Hospital-Based Quasi-Experimental Study on Hydroxychloroquine Pre-Exposure Prophylaxis for COVID-19 in Healthcare Providers with Its Potential Side-Effects

DOI record: { "DOI": "10.3390/life12122047", "ISSN": [ "2075-1729" ], "URL": "http://dx.doi.org/10.3390/life12122047", "abstract": "<jats:p>Considering that it has been more than 24 months since SARS-CoV-2 emerged, it is crucial to identify measures that prevent and control pathogen transmission in workplace settings. Our aim was to report results of a hospital-based program that delivered hydroxychloroquine (HCQ) tablets as COVID-19 prophylaxis to the frontline healthcare workers (HCW)s who cared for COVID-19 patients and to evaluate the efficacy of HCQ. Setting and participants: Quasi-experimental, controlled, single-center study. The included participants were doctors, nurses, health workers, cleaning staff, and non-healthcare supportive staff. The main outcome was contracting COVID-19 anytime during the period of taking the prophylaxis, confirmed by RT-PCR. A total of 336 participants, without any clinical evidence of COVID-19 and without any known contact with family members, were included in the trial; 230 were assigned to HCQ and 106 declined to take any drug. Results: Among the participants, 43 (18.7%) in the HCQ group and 11 (10.4%) participants in the control group developed COVID-19. For the evaluation of side effects, we evaluated 12-lead ECGs of both groups at the baseline and after 4 weeks to monitor QTc interval. A total of 91% (198 of 217) participants in the prophylaxis group and 92% (11 of 12) in the control group had a QTc &lt; 45o msec, which is within normal limits. Conclusions: Although the number of symptomatic infections in health personnel was lower in the control group, the difference was not statistically significant. However, in the absence of any effective pre-exposure prophylaxis medicine for COVID-19, practicing proper infection prevention and control (IPC) and vaccination is the only way forward.</jats:p>", "alternative-id": [ "life12122047" ], "author": [ { "ORCID": "http://orcid.org/0000-0002-5676-3280", "affiliation": [], "authenticated-orcid": false, "family": "Shahrin", "given": "Lubaba", "sequence": "first" }, { "ORCID": "http://orcid.org/0000-0002-4090-785X", "affiliation": [], "authenticated-orcid": false, "family": "Mahfuz", "given": "Mustafa", "sequence": "additional" }, { "affiliation": [], "family": "Rahman", "given": "Md. Waliur", "sequence": "additional" }, { "ORCID": "http://orcid.org/0000-0001-9107-1506", "affiliation": [], "authenticated-orcid": false, "family": "Hossain", "given": "Md. Rezaul", "sequence": "additional" }, { "affiliation": [], "family": "Khandaker", "given": "Afsana Mim", "sequence": "additional" }, { "ORCID": "http://orcid.org/0000-0003-1389-8510", "affiliation": [], "authenticated-orcid": false, "family": "Alam", "given": "Md. Ashraful", "sequence": "additional" }, { "ORCID": "http://orcid.org/0000-0001-5463-3880", "affiliation": [], "authenticated-orcid": false, "family": "Osmany", "given": "Din M. M. F.", "sequence": "additional" }, { "affiliation": [], "family": "Islam", "given": "Md. Munirul", "sequence": "additional" }, { "ORCID": "http://orcid.org/0000-0001-9958-3071", "affiliation": [], "authenticated-orcid": false, "family": "Chisti", "given": "Mohammod Jobayer", "sequence": "additional" }, { "affiliation": [], "family": "Ahmed", "given": "Chaudhury Meshkat", "sequence": "additional" }, { "affiliation": [], "family": "Ahmed", "given": "Tahmeed", "sequence": "additional" } ], "container-title": "Life", "container-title-short": "Life", "content-domain": { "crossmark-restriction": false, "domain": [] }, "created": { "date-parts": [ [ 2022, 12, 7 ] ], "date-time": "2022-12-07T11:22:18Z", "timestamp": 1670412138000 }, "deposited": { "date-parts": [ [ 2022, 12, 7 ] ], "date-time": "2022-12-07T11:45:32Z", "timestamp": 1670413532000 }, "funder": [ { "name": "the core donors of icddr, b" } ], "indexed": { "date-parts": [ [ 2022, 12, 8 ] ], "date-time": "2022-12-08T06:07:19Z", "timestamp": 1670479639310 }, "is-referenced-by-count": 0, "issue": "12", "issued": { "date-parts": [ [ 2022, 12, 7 ] ] }, "journal-issue": { "issue": "12", "published-online": { "date-parts": [ [ 2022, 12 ] ] } }, "language": "en", "license": [ { "URL": "https://creativecommons.org/licenses/by/4.0/", "content-version": "vor", "delay-in-days": 0, "start": { "date-parts": [ [ 2022, 12, 7 ] ], "date-time": "2022-12-07T00:00:00Z", "timestamp": 1670371200000 } } ], "link": [ { "URL": "https://www.mdpi.com/2075-1729/12/12/2047/pdf", "content-type": "unspecified", "content-version": "vor", "intended-application": "similarity-checking" } ], "member": "1968", "original-title": [], "page": "2047", "prefix": "10.3390", "published": { "date-parts": [ [ 2022, 12, 7 ] ] }, "published-online": { "date-parts": [ [ 2022, 12, 7 ] ] }, "publisher": "MDPI AG", "reference": [ { "DOI": "10.1056/NEJMoa2001017", "article-title": "China Novel Coronavirus Investigating and Research Team. A novel coronavirus from patients with pneumonia in China", "author": "Zhu", "doi-asserted-by": "crossref", "first-page": "727", "journal-title": "N. Engl. J. Med.", "key": "ref_1", "volume": "382", "year": "2019" }, { "key": "ref_2", "unstructured": "World Health Organization (2020). Statement on the Second Meeting of the International Health Regulations (2005) Emergency Committee Regarding the Outbreak of Novel Coronavirus (2019-nCoV), World Health Organization." }, { "key": "ref_3", "unstructured": "Director, W. (2020). General’s Opening Remarks at the Media Briefing on COVID-19—11 March 2020, World Health Organization." }, { "key": "ref_4", "unstructured": "World Health Organization (2020). Coronavirus Disease 2019 (COVID-19): Situation Report, World Health Organization." }, { "article-title": "2019 Novel Coronavirus COVID-19 (2019-nCoV) Data Repository: Johns Hopkins University Center for Systems Science and Engineering", "author": "Miller", "first-page": "47", "journal-title": "Bull.-Assoc. Can. Map Libr. Arch.", "key": "ref_5", "volume": "164", "year": "2020" }, { "DOI": "10.1016/S1473-3099(20)30120-1", "article-title": "An interactive web-based dashboard to track COVID-19 in real time", "author": "Dong", "doi-asserted-by": "crossref", "first-page": "533", "journal-title": "Lancet Infect. Dis.", "key": "ref_6", "volume": "20", "year": "2020" }, { "DOI": "10.1016/j.ijantimicag.2020.105924", "article-title": "Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and coronavirus disease-2019 (COVID-19): The epidemic and the challenges", "author": "Lai", "doi-asserted-by": "crossref", "first-page": "105924", "journal-title": "Int. J. Antimicrob. Agents", "key": "ref_7", "volume": "55", "year": "2020" }, { "DOI": "10.1136/bmj.m2013", "article-title": "COVID-19: Doctors sound alarm over hospital transmissions", "author": "Iacobucci", "doi-asserted-by": "crossref", "first-page": "2013", "journal-title": "Br. Med. J. Publ. Group", "key": "ref_8", "volume": "369", "year": "2020" }, { "DOI": "10.7554/eLife.59391", "article-title": "Effective control of SARS-CoV-2 transmission between healthcare workers during a period of diminished community prevalence of COVID-19", "author": "Jones", "doi-asserted-by": "crossref", "first-page": "e59391", "journal-title": "Elife", "key": "ref_9", "volume": "9", "year": "2020" }, { "DOI": "10.9734/jpri/2021/v33i43A32477", "article-title": "The Situation and Preventive Measures Related to COVID-19 Infection for Medical Staff", "author": "Sherzad", "doi-asserted-by": "crossref", "first-page": "180", "journal-title": "J. Pharm. Res. Int.", "key": "ref_10", "volume": "33", "year": "2021" }, { "article-title": "Hydroxychloroquine for the prevention of COVID-19—Searching for evidence", "author": "Cohen", "first-page": "585", "journal-title": "Mass Med. Soc.", "key": "ref_11", "volume": "383", "year": "2020" }, { "DOI": "10.1093/cid/ciaa237", "article-title": "In vitro antiviral activity and projection of optimized dosing design of hydroxychloroquine for the treatment of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)", "author": "Yao", "doi-asserted-by": "crossref", "first-page": "732", "journal-title": "Clin. Infect. Dis.", "key": "ref_12", "volume": "71", "year": "2020" }, { "DOI": "10.1111/1756-185X.13842", "article-title": "A systematic review of the prophylactic role of chloroquine and hydroxychloroquine in coronavirus disease-19 (COVID-19)", "author": "Shah", "doi-asserted-by": "crossref", "first-page": "613", "journal-title": "Int. J. Rheum. Dis.", "key": "ref_13", "volume": "23", "year": "2020" }, { "DOI": "10.1093/jac/dkaa114", "article-title": "COVID-19: A recommendation to examine the effect of hydroxychloroquine in preventing infection and progression", "author": "Zhou", "doi-asserted-by": "crossref", "first-page": "1667", "journal-title": "J. Antimicrob. Chemother.", "key": "ref_14", "volume": "75", "year": "2020" }, { "DOI": "10.7326/M20-2496", "article-title": "Hydroxychloroquine or chloroquine for treatment or prophylaxis of COVID-19: A living systematic review", "author": "Hernandez", "doi-asserted-by": "crossref", "first-page": "287", "journal-title": "Ann. Intern. Med.", "key": "ref_15", "volume": "173", "year": "2020" }, { "DOI": "10.1056/NEJMoa2016638", "article-title": "A randomized trial of hydroxychloroquine as postexposure prophylaxis for COVID-19", "author": "Boulware", "doi-asserted-by": "crossref", "first-page": "517", "journal-title": "N. Engl. J. Med.", "key": "ref_16", "volume": "383", "year": "2020" }, { "DOI": "10.1371/journal.pone.0261980", "doi-asserted-by": "crossref", "key": "ref_17", "unstructured": "Rojas-Serrano, J., Portillo-Vásquez, A.M., Vázquez-Pérez, J., Ramírez-Venegas, F.M.-N.A., Pérez-Kawabe, K.M., and Pérez-Padilla, R. (2022). Hydroxychloroquine for Prophylaxis of COVID-19 in Health Workers: A Randomized Clinical Trial. PLoS ONE, 17." }, { "key": "ref_18", "unstructured": "Selection WECot, Medicines UoE, and World Health Organization (2014). The Selection and Use of Essential Medicines: Report of the WHO Expert Committee, 2013 (Including the 18th WHO Model List of Essential Medicines and the 4th WHO Model List of Essential Medicines for Children), World Health Organization." }, { "DOI": "10.1016/S0140-6736(20)30251-8", "article-title": "Genomic characterisation and epidemiology of 2019 novel coronavirus: Implications for virus origins and receptor binding", "author": "Lu", "doi-asserted-by": "crossref", "first-page": "565", "journal-title": "Lancet", "key": "ref_19", "volume": "395", "year": "2020" }, { "DOI": "10.1186/1743-422X-2-69", "article-title": "Chloroquine is a potent inhibitor of SARS coronavirus infection and spread", "author": "Vincent", "doi-asserted-by": "crossref", "first-page": "69", "journal-title": "Virol. J.", "key": "ref_20", "volume": "2", "year": "2005" }, { "DOI": "10.1038/s41422-020-0282-0", "article-title": "Remdesivir and chloroquine effectively inhibit the recently emerged novel coronavirus (2019-nCoV) in vitro", "author": "Wang", "doi-asserted-by": "crossref", "first-page": "269", "journal-title": "Cell Res.", "key": "ref_21", "volume": "30", "year": "2020" }, { "DOI": "10.12688/wellcomeopenres.16880.2", "article-title": "Good participatory practice for coronavirus disease 2019 (COVID-19) research: The case of a COVID-19 prevention study", "author": "Perrone", "doi-asserted-by": "crossref", "first-page": "216", "journal-title": "Wellcome Open Res.", "key": "ref_22", "volume": "6", "year": "2021" }, { "DOI": "10.1186/s13063-020-04659-7", "article-title": "Hydroxychloroquine for post-exposure prophylaxis of COVID-19 among naval personnel in Sri Lanka: Study protocol for a randomized, controlled trial", "author": "Niriella", "doi-asserted-by": "crossref", "first-page": "748", "journal-title": "Trials", "key": "ref_23", "volume": "21", "year": "2020" }, { "DOI": "10.1093/cid/ciaa1654", "article-title": "COVID-19—Lessons learned and questions remaining", "author": "Fang", "doi-asserted-by": "crossref", "first-page": "2225", "journal-title": "Clin. Infect. Dis.", "key": "ref_24", "volume": "72", "year": "2021" }, { "DOI": "10.1056/NEJMoa2023184", "article-title": "Repurposed antiviral drugs for COVID-19—Interim WHO SOLIDARITY trial results", "author": "Consortium", "doi-asserted-by": "crossref", "first-page": "497", "journal-title": "N. Engl. J. Med.", "key": "ref_25", "volume": "384", "year": "2021" }, { "DOI": "10.1093/jac/dkaa477", "doi-asserted-by": "crossref", "key": "ref_26", "unstructured": "Revollo, B., Tebe, C., Peñafiel, J., Blanco, I., Perez-Alvarez, N., Lopez, R., and Llibre, J.M. (2020). Hydroxychloroquine pre-exposure prophylaxis for COVID-19 in healthcare workers. J. Antimicrob. Chemother." }, { "DOI": "10.1161/JAHA.120.017144", "article-title": "Experience with hydroxychloroquine and azithromycin in the coronavirus disease 2019 pandemic: Implications for QT interval monitoring", "author": "Ramireddy", "doi-asserted-by": "crossref", "first-page": "e017144", "journal-title": "J. Am. Heart Assoc.", "key": "ref_27", "volume": "9", "year": "2020" }, { "DOI": "10.1096/fj.202000919", "article-title": "Rethinking the role of hydroxychloroquine in the treatment of COVID-19", "author": "Meyerowitz", "doi-asserted-by": "crossref", "first-page": "6027", "journal-title": "FASEB J.", "key": "ref_28", "volume": "34", "year": "2020" }, { "DOI": "10.1080/14787210.2020.1799785", "article-title": "Hydroxychloroquine in the COVID-19 pandemic era: In pursuit of a rational use for prophylaxis of SARS-CoV-2 infection", "author": "Infante", "doi-asserted-by": "crossref", "first-page": "5", "journal-title": "Expert Rev. Anti-Infect. Ther.", "key": "ref_29", "volume": "19", "year": "2021" }, { "DOI": "10.1101/2021.03.26.21254398", "doi-asserted-by": "crossref", "key": "ref_30", "unstructured": "Chahla, R.E., Ruiz, L.M., Ortega, E.S., Morales, M.F., Barreiro, F., George, A., and Goroso, D.G. (2021). A randomized trial-intensive treatment based in Ivermectin and Iota-Carrageenan as pre-exposure prophylaxis for COVID-19 in healthcare agents. medRxiv." }, { "DOI": "10.21203/rs.3.rs-100956/v3", "doi-asserted-by": "crossref", "key": "ref_31", "unstructured": "Elgazzar, A., Hany, B., Youssef, S.A., Hafez, M., Moussa, H., and Eltaweel, A. (2020). Efficacy and Safety of Ivermectin for Treatment and prophylaxis of COVID-19 Pandemic. Europe PMC." }, { "key": "ref_32", "unstructured": "World Health Organization (2020). Modes of Transmission of Virus Causing COVID-19: Implications for IPC Precaution Recommendations: Scientific Brief, 29 March 2020, World Health Organization." }, { "DOI": "10.31219/osf.io/vn7x6", "doi-asserted-by": "crossref", "key": "ref_33", "unstructured": "Ingram, C., Downey, V., Roe, M., Chen, Y., Archibald, M., Kallas, K.-A., and Perrotta, C. (2021). COVID-19 prevention and control measures in workplace settings: A rapid review and meta-analysis. Int. J. Environ. Res. Public Health, 18." } ], "reference-count": 33, "references-count": 33, "relation": {}, "resource": { "primary": { "URL": "https://www.mdpi.com/2075-1729/12/12/2047" } }, "score": 1, "short-title": [], "source": "Crossref", "subject": [ "Paleontology", "Space and Planetary Science", "General Biochemistry, Genetics and Molecular Biology", "Ecology, Evolution, Behavior and Systematics" ], "subtitle": [], "title": "Hospital-Based Quasi-Experimental Study on Hydroxychloroquine Pre-Exposure Prophylaxis for COVID-19 in Healthcare Providers with Its Potential Side-Effects", "type": "journal-article", "volume": "12" }