Hydroxychloroquine pre-exposure prophylaxis to prevent SARS-CoV-2 among health care workers at risk for SARS-CoV-2 exposure: A nonrandomized controlled trial
MD Vanessa N Raabe, MD Andrew Fleming, Ph. D Marie I Samanovic, MD Lilin Lai, Ph. D Hayley M Belli, MD Mark J Mulligan, H Michael Belmont
doi:10.1101/2022.07.01.22277058
Background: Aerosol-generating procedures increase the risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection among health care workers (HCWs). An effective pre-exposure prophylaxis would mitigate this risk. Objective: To determine the efficacy of pre-exposure prophylactic hydroxychloroquine for the prevention of SARS-CoV-2 infection and symptomatic coronavirus 19 disease (COVID-19) among HCWs at high occupational risk of SARS-CoV-2 exposure. Methods: 130 HCWs in the New York University Langone Health System (NYULHS) who performed aerosol-generating procedures on patients with COVID-19 or provided bedside care for inpatients with COVID-19 or persons with suspected COVID-19 in an emergency department, for at least three shifts in a 7-day period, during the first 2020 COVID-19 wave in New York City were enrolled. Participants elected to take oral hydroxychloroquine, 600 mg on day 1 followed by 200 mg daily, or not take hydroxychloroquine for up to 90 days. Participants self-collected dried blood spots and completed digital questionnaires regarding COVID-19 symptoms, adverse events, and other COVID-19 medication use. Results: Six participants (7.5%) seroconverted during the trial: four who took hydroxychloroquine (6.8%) and two who declined hydroxychloroquine (9.5%). All participants not taking hydroxychloroquine reported COVID-19 symptoms at seroconversion compared to one of four participants (25%) who took hydroxychloroquine. Adverse events occurred in eight participants (9.6%) on hydroxychloroquine and were mostly mild. .
Conflicts of Interest
Data Sharing Statement Individual level data from participants will not be shared to protect the privacy of the participating health care workers. .
Serious Adverse Events 0 (0) (0) Grade II 0 (0) (0) Grade II 0 (0) (0) Grade II 0 (0) (0) Grade III 0 (0) (0) Serious Adverse Events 0 (0) (0) 440 441 .
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'abstract': '<jats:p>Background: Aerosol-generating procedures increase the risk of severe acute '
'respiratory syndrome coronavirus 2 (SARS-CoV-2) infection among health care workers (HCWs). '
'An effective pre-exposure prophylaxis would mitigate this risk. \n'
'\n'
'Objective: To determine the efficacy of pre-exposure prophylactic hydroxychloroquine for the '
'prevention of SARS-CoV-2 infection and symptomatic coronavirus 19 disease (COVID-19) among '
'HCWs at high occupational risk of SARS-CoV-2 exposure.\n'
'\n'
'Methods: 130 HCWs in the New York University Langone Health System (NYULHS) who performed '
'aerosol-generating procedures on patients with COVID-19 or provided bedside care for '
'inpatients with COVID-19 or persons with suspected COVID-19 in an emergency department, for '
'at least three shifts in a 7-day period, during the first 2020 COVID-19 wave in New York City '
'were enrolled. Participants elected to take oral hydroxychloroquine, 600 mg on day 1 followed '
'by 200 mg daily, or not take hydroxychloroquine for up to 90 days. Participants '
'self-collected dried blood spots and completed digital questionnaires regarding COVID-19 '
'symptoms, adverse events, and other COVID-19 medication use. \n'
'\n'
'Results: Six participants (7.5%) seroconverted during the trial: four who took '
'hydroxychloroquine (6.8%) and two who declined hydroxychloroquine (9.5%). All participants '
'not taking hydroxychloroquine reported COVID-19 symptoms at seroconversion compared to one of '
'four participants (25%) who took hydroxychloroquine. Adverse events occurred in eight '
'participants (9.6%) on hydroxychloroquine and were mostly mild. \n'
'\n'
'Conclusions: This study (ClinicalTrials.gov <jats:ext-link '
'xmlns:xlink="http://www.w3.org/1999/xlink" ext-link-type="clintrialgov" '
'xlink:href="NCT04354870">NCT04354870</jats:ext-link>) did not demonstrate a statistically '
'significant difference in SARS-CoV-2 seroconversion associated with hydroxychloroquine '
'pre-exposure prophylaxis among HCWs at high risk of occupational SARS-CoV-2 exposure, '
'although was underpowered and a high rate of hydroxychloroquine discontinuation was '
'observed.</jats:p>',
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