Professor Émile Ferrari heads the cardiology department at the Pasteur hospital in Nice. He returned to the hydroxychloroquine-azithromycin association in the context of severe forms of Covid-19.
The CHU de Nice, like other establishments, is testing the hydroxychloroquine-azithromycin combination in patients hospitalized with severe forms of Covid-19. How are these patients followed from a cardiological point of view?
“We have implemented a 7/7 and H24 monitoring method; all the Covid sectors of the Nice University Hospital send us the patient’s ECG [electrocardiogram, ed] recordings. We interpret them live and report anomalies to them which predispose to toxicity. And which then require a cessation of treatment. “Has this ever happened?
“Yes, from the start of the trial. Thanks to this ECG follow-up, we highlighted the major risks of a very serious accident in a patient, and the treatment was immediately stopped.”How is this toxic risk on the heart explained?
“The cells of the heart have a spontaneous electrical activity, which makes it possible to generate the cardiac contraction. This activation happens a little like an alternating current with a phase of contraction and a phase of recovery. These phases are ordered and successive. or certain conditions can desynchronize these phases. It can then cause chaos, a big disorder in the electric current of the cells of the heart with a risk of “short circuit”; the heart rate is racing, it is disordered, which does not allows the heart muscle to be more efficient. The subsequent drop in blood flow then causes dizziness, malaise, syncope … up to cardiac arrest which are the translation of serious arrhythmias. “Hydroxychloroquine and azithromycin are widely prescribed despite these risks …
“When hydroxychloroquine is given alone, the cardiac risk is very low. On the other hand, the antibiotic (azithromycin) which is systematically prescribed in combination with hydroxychloroquine in the anti-Covid protocol also favors these abnormalities. Cardiological risk is then potentiated, a fortiori, if there are other associated drugs which have the same undesirable effect, if the oxygenation of the blood is not done well or if the potassium in the blood is low. if prescribed, must be prescribed with ECG monitoring at D0 and D2 minimum. “Your personal opinion on this cocktail?
“It is true that Covid-19 kills, but the remedy should not be more harmful than the disease itself in patients whose spontaneous evolution is favorable and in particular in ambulatory patients.”