Table 3.
Electrocardiographic and clinical outcomes of included studies
| Study first author | Electrocardiographic outcomes | Clinical outcomes |
|---|---|---|
| Non–COVID-19 participants | ||
| Haeusler17 | NR | No serious cardiac adverse events reported in chloroquine trials with 1702 patients. |
| Pfizer18 | CQ phosphate 1000 mg/d alone: Mean maximum day 3 QTc increase 18.4–35 ms relative to placebo. CQ phosphate 1000 mg/d plus azithromycin 500 mg/d: Increase of 5 ms (upper limit 90% confidence interval: 10 ms) beyond CQ alone. No ECG-related discontinuations reported. |
NR |
| WHO Evidence Review Group19 | NR | No sudden deaths reported in 23,773 courses of CQ for malaria treatment. |
| COVID-19 participants | ||
| Borba20 | QTc >500 ms developed in 7/28 in the high-dose arm and 3/28 in the low-dose CQ arm. | Ventricular arrhythmia developed in 2/28 in the high-dose CQ arm and 0/28 in the low-dose CQ arm. |
| Chen21 | NR | No serious adverse events reported in 15 patients. |
| Chen (preprint) | NR | No serious cardiac events reported in 31 patients. |
| Chorin22 | Increase in QTc from mean baseline of 435 ± 24 ms to mean maximum of 463 ± 32 ms. In 12%, QTc increased by >60 ms, and 11% developed QTc >500 ms. | No arrhythmias reported in 84 patients. |
| Gautret23 | NR | No serious adverse events reported in 80 patients. |
| Huang24 | NR | No adverse cardiac events reported in 10 patients. |
| Mahévas25 | QTc increase >60 ms occurred in 7/84 (1 with QTc >500 ms). | Of 84 patients treated with HCQ, first-degree atrioventricular block developed in 1 patient 2 days after starting HCQ. One patient also developed left bundle branch block on day 8, after being admitted to the ICU and receiving lopinavir-ritonavir. |
| Million (preprint) | NR | No adverse cardiac events reported in 1061 patients. |
| Molina26 | HCQ discontinued in 1/11 due to excessive QT prolongation on day 4 (from 405 to 460–470 ms). | NR |
| Perinel27 | QTc >500 ms occurred in 2/13 patients (from 381 to 510 ms; and from 432 to 550 ms) on days 2 and 3, leading to discontinuation of therapy. | NR |
| Tang28 | No QT prolongation observed in 70 patients. | No arrhythmias reported in 70 patients. |
CQ = chloroquine; ECG = electrocardiogram; HCQ = hydroxychloroquine; ICU = intensive care unit; NR = not reported; WHO = World Health Organization.