Hydroxychloroquine pre-exposure prophylaxis to prevent SARS-CoV-2 among health care workers at risk for SARS-CoV-2 exposure: A nonrandomized controlled trial
Small prophylaxis study with 130 healthcare workers in the USA, showing lower symptomatic cases with HCQ prophylaxis, without statistical significance. HCQ participants were significantly older. The only symptomatic HCQ patient reported headache only as a potential COVID-19 symptom.
risk of symptomatic case, 82.2% lower, RR 0.18, p = 0.17, treatment 1 of 59 (1.7%), control 2 of 21 (9.5%), NNT 13.
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risk of symptomatic case, 88.4% lower, RR 0.12, p = 0.07, treatment 0 of 59 (0.0%), control 2 of 21 (9.5%), NNT 10, relative risk is not 0 because of continuity correction due to zero events (with reciprocal of the contrasting arm), fever.
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risk of case, 28.8% lower, RR 0.71, p = 0.65, treatment 4 of 59 (6.8%), control 2 of 21 (9.5%), NNT 36, seroconversion.
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Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
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Contact:
vanessa.raabe@nyulangone.org.
Abstract: medRxiv preprint doi: https://doi.org/10.1101/2022.07.01.22277058; this version posted July 3, 2022. The copyright holder for this preprint
(which was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity.
It is made available under a CC-BY-NC-ND 4.0 International license .
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Title: Hydroxychloroquine pre-exposure prophylaxis to prevent SARS-CoV-2 among
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health care workers at risk for SARS-CoV-2 exposure: A nonrandomized controlled trial
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Running Title: Hydroxychloroquine pre-exposure prophylaxis for SARS-CoV-2
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Authors: Vanessa N. Raabe, MD1; Andrew Fleming, MD1,2; Marie I. Samanovic, Ph. D1; Lilin
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Lai, MD1,3; Hayley M. Belli, Ph. D4; Mark J. Mulligan, MD1; H. Michael Belmont, MD5
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Affiliations:
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Division of Infectious Diseases & Immunology and NYU Langone Vaccine Center, Department
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of Medicine, New York University Grossman School of Medicine
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New York University Long Island School of Medicine
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Current affiliation: Emory Vaccine Center, Emory University School of Medicine
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Division of Biostatistics, Department of Population Health, New York University Grossman
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School of Medicine
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School of Medicine
Current affiliation: Division of Infectious Diseases & Immunology, Department of Medicine,
Department of Rheumatology, Department of Medicine, New York University Grossman
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Corresponding Author: Vanessa Raabe, 430 E 29th St., Alexandria Center for Life Sciences West
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Tower, 3rd Floor, New York, NY 10016. Vanessa.Raabe@nyulangone.org
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World Count: Abstract – 274; Text - 3041
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NOTE: This preprint reports new research that has not been certified by peer review and should not be used to guide clinical practice.
medRxiv preprint doi: https://doi.org/10.1101/2022.07.01.22277058; this version posted July 3, 2022. The copyright holder for this preprint
(which was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity.
It is made available under a CC-BY-NC-ND 4.0 International license .
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Abstract:
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Background: Aerosol-generating procedures increase the risk of severe acute respiratory
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syndrome coronavirus 2 (SARS-CoV-2) infection among health care workers (HCWs). An
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effective pre-exposure prophylaxis would mitigate this risk.
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Objective: To determine the efficacy of pre-exposure prophylactic hydroxychloroquine for the
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prevention of SARS-CoV-2 infection and symptomatic coronavirus 19 disease (COVID-19)
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among HCWs at high occupational risk of SARS-CoV-2 exposure.
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Methods: 130 HCWs in the New York University Langone Health System (NYULHS) who
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performed aerosol-generating procedures on patients with COVID-19 or provided bedside care
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for inpatients with COVID-19 or persons with suspected COVID-19 in an emergency
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department, for at least three shifts in a 7-day period, during the first 2020 COVID-19 wave in
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New York City were enrolled. Participants elected to take oral hydroxychloroquine, 600 mg on
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day 1 followed by 200 mg daily, or not take hydroxychloroquine for up to 90 days. Participants
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self-collected dried blood spots and completed digital questionnaires regarding COVID-19
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symptoms, adverse events, and other COVID-19 medication use.
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Results: Six participants (7.5%) seroconverted during the trial: four who took
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hydroxychloroquine..
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