{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,21]],"date-time":"2026-04-21T01:50:58Z","timestamp":1776736258803,"version":"3.51.2"},"reference-count":0,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2022,1,31]],"date-time":"2022-01-31T00:00:00Z","timestamp":1643587200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Advances in Respiratory Medicine"],"abstract":"<jats:p>Introduction: To explore the incidence of pro-arrhythmic effects such as corrected QT interval (QTc) prolongation, arrhythmic events and myocardial injury of azithromycin as administered for the treatment of COVID-19. Material and Methods: We searched PubMed, the Cochrane Library and Web of Science databases from inception to 18 January 2021, as well as the medR\u03c7iv preprint database from 1 August 2020 to 18 January 2021, for studies exploring the cardiotoxicity effects of azithromycin, with or without concomitant use of hydroxychloroquine, in the context of COVID-19. We performed a random effects single-arm meta-analysis of studies to calculate pooled proportion estimates for pro-arrhythmic effects. Meta-regression analyses were conducted to explain between-study heterogeneity. Results: Thirty-four studies with a total of 3088 patients were included. Among 12 studies, the incidence of &gt;60 ms QTc prolongation from baseline was 13% (95% CI 9%\u201318%, I\u00b2 = 73%), whereas, among 28 studies, the incidence of QTc \u2265 500 ms at follow-up was 8% (95% CI 6%\u201311%, I\u00b2 = 78%). Still, the discontinuation rate due to QTc prolongation was only 3% (95% CI 2%\u20135%, I\u00b2 = 55%). The absolute risk of Torsade de pointes and ventricular tachycardia was 0.2% and 0.8%, respectively. Increased age, male sex, presence of hypertension or diabetes mellitus, use of QTc prolonging medication, prolonged baseline QTc interval and indicators of disease severity such as death explained between-study heterogeneity. Conclusions: Azithromycin, with or without hydroxychloroquine, leads to a significant risk for critical QTc prolongation in patients with COVID-19. Due to its cardiotoxicity effects and its unproven efficacy in Covid19, azithromycin use should be limited to cases of bacterial co-infection.<\/jats:p>","DOI":"10.5603\/arm.a2022.0022","type":"journal-article","created":{"date-parts":[[2022,5,10]],"date-time":"2022-05-10T11:11:09Z","timestamp":1652181069000},"page":"171-182","source":"Crossref","is-referenced-by-count":5,"title":["Cardiotoxicity of Azithromycin in COVID-19: An Overall Proportion Meta-Analysis"],"prefix":"10.3390","volume":"90","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0586-6386","authenticated-orcid":false,"given":"Ioannis","family":"Farmakis","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9499-5138","authenticated-orcid":false,"given":"Ioanna","family":"Minopoulou","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7491-6319","authenticated-orcid":false,"given":"George","family":"Giannakoulas","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7366-2038","authenticated-orcid":false,"given":"Afroditi","family":"Boutou","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,1,31]]},"container-title":["Advances in Respiratory Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2543-6031\/90\/3\/24\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,11,29]],"date-time":"2022-11-29T12:07:26Z","timestamp":1669723646000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2543-6031\/90\/3\/24"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,1,31]]},"references-count":0,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2022,6]]}},"alternative-id":["ARM.a2022.0022"],"URL":"https:\/\/doi.org\/10.5603\/arm.a2022.0022","relation":{},"ISSN":["2543-6031"],"issn-type":[{"value":"2543-6031","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,1,31]]}}}