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Torsades-de-pointes following off label treatment: case report In a retrospective cohort study of 91 patients, a male patient [exact age not stated] was described, who developed torsades de pointes (TdP) during off-label treatment with azithromycin and hydroxychloroquine for coronavirus disease 2019 (COVID-19). The male patient, who was hospitalised due to COVID-19 infection, started receiving off label treatment with oral hydroxychloroquine 400mg twice daily for 1 day, followed by 200mg twice daily for 4 days and oral azithromycin 500mg followed by 250mg daily for the next 4 days. He had stable QTc for the first 7 days of hospitalisation. However, in the setting of worsening glomerular filtration rate and acute renal failure on day 8, the QTc increased to 591ms on day 9. This finding was consistent with TdP associated with the use of azithromycin and hydroxychloroquine [time to reaction onset not clearly stated]. Despite the discontinuation of hydroxychloroquine and azithromycin, the male patient developed TdP. Thereafter, he was successfully treated with magnesium and lidocaine. Hummel JP, et al. Temporal Trends in Arrhythmogenicity Related to Treatment of COVID-19 Infection. Circulation: Arrhythmia and Electrophysiology 13: 1220-1222, No. 803517470 10, Oct 2020. Available from: URL: http://doi.org/10.1161/CIRCEP.120.008841

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Editorial comment: Details of this case report have previously been published and processed for Adis PV [see Reactions 1819 p61; 803498714] (The patient with classic Torsades-de-pointes).

0114-9954/20/1832-0001/$14.95 Adis © 2020 Springer Nature Switzerland AG. All rights reserved

Reactions 28 Nov 2020 No. 1832