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Rigshospitalet - a part of Copenhagen University Hospital
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Hydroxychloroquine as a primary prophylactic agent against sars-cov-2 infection: a cohort study

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  • Peter Kamstrup
  • Pradeesh Sivapalan
  • Josefin Eklöf
  • Nils Hoyer
  • Charlotte Suppli Ulrik
  • Lars Pedersen
  • Therese S Lapperre
  • Zitta Barrella Harboe
  • Uffe Bodtger
  • Rasmus Dahlin Bojesen
  • Kjell Ej Håkansson
  • Casper Tidemandsen
  • Karin Armbruster
  • Andrea Browatzki
  • Howraman Meteran
  • Christian Niels Meyer
  • Kristoffer Grundtvig Skaarup
  • Mats Christian Højbjerg Lassen
  • Jens D Lundgren
  • Tor Biering-Sørensen
  • Jens-Ulrik Stæhr Jensen
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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.

Original languageEnglish
JournalInternational journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases
Volume108
Pages (from-to)370-376
Number of pages7
ISSN1201-9712
DOIs
Publication statusPublished - Jul 2021

    Research areas

  • COVID-19, Epidemiology, Hydroxychloroquine, Prophylaxis, SARS-CoV-2

ID: 66135180