No difference in biomarkers of ischemic heart injury and heart failure in patients with COVID-19 who received treatment with chloroquine phosphate and those who did not

• Published in: PloS one Vol. 16; no. 8; p. e0256035
• Main Authors: Beck-Friis, Josefine, Leach, Susannah, Omerovic, Elmir, Zeijlon, Rickard, Gisslen, Magnus, Yilmaz, Aylin
• Format: Journal Article
• Language: English
• Published: San Francisco Public Library of Science 16.08.2021; Public Library of Science (PLoS)
• Subjects: Adverse events; Biology and Life Sciences; Biomarkers; C-reactive protein; Calcium-binding protein; Cardiac arrhythmia; Cardiology and Cardiovascular Disease; Chloroquine; Clinical trials; Complications and side effects; Congestive heart failure; Coronaviruses; COVID-19; Creatinine; Cytokines; Data collection; Demographics; Demography; Dosage and administration; Drugs; Electrocardiography; Health risks; Heart diseases; Heart failure; Hospitals; Infectious diseases; Injuries; Ischemia; Kardiologi och kardiovaskulära sjukdomar; Laboratories; Medical records; Medicine and Health Sciences; Mortality; Myocardial ischemia; Oxygen therapy; Pandemics; Patients; Physical Sciences; Platelets; Pneumonia; Research and Analysis Methods; Risk; Risk factors; Severe acute respiratory syndrome coronavirus 2; Statistical analysis; Supervision; Thrombocytes; Troponin; Troponin T; Sweden
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0256035

Background Chloroquine was promoted as a COVID-19 therapeutic early in the pandemic. Most countries have since discontinued the use of chloroquine due to lack of evidence of any benefit and the risk of severe adverse events. The primary aim of this study was to examine if administering chloroquine during COVID-19 imposed an increased risk of ischemic heart injury or heart failure. Methods Medical records, laboratory findings, and electrocardiograms of patients with COVID-19 who were treated with 500 mg chloroquine phosphate daily and controls not treated with chloroquine were reviewed retrospectively. Controls were matched in age and severity of disease. Results We included 20 patients receiving chloroquine (500 mg twice daily) for an average of five days, and 40 controls. The groups were comparable regarding demographics and biochemical analyses including C-reactive protein, thrombocytes, and creatinine. There were no statistically significant differences in cardiac biomarkers or in electrocardiograms. Median troponin T was 10,8 ng/L in the study group and 17.9 ng/L in the control group, whereas median NT-proBNP was 399 ng/L in patients receiving chloroquine and 349 ng/L in the controls. Conclusions We found no increased risk of ischemic heart injury or heart failure as a result of administering chloroquine. However, the use of chloroquine to treat COVID-19 outside of clinical trials is not recommended, considering the lack of evidence of its effectiveness, as well as the elevated risk of fatal arrythmias.