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
{"title":"COVID-19刚果患者的羟氯喹-阿奇霉素、双酶C和QTc延长：神话还是现实？","authors":"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","doi":"10.5501/wjv.v13.i2.90668","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Aim: </strong>To determine the incidence of QTc prolongation and Tsd in COVID-19 patients treated with HCQ-AZIs <i>vs</i> doubase C (new molecule).</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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 (<i>P</i> < 0.05). None of the patients developed Tsd.</p><p><strong>Conclusion: </strong>QTc prolongation without Tsd was observed at a lower frequency in patients treated with HCQ-AZI <i>vs</i> doubase C. The absence of comorbidities and concurrent use of other products that are likely to cause arrhythmia may explain our results.</p>","PeriodicalId":61903,"journal":{"name":"世界病毒学杂志(英文版)","volume":"13 2","pages":"90668"},"PeriodicalIF":0.0000,"publicationDate":"2024-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11229849/pdf/","citationCount":"0","resultStr":"{\"title\":\"Hydroxychloroquine-azithromycin, doubase C, and QTc prolongation in congolese patients with COVID-19: Myth or reality?\",\"authors\":\"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\",\"doi\":\"10.5501/wjv.v13.i2.90668\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>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.</p><p><strong>Aim: </strong>To determine the incidence of QTc prolongation and Tsd in COVID-19 patients treated with HCQ-AZIs <i>vs</i> doubase C (new molecule).</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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 (<i>P</i> < 0.05). None of the patients developed Tsd.</p><p><strong>Conclusion: </strong>QTc prolongation without Tsd was observed at a lower frequency in patients treated with HCQ-AZI <i>vs</i> doubase C. The absence of comorbidities and concurrent use of other products that are likely to cause arrhythmia may explain our results.</p>\",\"PeriodicalId\":61903,\"journal\":{\"name\":\"世界病毒学杂志(英文版)\",\"volume\":\"13 2\",\"pages\":\"90668\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2024-06-25\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11229849/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"世界病毒学杂志(英文版)\",\"FirstCategoryId\":\"1089\",\"ListUrlMain\":\"https://doi.org/10.5501/wjv.v13.i2.90668\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"世界病毒学杂志(英文版)","FirstCategoryId":"1089","ListUrlMain":"https://doi.org/10.5501/wjv.v13.i2.90668","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
Hydroxychloroquine-azithromycin, doubase C, and QTc prolongation in congolese patients with COVID-19: Myth or reality?
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.
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