Hydroxychloroquine versus hydroxychloroquine-azithromycin combination therapy on QT interval prolongation of COVID-19 patients: A systematic review and meta-analysis

Research related to the treatment of COVID-19 put hydroxychloroquine (HCQ)-based as a treatment option. The effectiveness of HCQ can be increased if combined with azithromycin (AZM). However, HCQ can trigger arrhythmias in the form of QT interval prolongation. Combining AZM to HCQ might also amplify the risk of QT prolongation. Since the mechanism remains elusive, a systematic review study of existing research is absolutely necessary. This study aimed to compare the incidence of QT interval prolongation in COVID-19 patients who received HCQ therapy with those who received HCQ-AZM therapy. The design used is comparative study of two independent groups. Data were collected from journals published online, from January to July 2020, regarding the comparison of QT interval prolongation between COVID-19 patients treated with HCQ only and those treated with HCQ-AZM combination, which had undergone a systematic review. Five studies that met the criteria were obtained, which included a total sample of 477 people in France and the United States. The data were then analysed descriptively and statistically. Statistical analysis was done using the fixed-effects model from the pooling of the research. It was found that there is no significant difference statistically in the QT interval prolongation between HCQ therapy group and HCQ-AZM therapy group (OR 1.294; 95% CI 0.707-2.370).