Hydroxychloroquine as a primary prophylactic agent against SARS-CoV-2 infection: A cohort study

羟氯喹作为 SARS-CoV-2 感染的主要预防药物:一项队列研究

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作者: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 E J Håkansson, Casper Tidemandsen, Karin Armbruster, Andrea Browatzki, Howraman Meteran, Christian Niels Meyer, 

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.

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

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.

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.

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