TITLE:
Electrocardiographic Safety of Daily Hydroxychloroquine 400 mg Plus Azithromycin 250 mg as an Ambulatory Treatment for COVID-19 Patients in Cameroon
AUTHORS:
Liliane Mfeukeu-Kuate, William Djomo Ngatchou, Mazou Ngou Temgoua, Charles Kouanfack, Daniel Lemoungoum, Joel Noutakdie Tochie, Armel Zemsi, Lauriane Fomete, Skinner Lekelem, Sylvain Zemsi, Joelle Sobngwi, Thierry Ntandzi, Christian Ngongang Ouankou, Yves Wasnyo, Antoinette Tsama Assiga, Jan René Nkeck, Ahmadou Musa Jingi, Magellan Guewo, Eric Walter Pefura Yone, Charlotte Moussi Omgba, Paul Owono Etoundi, Jean Cyr Yombi, Samuel Kingue, Alain Menanga, Jacqueline Ze Minkande, Pierre Ongolo Zogo, Jean Claude Mbanya, Pierre Joseph Fouda, Eugène Sobngwi
KEYWORDS:
Early Electrocardiographic Changes, COVID-19, Hydroxychloroquine, Azithromycin, Cameroon
JOURNAL NAME:
World Journal of Cardiovascular Diseases,
Vol.11 No.2,
February
19,
2021
ABSTRACT: Objective: To determine the early electrocardiographic changes in a cohort of ambulatory cameroonian COVID-19 patients treated with hydroxychlo- roquine and Azithromycin. Design: Prospective study. Setting: Treatment centres of the city of Yaounde, Cameroon, from May 7th to 24th 2020. Participants: We enrolled 51 consecutive confirmed COVID-19 on RT-PCR who having mild forms of COVID-19 and treated by hydroxychloroquine 200 mg twice daily during seven #days plus Azithromycin 500 mg the first day and 250 mg the remaining 4 days as per national standard. Main Outcomes Measures: The primary end-point was the change in QTc interval between day 0 (D0), day 3 (D3) and day 7 (D7). Secondary endpoints were changes in all other cardiac electrical conductivity patterns and the occurrence of clinical arrhythmic events during the course of treatment. Results: The population (29 men and 22 women) was aged 39 ± 11 years (range 17 to 61 years). Mean Tisdale score was 3.35 ± 0.48. No significant change from baseline (D0) of QTc was observed at D7 (429 ± 27 ms at D0 versus 396 ± 26 ms at D7; p = 0.27). A reduction of heart rate was observed between the D0 and D7 (75 ± 13 bpm versus 70 ± 13 bpm, p = 0.02) with increased QRS duration between D0 and D7 (95 ± 10 ms versus 102 ± 17 ms, p = 0.004). No symptomatic arrhythmic events occurred during the treatment course. Conclusions: No life-threatening modification of the QT interval was observed in non-severe COVID-19 patients treated ambulatory with hydroxychloroquine and azithromycin. Studies are needed in critical-ill and older patients.