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. 2020 Aug 18;42(3):493-503.
doi: 10.1093/pubmed/fdaa074.

HyPE study: hydroxychloroquine prophylaxis-related adverse events' analysis among healthcare workers during COVID-19 pandemic: a rising public health concern

Bada Sharanappa Nagaraja  1 , Kalhalli Narayanaswamy Ramesh  1 , Debjyoti Dhar  2   3 , Mahammad Samim Mondal  2   3 , Treshita Dey  4 , Subhrakamal Saha  5 , Mumtaz Ali Khan  1 , Shah Dhiren Rutul  2 , Kishore Pratik  2 , Jayaram Manjula  3 , Thuppanattumadam Ananthasubramanian Sangeeth  2   3 , Vikram Singh  2   3
Affiliations

HyPE study: hydroxychloroquine prophylaxis-related adverse events' analysis among healthcare workers during COVID-19 pandemic: a rising public health concern

Bada Sharanappa Nagaraja et al. J Public Health (Oxf). .

Abstract

Background: The rising burden of Coronavirus disease (COVID-19) has led to the mass use of hydroxychloroquine by healthcare workers (HCWs). Adverse event profile of this drug when used as prophylaxis is not well known in the literature.

Methods: A retrospective, cross-sectional study was conducted across the country using semi-structured web-based questionnaire among COVID-19 negative and asymptomatic healthcare workers, taking hydroxychloroquine prophylaxis. Descriptive and multivariate logistic-regression models were applied for analysis.

Results: Of the 166 participants, at least one adverse event was experienced by 37.9% participants, gastrointestinal being the most common (30.7%). Risk was higher in participants <40 years age (odd's ratio (OR): 2.44, 95% confidence interval (CI): 1.18-5.05) and after first dose of hydroxychloroquine (51.2%, OR: 2.38, 95%CI: 1.17-4.84). Hydroxychloroquine prophylaxis was initiated without electrocardiography by 80.1% of HCWs. Only 21.6% of those with cardiovascular disease could get prior ECG.

Conclusions: A higher incidence of adverse events was observed when results were compared with studies involving patients on long-term hydroxychloroquine therapy. Younger age and first dose were associated with greater incidence of adverse events though all were self-limiting. Monitoring prior and during prophylaxis was inadequate even among those with cardiovascular disease and risk-factors. However, no serious cardiovascular events were reported.

Keywords: COVID-19; adverse effects; hydroxychloroquine; prophylaxis.

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Figures

Fig. 1
Fig. 1
Depicting proposed mechanism of transmission, viral replication cycle, pathogenesis and therapeutic options with proposed mechanisms for SARS-CoV-2. All drugs are investigational, ongoing trial results awaited.
Fig. 2
Fig. 2
(a) Showing odd’s ratio and 95% CI plotted on logarithmic scale, of the risk factors predicting risk of adverse drug reaction with hydroxychloroquine prophylactic therapy. (b) Adverse event analysis based on the percentage of occurrence.
See this image and copyright information in PMC

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