Hydroxychloroquine-azithromycin,doubase C,and QTc prolongation in congolese patients with COVID-19:Myth or reality?  

作　　者：Brady Madioko Makanzu Jean-Robert Makulo Madone Ndona Mandina Dimosi Roger Wumba Murielle Mashi Longokolo Hippolyte Situakibanza Ossam Odio Donat Sonzi Mangala Constantin Mihigo Bashengezi Benjamin Kabwe Mwilambwe Gilbert Kabanda Kurhenga Benjamin Longo-Mbenza Roger Mwimba Mbungu 

机构地区：[1]Department of Cardiology,Kinshasa University Hospital,Kinshasa,DR Congo,Kinshasa University Hospital,Kinshasa 11,Congo [2]Nephrology Unit,Kinshasa University Hospital,Kinshasa,Democratic Republic of the Congo,Kinshasa 11,Kinshasa,Congo [3]Department of Infectious Diseases,Kinshasa University Hospital,Kinshasa,DR Congo,Kinshasa 11,Congo [4]Department of Tropical Medicine,University of Kinshasa,Kinshasa 11,Congo [5]Department of Infectious Diseases,University of Kinshasa Hospital,Kinshasa 11,Congo [6]Department of Tropical Medicine and Infectious Disease,School of Medicine,University of Kinshasa,Kinshasa 11,Congo [7]COVID-19 Treatment Center,Kinshasa University Hospital,Kinshasa,Kinshasa 11,Congo [8]Centre de Recherche en Phytothérapie,Pharmacopée Africaine et Technologie pharmaceutique,Kinshasa 11,Congo [9]Intensive Care Unit,Kinshasa University Hospital,Kinshasa 11,Congo [10]Department of Gynecology and Obstetrics,Kinshasa University Hospital,Kinshasa 11,Congo

出　　处：《World Journal of Virology》2024年第2期107-114,共8页世界病毒学杂志

摘　　要：BACKGROUND QTc interval prolongation with an increased risk of torsade de pointes(Tsd)has been described in coronavirus disease 2019(COVID-19)patients treated with hydroxychloroquine(HCQ)and azithromycin(AZI)in Western countries.In the DR Congo,few studies have evaluated the safety of this association or proposed new molecules.AIM To determine the incidence of QTc prolongation and Tsd in COVID-19 patients treated with HCQ-AZIs vs doubase C(new molecule).METHODS In present randomized clinical trial,we have included patients with mild or moderate COVID-19 treated with either HCQ-AZI or doubase C.Electrocardiogram(ECG)changes on day 14 of randomization were determined based on pretreatment tracing.Prolonged QTc was defined as≥500 ms on day 14 or an increase of≥80 ms compared to pretreatment tracing.Patients with cardiac disease,those undergoing other treatments likely to prolong QTc,and those with disturbed ECG tracings were excluded from the study.RESULTS The study included 258 patients(mean age 41±15 years;52%men;3.4%diabetics,11.1%hypertensive).Mild and moderate COVID-19 were found in 93.5%and 6.5%of patients,respectively.At baseline,all patients had normal sinus rhythm,a mean heart rate 78±13/min,mean PR space 170±28 ms,mean QRS 76±13 ms,and mean QTc 405±30 ms.No complaints suggesting cardiac involvement were reported during or after treatment.Only four patients(1.5%)experienced QTc interval prolongation beyond 500 ms.Similarly,only five patients(1.9%)had an increase in the QTc interval of more than 80 ms.QTc prolongation was more significant in younger patients,those with high viral load at baseline,and those receiving HCQ-AZI(P<0.05).None of the patients developed Tsd.CONCLUSION QTc prolongation without Tsd was observed at a lower frequency in patients treated with HCQ-AZI vs doubase C.The absence of comorbidities and concurrent use of other products that are likely to cause arrhythmia may explain our results.

关 键 词：QTc prolongation COVID-19 Doubase C HCQ-AZT Sub-Saharan Africa 

分 类 号：R563.1[医药卫生—呼吸系统]