Use of drugs associated with QT interval prolongation at the hospital level during the start of the COVID-19 pandemic in Colombia v1

Introduction: Many of the therapeutic proposals for COVID-19 have been associated with adverse effects, including the risk of QT interval prolongation and torsades de pointes (TdP). Objective: To determine the use of drugs with a risk of QT interval prolongation in 21 clinics/hospitals in Colombia from January to March 2020. Methods: This observational study identified drug use according to pharmacological groups with potential risk of QT interval prolongation according to a risk classification: conditional , possible and known risk of TdP. Descriptive analyses were performed. Results: A total of 106,127 patients who received QT-prolonging drugs were identified (equivalent to 46.0% of all inpatients treated during the study period). Of the group of patients on QT drugs, 50.1% used at least one drug with conditional risk, 52.7% with possible risk and 38.4% with known risk. The most commonly used belonged to the group of drugs for the nervous system (63.9%), alimentary tract and metabolism (52.3%), antiinfectives for systemic use (11.3%) and the cardiovascular system (10.7%). On average, patients received 1.8 ± 1.3 risk drugs. Regarding potentially useful drugs against COVID-19, 319 patients (0.3%) received azithromycin, 243 (0.2%) received chloroquine, 65 received lopinavir/ritonavir (0.1%) and 54 received hydroxychloroquine (0.1%). Conclusion: The high proportion of patients treated at the hospital level who receive drugs with risk of prolonging the QT interval should alert those responsible for their care to avoid fatal outcomes, especially during the COVID-19 epidemic, when some QT drugs are being used more frequently.