QT interval prolongation and its related factors before and after receiving lopinavir-ritonavir in the COVID-19 era: a historical cohort study.

A historical cohort study in southern Iran investigated the effect of lopinavir-ritonavir treatment, with or without azithromycin and/or hydroxychloroquine, on QT interval prolongation in 500 confirmed COVID-19 patients. The outcomes showed a notable increase in the mean corrected QT interval post-treatment, specifically from 415.75±46.848 ms to 437.91±50.455 ms. QTc prolongation was observed only in patients receiving lopinavir-ritonavir monotherapy who also presented with cardiovascular conditions, angina pectoris, or hypomagnesemia, whereas those receiving concomitant therapy with azithromycin or hydroxychloroquine did not exhibit this effect. Other than one-third of patients with comorbidities or additional QT-prolonging drugs, aside from hypertension and obesity, had clinically the same potential of QT prolongation, and only 10.6% of patients had the problem. The work stresses the significance of careful monitoring of cardiac health, especially for those patients who have electrolyte imbalances and cardiovascular diseases as underlying diseases when they use lopinavir-ritonavir with other QT-prolonging medications.