SAFETY OF HYDROXYCHLOROQUINE FOR COVID-19 PROPHYLAXIS AMONG HEALTHCARE WORKERS: AN OBSERVATIONAL STUDY

SANGEETA KHANNA; NITUL M BEWAL; AMIT ARORA; KRISHNA PRASAD G V

doi:10.22159/ajpcr.2020.v13i11.39150

Authors

SANGEETA KHANNA Department of Anaesthesiology, Military Hospital Kirkee, Pune, Maharashtra, India.
NITUL M BEWAL Department of Medicine, Military Hospital Kirkee, Pune, Maharashtra, India.
AMIT ARORA Department of Ophtholmology, Military Hospital Kirkee, Pune, Maharashtra, India.
KRISHNA PRASAD G V Department of Anaesthesiology, Military Hospital Kirkee, Pune, Maharashtra, India.

DOI:

https://doi.org/10.22159/ajpcr.2020.v13i11.39150

Keywords:

Adverse drug reaction, COVID-19, Healthcare workers, Hydroxychloroquine, Prophylaxis

Abstract

Objective: Indian Council of Medical Research recommended hydroxychloroquine (HCQ) for prophylaxis of COVID‐19 for healthcare workers and the Food and Drug Administration approved its use in the treatment and prophylaxis of COVID‐19 disease. Even though HCQ is adequately tolerated in usual circumstances, still questions about the harmful effects of the drug remain a cause for concern in adults treated with HCQ. The objective of this study was to evaluate the major and minor adverse effects of prophylactic HCQ for COVID-19 among healthcare workers.

Methods: Our analysis was intended to analyze HCQ’s adverse drug reaction profile for COVID‐19 prophylaxis in prophylactic doses in health-care staff. This was a cross-sectional study carried out among healthcare workers taking HCQ prophylaxis for COVID‑19. The study was carried out over 08 weeks period from April to May 2020. The data were obtained regarding age, sex, comorbidities, and possible adverse effects. A pretested and validated online questionnaire was provided to the participants to assess the harmful effects that they experienced when taking HCQ. Furthermore, pre and post 8 weeks prophylaxis, individuals underwent general and systemic examination, along with ECG and blood sugar level monitoring.

Results: The research group comprised 70 previously healthy and health-care staff. In 70 patients, 27 minor adverse effects were reported (18.9%). Headache was the most frequently reported symptoms followed by nausea and vomiting, itching, and skin rashes. There was no statistically relevant variation in harmful effects due to age or number of doses administered. However, none of the adverse effects was serious or debilitating.

Conclusion: With adequate pre-prophylaxis evaluation, health education, and regular monitoring, HCQ prophylaxis is safe and devoid of any serious adverse effects in previously healthy individuals.

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Author Biographies

SANGEETA KHANNA, Department of Anaesthesiology, Military Hospital Kirkee, Pune, Maharashtra, India.

Department Of Anaesthesiology

Military Hospital. Kirkee

Pune Maharashtra 411020

NITUL M BEWAL, Department of Medicine, Military Hospital Kirkee, Pune, Maharashtra, India.

Department Of Medicine

Military Hospital.Kirkee

Pune Maharashtra 411020

AMIT ARORA, Department of Ophtholmology, Military Hospital Kirkee, Pune, Maharashtra, India.

Department Of Ophthalmology

Military Hospital.Kirkee

Pune, Maharashtra

411020

References

Schatz S, Weber RJ. Adverse drug reactions. Pharm Pract 2015;1:1.

Masui Y, Yanai H, Hiraga K, Tsuda N, Kano T. Effects of anti-malarial drug, hydroxychloroquine, on glucose and lipid metabolism in Japanese Population. J Endocrinol Metab 2019;9:159-64.

Yazdany J, Kim AH. Use of hydroxychloroquine and chloroquine during the COVID-19 pandemic: What every clinician should know. Ann Intern Med 2020;172:754-5.

Tripathy JP. Does pandemic justify the use of hydroxychloroquine for treatment and prevention of COVID‐19 in India? J Med Virol 2020;92:1391-3.

Kapoor A, Pandurangi U, Arora V, Gupta A, Jaswal A, Nabar A, et al. Cardiovascular risks of hydroxychloroquine in treatment and prophylaxis of COVID-19 patients: A scientific statement from the Indian Heart Rhythm Society. Indian Pacing Electrophysiol J 2020;20:117-20.

Magagnoli J, Narendran S, Pereira F, Cummings TH, Hardin JW, Sutton SS, et al. Outcomes of hydroxychloroquine usage in United States veterans hospitalized with Covid-19. Med (N Y) 2020. Doi: 10.1016/j.medj.2020.06.001.

Lê MP, Peiffer-Smadja N, Guedj J, Néant N, Mentré F, Ader F, et al. Rationale of a loading dose initiation for hydroxychloroquine treatment in COVID-19 infection in the discovery trial. J Antimicrob Chemother 2020;75:2376-80.

Warnock DG. Clinical trials during the SARS-CoV-2 pandemic. Nephron 2020:144:248-50.

Singh AK, Singh A, Shaikh A, Singh R, Misra A. Chloroquine and hydroxychloroquine in the treatment of COVID-19 with or without diabetes: A systematic search and a narrative review with a special reference to India and other developing countries. Diabetes Metab Syndr 2020;14:241-6.

Principi N, Esposito S. Chloroquine or hydroxychloroquine for prophylaxis of COVID-19. Lancet Infect Dis 2020;20:1118.

Zhang W, Zhao Y, Zhang F, Wang Q, Li T, Liu Z, et al. The use of anti-inflammatory drugs in the treatment of people with severe coronavirus disease 2019 (COVID-19): The perspectives of clinical immunologists from China. Clin Immunol 2020;214:108393.

Tang TT, Lv LL, Pan MM, Wen Y, Wang B, Li ZL. Hydroxychloroquine attenuates renal ischemia/reperfusion injury by inhibiting cathepsin mediated NLRP3 inflammasome activation. Cell Death Dis 2018;9:351.

Chatterjee P, Anand T, Singh KJ, Rasaily R, Singh R, Das S, 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.

Nina PB, Dash AP. Hydroxychloroquine as prophylaxis or treatment for COVID-19: What does the evidence say? Indian J Public Health 2020;64:125-7.

Bhattacharyya D, Raizada N, Nagappa B, Tomar A, Maurya P, Chaudhary A, et al. Chemoprophylaxis of COVID-19 with Hydroxychloroquine: A Study of Health Care Workers Attitude, Adherence to Regime and Side Effects. New York: medRxiv; 2020.

Singh AK, Singh A, Singh R, Misra A. Hydroxychloroquine in patients with COVID-19: A systematic review and meta-analysis. Diabetes Metab Syndr 2020;14:589-96.

Srinivasa A, Tosounidou S, Gordon C. Increased incidence of gastrointestinal side effects in patients taking hydroxychloroquine: A brand-related issue? J Rheumatol 2017;44:398.

Tétu P, Hamelin A, Lebrun-Vignes B, Soria A, Barbaud A, Francès C, et al. Prevalence of hydroxychloroquine-induced side-effects in dermatology patients: A retrospective survey of 102 patients. Ann Dermatol Venereol 2018;145:395-404.

Olsen NJ, Schleich MA, Karp DR. Multifaceted effects of hydroxychloroquine in human disease. Semin Arthritis Rheum 2013;43:264-72.

Wang C, Fortin PR, Li Y, Panaritis T, Gans M, Esdaile JM. Discontinuation of antimalarial drugs in systemic lupus erythematosus. J Rheumatol 1999;26:808-15.

Chen Z, Hu J, Zhang Z, Jiang S, Han S, Yan D. Efficacy of Hydroxychloroquine in Patients with COVID-19: Results of a Randomized Clinical Trial. New York: MedRxiv; 2020.

Gevers S, Kwa MS, Wijnans E, Van Nieuwkoop C. Safety considerations for chloroquine and hydroxychloroquine in the treatment of COVID-19. Clin Microbiol Infect 2020;26:1276-7.