Journal-based CME Course: COVID-19 Infection and Corrected QT Interval Prolongation Collateral Damage From Our Newest Enemy

Activity ID

8493

Expires

May 10, 2024

Format Type

Journal-based

CME Credit

1

Fee

$30

CME Provider: JAMA Network Open

Description of CME Course

Unimagined a few short months ago, SARS-CoV-2 has spread rapidly across the globe to cause a worldwide pandemic, unparalleled since the 1918 H1N1 influenza pandemic. Deaths in the United States due to COVID-19 surpassed 500?000 in February 2021. The extraordinary efficiency in person-to-person transmission and the relatively high level of morbidity and mortality represent the perfect storm of an emerging infectious disease. New York City was among the original US epicenters of the COVID-19 pandemic. Thus, it is fitting that the article by Rubin et al featured elsewhere in JAMA Network Open originates from this epicenter. Uniquely and because of early contact with this virus, the authors were able to compare a population of hospitalized adult patients who tested positive for COVID-19 with those who ultimately tested negative. This is a large and important study that assessed the association of COVID-19 infection with the QT interval. Importantly, Rubin et al found that a COVID-19 infection was independently associated with a significant increase in the QTc, with a greater likelihood of a QTc greater than 500 milliseconds among patients with COVID-19 than among their counterparts, who were ill but ultimately tested negative for COVID-19. The authors are uniquely suited based on location and infection timing to report these important data. Because the data reflect the early days of the pandemic, hydroxychloroquine and azithromycin were still being used. However, these data provide information about the association of the virus with the QT interval even in the absence of these medications as well as in a small cohort of patients empirically treated with hydroxychloroquine and azithromycin who ultimately tested negative for COVID-19. Interestingly, there was 1 patient with COVID-19 who developed torsade de pointes. She had multiple additional risk factors for QTc prolongation: nonischemic cardiomyopathy and QTc prolongation at baseline, QTc greater than 500 milliseconds on presentation, hypomagnesemia, administration of azithromycin, and elevated inflammatory markers and troponin levels, indicating systemic inflammation and myocardial injury.

Disclaimers

1. This activity is accredited by the American Medical Association.
2. This activity is free to AMA members.

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