Electrocardiographic Safety of Daily Hydroxychloroquine 400mg Plus Azithromycin 250mg as an Ambulatory Treatment for COVID-19 Patients in Cameroon

Objective: To determine the early electrocardiographic changes in a cohort of ambulatory cameroonian COVID-19 patients treated with hydroxychloroquine plus 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 6 days. Main Outcomes Measures: The primary end-point was the change in QTc interval between the day 0 (D0), the day 3 (D3) and the day 7 (D7). Secondary end-points were modifications of all other cardiac electrical conductivity patterns and the occurrence of clinical arrhythmic events during the treatment course. Results: The mean age of the population was 39 ± 11 years (ranged between 17 to 61 years). The male gender was predominant (n=29 ; 56.86%). The mean Tisdale score was 3.35±0.48. The modification of QTc was not statistically significant between the D0 and the D7 (429±27 ms versus 396±26 ms ; p value= 0.27). There were statistical electrocardiographic changes in mean heart rate and QRS duration between the D0 and the D7. A reduction of heart rate was observed between the D0 and D7, 75±13 bpm versus 70±13 bpm (p value= 0.02). There were also a statistically significant increased of the QRS duration between D0 to D7 ; 95±10 ms versus 102±17 (p value= 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 in Cameroon. More studies are needed particularly in critical-ill and older patients. Funding Statement: None. Declaration of Interests: The authors declare no conflicts of interest. Ethics Approval Statement: The study was approved by the National Committee on Research Ethics for Human Health in cameroon before the conduct of the study (N°2020/05/1505/L/CNERSH/SP).