Safety and tolerability of hydroxychloroquine in health care workers and first responders for the prevention of COVID-19: WHIP COVID-19 Study. (March 2022)

• Record Type: Journal Article
• Authors: McKinnon, John E.; Wang, Dee Dee; Zervos, Marcus; Saval, Matt; Marshall-Nightengale, Laurie; Kilgore, Paul; Pabla, Pardeep; Szandzik, Ed; Maksimowicz-McKinnon, Kathleen; O'Neill, William W.
• Is Part Of: International journal of infectious diseases. Volume 116(2022)
• Page Start: 167
• Page End: 173
• Publication Date: 2022-03
• Subjects: Hydroxychloroquine -- COVID-19 -- Chemoprophylaxis -- Randomized trial -- Health care workers; Communicable diseases -- Periodicals; Communicable Diseases -- Periodicals; Communicable diseases; Periodicals; Electronic journals; 616.9
• DOI: 10.1016/j.ijid.2021.12.343
• Languages: English
• ISSNs: 1201-9712

Abstract

Highlights: Hydroxychloroquine chemoprophylaxis is safe in high-risk populations for COVID-19. No increased cardiovascular risks were observed with hydroxychloroquine chemoprophylaxis. Adverse events were similar between placebo and hydroxychloroquine treatment arms. Abstract: 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: 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: 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: 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.