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Hydroxychloroquine as a primary prophylactic agent against sars-cov-2 infection: a cohort study

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@article{afa82b127d014494a2eefca4ae735fa3,
title = "Hydroxychloroquine as a primary prophylactic agent against sars-cov-2 infection: a cohort study",
abstract = "Objective: Hydroxychloroquine has been proposed as a primary prophylactic agent against coronavirus disease 2019 (COVID-19). This study aimed to investigate if patients treated with hydroxychloroquine for a non-COVID-19 indication had a lower risk of verified infection with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) compared with matched controls. Methods: A cohort comprising all persons in Denmark collecting hydroxychloroquine prescriptions in 2020 and 2019 (i.e., both during and before SARS-CoV-2 was confirmed in Denmark), matched by age and sex with controls, was studied. Data were collected using the Danish national registries, which contain complete information on patient health data, prescriptions and microbiological test results. The main outcome was microbiologically verified SARS-CoV-2 infection. Results: In total, 5488 hydroxychloroquine users were matched with 54,486 non-users. At baseline, the groups differed in terms of diagnoses of pulmonary disease, cardiovascular disease, renal disease, gastrointestinal/metabolic disease and dementia, as well as treatment with antirheumatic drugs. The final model was adjusted for these potential confounders. Use of hydroxychloroquine for non-COVID-19 indications was not associated with any change in confirmed SARS-CoV-2 (hazard ratio 0.90, 95% confidence interval 0.76–1.07). This result was robust in the propensity-score-matched sensitivity analysis. Conclusion: This study, which is the largest to date to investigate the primary prophylactic effect of hydroxychloroquine against SARS-CoV-2, does not support any prophylactic benefit of hydroxychloroquine in the prevention of infection with SARS-CoV-2.",
keywords = "COVID-19, Epidemiology, Hydroxychloroquine, Prophylaxis, SARS-CoV-2",
author = "Peter Kamstrup and Pradeesh Sivapalan and Josefin Ekl{\"o}f and Nils Hoyer and Ulrik, {Charlotte Suppli} and Lars Pedersen and Lapperre, {Therese S} and Harboe, {Zitta Barrella} and Uffe Bodtger and Bojesen, {Rasmus Dahlin} and H{\aa}kansson, {Kjell Ej} and Casper Tidemandsen and Karin Armbruster and Andrea Browatzki and Howraman Meteran and Meyer, {Christian Niels} and Skaarup, {Kristoffer Grundtvig} and Lassen, {Mats Christian H{\o}jbjerg} and Lundgren, {Jens D} and Tor Biering-S{\o}rensen and Jensen, {Jens-Ulrik St{\ae}hr}",
note = "Copyright {\textcopyright} 2021 The Authors. Published by Elsevier Ltd.. All rights reserved.",
year = "2021",
month = jul,
doi = "10.1016/j.ijid.2021.05.076",
language = "English",
volume = "108",
pages = "370--376",
journal = "International Journal of Infectious Diseases",
issn = "1201-9712",
publisher = "Elsevier Ltd",

}

RIS

TY - JOUR

T1 - Hydroxychloroquine as a primary prophylactic agent against sars-cov-2 infection

T2 - a cohort study

AU - Kamstrup, Peter

AU - Sivapalan, Pradeesh

AU - Eklöf, Josefin

AU - Hoyer, Nils

AU - Ulrik, Charlotte Suppli

AU - Pedersen, Lars

AU - Lapperre, Therese S

AU - Harboe, Zitta Barrella

AU - Bodtger, Uffe

AU - Bojesen, Rasmus Dahlin

AU - Håkansson, Kjell Ej

AU - Tidemandsen, Casper

AU - Armbruster, Karin

AU - Browatzki, Andrea

AU - Meteran, Howraman

AU - Meyer, Christian Niels

AU - Skaarup, Kristoffer Grundtvig

AU - Lassen, Mats Christian Højbjerg

AU - Lundgren, Jens D

AU - Biering-Sørensen, Tor

AU - Jensen, Jens-Ulrik Stæhr

N1 - Copyright © 2021 The Authors. Published by Elsevier Ltd.. All rights reserved.

PY - 2021/7

Y1 - 2021/7

N2 - Objective: Hydroxychloroquine has been proposed as a primary prophylactic agent against coronavirus disease 2019 (COVID-19). This study aimed to investigate if patients treated with hydroxychloroquine for a non-COVID-19 indication had a lower risk of verified infection with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) compared with matched controls. Methods: A cohort comprising all persons in Denmark collecting hydroxychloroquine prescriptions in 2020 and 2019 (i.e., both during and before SARS-CoV-2 was confirmed in Denmark), matched by age and sex with controls, was studied. Data were collected using the Danish national registries, which contain complete information on patient health data, prescriptions and microbiological test results. The main outcome was microbiologically verified SARS-CoV-2 infection. Results: In total, 5488 hydroxychloroquine users were matched with 54,486 non-users. At baseline, the groups differed in terms of diagnoses of pulmonary disease, cardiovascular disease, renal disease, gastrointestinal/metabolic disease and dementia, as well as treatment with antirheumatic drugs. The final model was adjusted for these potential confounders. Use of hydroxychloroquine for non-COVID-19 indications was not associated with any change in confirmed SARS-CoV-2 (hazard ratio 0.90, 95% confidence interval 0.76–1.07). This result was robust in the propensity-score-matched sensitivity analysis. Conclusion: This study, which is the largest to date to investigate the primary prophylactic effect of hydroxychloroquine against SARS-CoV-2, does not support any prophylactic benefit of hydroxychloroquine in the prevention of infection with SARS-CoV-2.

AB - Objective: Hydroxychloroquine has been proposed as a primary prophylactic agent against coronavirus disease 2019 (COVID-19). This study aimed to investigate if patients treated with hydroxychloroquine for a non-COVID-19 indication had a lower risk of verified infection with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) compared with matched controls. Methods: A cohort comprising all persons in Denmark collecting hydroxychloroquine prescriptions in 2020 and 2019 (i.e., both during and before SARS-CoV-2 was confirmed in Denmark), matched by age and sex with controls, was studied. Data were collected using the Danish national registries, which contain complete information on patient health data, prescriptions and microbiological test results. The main outcome was microbiologically verified SARS-CoV-2 infection. Results: In total, 5488 hydroxychloroquine users were matched with 54,486 non-users. At baseline, the groups differed in terms of diagnoses of pulmonary disease, cardiovascular disease, renal disease, gastrointestinal/metabolic disease and dementia, as well as treatment with antirheumatic drugs. The final model was adjusted for these potential confounders. Use of hydroxychloroquine for non-COVID-19 indications was not associated with any change in confirmed SARS-CoV-2 (hazard ratio 0.90, 95% confidence interval 0.76–1.07). This result was robust in the propensity-score-matched sensitivity analysis. Conclusion: This study, which is the largest to date to investigate the primary prophylactic effect of hydroxychloroquine against SARS-CoV-2, does not support any prophylactic benefit of hydroxychloroquine in the prevention of infection with SARS-CoV-2.

KW - COVID-19

KW - Epidemiology

KW - Hydroxychloroquine

KW - Prophylaxis

KW - SARS-CoV-2

UR - http://www.scopus.com/inward/record.url?scp=85108262349&partnerID=8YFLogxK

U2 - 10.1016/j.ijid.2021.05.076

DO - 10.1016/j.ijid.2021.05.076

M3 - Journal article

C2 - 34087484

VL - 108

SP - 370

EP - 376

JO - International Journal of Infectious Diseases

JF - International Journal of Infectious Diseases

SN - 1201-9712

ER -

ID: 66135180