Background: Azithromycin is the most common antibiotic used nowadays. Objectives: To 
evaluate the cardio-toxicity of azithromycin and to assess the effect of Nigella Sativa (N Sativa) 
and Rosuvastatin in cardio-protection. Patient & methods: This clinical prospective study was 
carried out on adult patients diagnosed as positive COVID-19 and was admitted to isolation 
centers in Minia Governorate during the period from 1st of June 2021 to 30th of May 2022. It 
included 160 patients divided into 4 groups. Group I received 500 mg/ 24 hours (hrs) of 
azithromycin orally for five days, group II received 500 mg/ 24hrs of azithromycin + 20 mg/ day 
of Rosuvastatin orally for five days, group III also received 500 mg/ 24hrs of azithromycin + 4 
ml/ kg/ 24hrs N Sativa orally for five days, group IV received the same previously mentioned 
doses and duration of azithromycin, Rosuvastatin and N Sativa. Full clinical examination was 
done, electrocardiogram (ECG) was performed and venous blood samples were drawn for
estimation of CK-MB level from all patients before and after the treatment. Result: Patients 
aged 32- 59 years old, 62 were females and 98 were males. Significant elevation of CK-MB in 
group I after treatment with azithromycin comparing with before treatment in the same group 
(p<0.01) was detected. There were significant differences in all groups between pre and posttreatment regards QT interval (p<0.01). Conclusion: Azithromycin had toxic effect on the heart, 
Rosuvastatin was better than N Sativa in treating this toxic effect. Treatment with Rosuvastatin + 
N Sativa together leads to the best results. Recommendation of this study is taking of 
Rosuvastatin plus N Sativa during the treatment with azithromycin. 
Received in original form: 20 October 2022 Accepted in a final form: 20 January 2023