhan Aksel1, Mehmet Muzaffer Islam1, Tuncay Aslan1

  • 1Department of Emergency Medicine, University of Health Sciences, Umraniye Training and Research Hospital, Istanbul, Turkey.

Insights

A young patient experienced QT interval prolongation and bradycardia after accidentally taking 1,600 mg of hydroxychloroquine for COVID-19 treatment. This case highlights the cardiac risks associated with hydroxychloroquine, even at lower doses.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Pharmacology

Background:

  • Hydroxychloroquine was widely used for COVID-19 treatment.
  • Cardiac side effects, including QT interval prolongation, are known risks.
  • Patient education and monitoring are crucial for medications with potential cardiac effects.

Observation:

  • A 28-year-old male presented with nausea, diarrhea, and weakness after a hydroxychloroquine overdose (1,600 mg).
  • Electrocardiography revealed sinus bradycardia and a prolonged corrected QT interval (510 ms).
  • The patient was hospitalized and discharged after his QT interval normalized (420 ms) and bradycardia resolved.

Findings:

  • This is the first reported case of QT interval prolongation at a relatively low hydroxychloroquine dose of 1,600 mg.
  • Accidental overdose of hydroxychloroquine can lead to significant cardiac adverse events.
  • Early detection and management of cardiac side effects are essential.

Implications:

  • Healthcare providers must educate patients on hydroxychloroquine dosage and potential side effects.
  • Serial ECG monitoring is recommended for hospitalized patients on hydroxychloroquine.
  • Further research into the cardiac safety profile of hydroxychloroquine at various doses is warranted.

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