Safety and tolerability of hydroxychloroquine in health care workers and first responders for the prevention of COVID-19: WHIP COVID-19 Study.


Journal

International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases
ISSN: 1878-3511
Titre abrégé: Int J Infect Dis
Pays: Canada
ID NLM: 9610933

Informations de publication

Date de publication:
Mar 2022
Historique:
received: 30 11 2021
revised: 15 12 2021
accepted: 17 12 2021
pubmed: 27 12 2021
medline: 3 3 2022
entrez: 26 12 2021
Statut: ppublish

Résumé

Health care workers (HCW) are among the highest risk groups for acquisition of COVID-19 because of occupational exposures. The WHIP COVID-19 Study aimed to evaluate the safety and efficacy of hydroxychloroquine (HCQ) as chemoprophylaxis for SARS-CoV-2 infection in this population. HCW, first responders, and other occupationally high-risk participants were enrolled in a randomized, placebo-controlled clinical study of HCQ from April to October 2020. The trial compared daily versus weekly HCQ with placebo and with a prospective cohort on HCQ for autoimmune diseases. Participants were followed for 8 weeks. Serology or a positive polymerase chain reaction test was used to determine laboratory confirmed clinical cases. A total of 624 participants were randomized to placebo (n = 200), weekly HCQ (n = 201), daily HCQ (n = 197). For the primary safety end point, 279 (44.7%) participants experienced adverse event (AE) level II or lower (total AEs n = 589), similar rates in all randomized groups (P = .188) with no hospitalizations or interventions required. Only 4 laboratory confirmed COVID-19 cases occurred, with 2 in the placebo arm and one in each HCQ randomized arm. This randomized placebo-controlled trial was able to demonstrate the safety of HCQ outpatient chemoprophylaxis in high-risk groups against COVID-19. Future studies of chemoprophylaxis for SARS-CoV-2 are needed as the epidemic continues worldwide.

Sections du résumé

BACKGROUND BACKGROUND
Health care workers (HCW) are among the highest risk groups for acquisition of COVID-19 because of occupational exposures. The WHIP COVID-19 Study aimed to evaluate the safety and efficacy of hydroxychloroquine (HCQ) as chemoprophylaxis for SARS-CoV-2 infection in this population.
METHODS METHODS
HCW, first responders, and other occupationally high-risk participants were enrolled in a randomized, placebo-controlled clinical study of HCQ from April to October 2020. The trial compared daily versus weekly HCQ with placebo and with a prospective cohort on HCQ for autoimmune diseases. Participants were followed for 8 weeks. Serology or a positive polymerase chain reaction test was used to determine laboratory confirmed clinical cases.
RESULTS RESULTS
A total of 624 participants were randomized to placebo (n = 200), weekly HCQ (n = 201), daily HCQ (n = 197). For the primary safety end point, 279 (44.7%) participants experienced adverse event (AE) level II or lower (total AEs n = 589), similar rates in all randomized groups (P = .188) with no hospitalizations or interventions required. Only 4 laboratory confirmed COVID-19 cases occurred, with 2 in the placebo arm and one in each HCQ randomized arm.
CONCLUSIONS CONCLUSIONS
This randomized placebo-controlled trial was able to demonstrate the safety of HCQ outpatient chemoprophylaxis in high-risk groups against COVID-19. Future studies of chemoprophylaxis for SARS-CoV-2 are needed as the epidemic continues worldwide.

Identifiants

pubmed: 34954095
pii: S1201-9712(21)01243-1
doi: 10.1016/j.ijid.2021.12.343
pmc: PMC8695310
pii:
doi:

Substances chimiques

Hydroxychloroquine 4QWG6N8QKH

Types de publication

Journal Article Randomized Controlled Trial

Langues

eng

Sous-ensembles de citation

IM

Pagination

167-173

Informations de copyright

Copyright © 2021 The Authors. Published by Elsevier Ltd.. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of Competing Interest None of the investigators have potential conflict of interest related to this article.

Auteurs

John E McKinnon (JE)

Infectious Disease, Henry Ford Hospital, Detroit, Michigan, USA. Electronic address: jmckinn3@hfhs.org.

Dee Dee Wang (DD)

Division of Cardiovascular Disease, Center for Structural Heart, Henry Ford Hospital, Detroit, Michigan, USA.

Marcus Zervos (M)

Infectious Disease, Henry Ford Hospital, Detroit, Michigan, USA.

Matt Saval (M)

Division of Cardiovascular Disease, Center for Structural Heart, Henry Ford Hospital, Detroit, Michigan, USA.

Laurie Marshall-Nightengale (L)

Division of Cardiovascular Disease, Center for Structural Heart, Henry Ford Hospital, Detroit, Michigan, USA; Public Health Sciences, Henry Ford Hospital, Detroit, Michigan, USA.

Paul Kilgore (P)

Infectious Disease, Henry Ford Hospital, Detroit, Michigan, USA.

Pardeep Pabla (P)

Pharmacy, Henry Ford Hospital, Detroit, Michigan, USA.

Ed Szandzik (E)

Pharmacy, Henry Ford Hospital, Detroit, Michigan, USA.

Kathleen Maksimowicz-McKinnon (K)

Rheumatology, Henry Ford Hospital, Detroit, Michigan, USA.

William W O'Neill (WW)

Infectious Disease, Henry Ford Hospital, Detroit, Michigan, USA.

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