Prophylactic Use of Hydroxychloroquine and Subsequent SARS-CoV-2 Infection among Healthcare Workers - A Matched Case-control Study
Introduction: Healthcare Workers (HCWs) are at a higher risk of contracting SARS-CoV-2 infection as they have greater exposure to confirmed COVID-19 patients. It is essential to implement prophylactic measures to reduce the incidence of COVID-19 among them. The Indian guidelines recommend the use of hydroxychloroquine (HCQ) as prophylaxis for HCWs.
Objective: To investigate the role of HCQ as prophylaxis against SARS-CoV-2 infection among HCWs.
Method: The cases and controls were matched at an individual level on occupation (doctor, nurse, technical staff, attending/ cleaning staff, administrative staff), area of posting (whether designated COVID care area or non-COVID area), use of personal protective equipment (PPE), and risk category of exposure.
Results: In matched-pair analysis, no statistically significant difference was found in the incidence of COVID-19 infection with the use of HCQ for prophylaxis (OR 0.73, 95% CI: 0.40-1.36).
Conclusion: Prophylactic use of HCQ does not have any effect on the prevention of COVID-19 infection.
How to cite this article:
Kaur R, Kant S, Bairwa M, Kumar A, Mandal S, Gupta S, Kumar RSR. Prophylactic Use of Hydroxychloroquine and Subsequent SARS-CoV-2 Infection among Healthcare Workers - A Matched Case-control Study. Epidem Int. 2022;7(1):1-6.
1. Indian Council of Medical Research. Advisory on the use of Hydroxycholoroquine as prophylaxis for SARS CoV2 infection.pdf. Available online at: https://www.mohfw.gov.in/pdf/AdvisoryontheuseofHydroxychloroquinasprophylaxisforSARSCoV2infection.pdf. Last accessed on June 16, 2020.
2. Chatterjee P, Anand T, Singh KJ, et al. Healthcare workers & SARS-CoV-2 infection in India: A case-control investigation in the time of COVID-19. Indian J Med Res 2020; 151: 459-67
3. Tilangi P, Desai D, Khan A, and Soneja M. 2020. Hydroxychloroquine prophylaxis for high-risk COVID-19 contacts in India: a prudent approach. Lancet Infect Dis. 2020 ;20(10):1119-1120. doi: 10.1016/S1473-3099(20)30430-8.
4. Liu J., Cao R., Xu M., Wang X., et al. Hydroxychloroquine, a less toxic derivative of chloroquine, is effective in inhibiting SARS-CoV-2 infection in vitro. Cell Discovery. 2020;6:16. doi: 10.1038/s41421-020-0156-0.
5. Yao X, Ye F, Zhang M, et al. In Vitro antiviral activity and projection of optimized dosing design of hydroxy-chloroquine for the treatment of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Clin Infect Dis. 2020;71(15):732-9.
6. Bhattacharya R, Chowdhury S, Mukherjee R, et al. Pre exposure hydroxychloroquine use is associated with reduced COVID19 risk in healthcare workers - a retrospective cohort. Int J Res Med Sci. 2021;9(1):89-96
7. Rajasingham R, Bangdiwala AS, Nicol MR, et al. Hydroxychloroquine as pre-exposure prophylaxis for coronavirus disease 2019 (COVID-19) in healthcare workers: A Randomized Trial. Clin Infect Dis.. 2021; 72 (11): 853-43.
8. WHO. Coronavirus disease (COVID-19) weekly epidemiological update 31st August 2020. Available online at: https://www.who.int/COVID-19. (Accessed June 16, 2021)
9. Revised advisory on the use of Hydroxychloroquine (HCQ) as prophylaxis for SARS-CoV-2 infection. 2020.
https://www.icmr.gov.in/pdf/covid/techdoc/V5_Revised_advisory_on_the_use_of_HCQ_SARS_CoV2_infection.pdf Last accessed on June 16, 2020.
10. Kaur R, Kant S, Bairwa M, et al. Risk stratification as a tool to rationalize quarantine of health care workers exposed to COVID-19 cases: evidence from a tertiary health care center in India. Asia Pac J Public Health. 2021 Jan;33(1):134–7.
11. Abella BS, Jolkovsky EL, Biney BT, et al. Efficacy and safety of hydroxychloroquine vs Placebo for pre-exposure SARS-CoV-2 prophylaxis among health care workers: A Randomized Clinical Trial. JAMA Intern Med. 2021;181(2):195-202.
12. Rentsch CT, DeVito NJ, MacKenna B, et al. Effect of pre-exposure use of hydroxychloroquine on COVID-19 mortality: a population-based cohort study in patients with rheumatoid arthritis or systemic lupus erythematosus using the OpenSAFELY platform. Lancet Rheumatol. 2021 Jan;3(1):e19-e27. doi: 10.1016/S2665-9913(20)30378-7.
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