Electrocardiographic safety of daily Hydroxychloroquine 400mg plus Azithromycin 250mg as an ambulatory treatment for COVID-19 patients in Cameroon.

Mfeukeu Kuate, L.; Ngatchou, W.; Temgoua, M. N.; Kouanfack, C.; Lemogoum, D.; Noutakdie Tochie, J.; Zemsi, A.; Fomete, L.; Lekelem, S.; Zemsi, S.; Tambekou Sobngwi, J.; Ntandzi, T.; Ngongang Ouankou, C.; Wasnyo, Y.; Ntsama Assiga, A.; Nkeck, J. R.; Musa Jingi, A.; Guewo, M.; Pefura Yone, E. W.; Omgba Moussi, C.; Owono Etoundi, P.; Yombi, J. C.; Menanga, A. P.; Kingue, S.; Ze Minkande, J.; Mbanya, J. C.; Ongolo Zogo, P. C.; Fouda, P. J.; Sobngwi, E.

Objective : To determine the early electrocardiographic changes in a cohort of ambulatory cameroonian COVID-19 patients treated with hydroxychloroquine 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 200mg 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 modifications 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.