Abstract: Expert Review of Anti-infective Therapy ISSN: (Print) (Online) Journal homepage: https://www.tandfonline.com/loi/ierz20 Hydroxychloroquine as pre-exposure prophylaxis against COVID-19 infection among healthcare workers: a prospective cohort study Akshay Rao, Sundar Kumar Veluswamy, Banashankari Gunjiganur Shankarappa, Rithika Manjunatha Reddy, Nethravathi Umesh, Lissy John, Lysamma Mathew & Naresh Shetty To cite this article: Akshay Rao, Sundar Kumar Veluswamy, Banashankari Gunjiganur Shankarappa, Rithika Manjunatha Reddy, Nethravathi Umesh, Lissy John, Lysamma Mathew & Naresh Shetty (2021): Hydroxychloroquine as pre-exposure prophylaxis against COVID-19 infection among healthcare workers: a prospective cohort study, Expert Review of Anti-infective Therapy, DOI: 10.1080/14787210.2022.2015326 To link to this article: https://doi.org/10.1080/14787210.2022.2015326 Published online: 20 Dec 2021. Submit your article to this journal Article views: 13 View related articles View Crossmark data Full Terms & Conditions of access and use can be found at https://www.tandfonline.com/action/journalInformation?journalCode=ierz20 EXPERT REVIEW OF ANTI-INFECTIVE THERAPY https://doi.org/10.1080/14787210.2022.2015326 ORIGINAL RESEARCH Hydroxychloroquine as pre-exposure prophylaxis against COVID-19 infection among healthcare workers: a prospective cohort study Akshay Rao a, Sundar Kumar Veluswamy b,c, Banashankari Gunjiganur Shankarappad, Rithika Manjunatha Reddye, Nethravathi Umeshf, Lissy Johnf, Lysamma Mathewg and Naresh Shettyh a Department of Internal Medicine, MS Ramaiah Medical College, Bengaluru, India; bDepartment of Physiotherapy, MS Ramaiah Medical College; Healthy Living for Pandemic Event Protection (Hl- Pivot) Network, Chicago, Illinois, USA; dDepartment of Microbiology, MS Ramaiah Medical College; eMedical student, MS Ramaiah Medical College Bengaluru, India; fOffice of Nursing Superintendent, MS Ramaiah Medical College Hospital Bengaluru, India; gOffice of Nursing Superintendent, MS Ramaiah Memorial Hospital, Bengaluru, India; hCaring for the Caregivers Surveillance System, MS Ramaiah Medical College Hospitals c ABSTRACT ARTICLE HISTORY Background: Hydroxychloroquine had attracted significant attention in the initial phases of the COVID19 pandemic but current recommendations do not support its use. However, the evidence against its use as pre-exposure prophylaxis have been of low to moderate quality and have been limited by high risk of bias. Methods: Following institutional ethics committee approval, healthcare workers (n = 1294) completing their first week-long COVID in-patient duty, subsequent institutional quarantine and RT-PCR testing for COVID-19 infection were included for this prospective cohort study. Demographic data, hydroxychlor­ oquine usage and related adverse effects were captured through a ‘Caring for the Caregivers’ surveil­ lance system. A chi-Square test of independence was used to determine the effect of hydroxychloroquine prophylaxis. Results: Among the 1294 participants (age: 31 ± 7 years, 61% women), 273 (21.1%) healthcare workers used hydroxychloroquine prophylaxis as per Indian Council of Medical Research recommendations and 83/1294 (6.4%) tested positive after their duty. There was no significant difference in COVID-19 incidence between those on hydroxychloroquine prophylaxis and those not on it (5.9% vs 6.6%, χ2 = 0.177, p = 0.675; RR = 0.89, 95% CI – 0.53 to 1.52). There were no significant..