Safety of hydroxychloroquine in healthcare workers for COVID-19 prophylaxis

Atiya R Faruqui; Denis Xavier; Sandhya K Kamat; Sujith J Chandy; Bikash Medhi; Raakhi K Tripathi; Yashashri C Shetty; John Michael Raj; Sandeep Kaushal; S Balakrishnan; Shubham Atal; Santanu K Tripathi; Dinesh K Badyal; Harihar Dikshit; Sukalyan Saha Roy; Niyati Trivedi; Suparna Chatterjee; Chetna Desai; CD Tripathi; Nirmala N Rege; Pooja Gupta; R Raveendran; Rajni Kaul; Nilima A Kshirsagar

doi:10.4103/ijmr.IJMR_2294_20

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ORIGINAL ARTICLE

Year : 2021 | Volume : 153 | Issue : 1 | Page : 219-226

Safety of hydroxychloroquine in healthcare workers for COVID-19 prophylaxis

Atiya R Faruqui¹, Denis Xavier¹, Sandhya K Kamat², Sujith J Chandy³, Bikash Medhi⁴, Raakhi K Tripathi², Yashashri C Shetty², John Michael Raj⁵, Sandeep Kaushal⁶, S Balakrishnan⁷, Shubham Atal⁷, Santanu K Tripathi⁸, Dinesh K Badyal⁹, Harihar Dikshit¹⁰, Sukalyan Saha Roy¹⁰, Niyati Trivedi¹¹, Suparna Chatterjee¹², Chetna Desai¹³, CD Tripathi¹⁴, Nirmala N Rege², Pooja Gupta¹⁵, R Raveendran¹⁶, Rajni Kaul¹⁷, Nilima A Kshirsagar¹⁸
¹ Department of Pharmacology, St. John's Medical College, Bengaluru, Karnataka, India
² Department of Pharmacology & Therapeutics, Seth Gordhandas Sunderdas Medical College & King Edwards Medical Hospital, Mumbai, Maharashtra, India
³ Department of Pharmacology & Clinical Pharmacology, Christian Medical College, Vellore, Tamil Nadu, India
⁴ Department of Pharmacology, Postgraduate Institute of Medical Education & Research, Chandigarh, India
⁵ Department of Biostatistics, St. John's Medical College, Bengaluru, Karnataka, India
⁶ Department of Pharmacology, Dayanand Medical College & Hospital, Ludhiana, Punjab, India
⁷ Department of Pharmacology, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
⁸ Department of Clinical & Experimental Pharmacology, School of Tropical Medicine, Kolkata, West Bengal, India
⁹ Department of Pharmacology, Christian Medical College, Ludhiana, Punjab, India
¹⁰ Department of Pharmacology, Indira Gandhi Institute of Medical Science, Patna, Bihar, India
¹¹ Department of Pharmacology, Medical College Baroda, Vadodara, Ahmedabad, Gujarat, India
¹² Department of Pharmacology, Institute of Postgraduate Medical Education & Research, Kolkata, West Bengal, India
¹³ Department of Pharmacology, B.J. Medical College, Ahmedabad, Gujarat, India
¹⁴ Department of Pharmacology, Vardhman Mahavir Medical College & Safdarjung Hospital, New Delhi, India
¹⁵ Department of Pharmacology, All India Institute of Medical Sciences, New Delhi, India
¹⁶ Department of Pharmacology, Jawaharlal Institute of Postgraduate Education & Research, Puducherry, India
¹⁷ Division of Basic Medical Sciences, New Delhi, India
¹⁸ National Chair Clinical Pharmacology, Indian Council for Medical Research, New Delhi, India

Correspondence Address:
Nilima A Kshirsagar
Emeritus Scientist, ICMR-National Institute for Research in Reproductive Health, Jehangir Merwanji Street Road, Parel, Mumbai 400 012, Maharashtra
India

Source of Support: None, Conflict of Interest: None

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DOI: 10.4103/ijmr.IJMR_2294_20

Background & objectives: Hydroxychloroquine (HCQ), reported to inhibit severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) replication in in vitro studies, has been recommended for prophylaxis of COVID-19 in healthcare workers (HCWs). The objective of this study was to assess short-term adverse events (AEs) of HCQ in HCWs. Methods: This cross-sectional study among consenting HCWs taking prophylaxis and working in hospitals with COVID-19 patients used online forms to collect details of HCWs, comorbidities, prophylactic drugs used and AEs after the first dose of HCQ. Verification of dose and AEs was done by personal contact. Multivariate logistic regression analysis was done to determine the effect of age, gender and dose of HCQ on AE. Results: Of the 1303 HCWs included, 98.4 per cent (n=1282) took HCQ and 66 per cent (n=861) took 800 mg as first day's dose. Among the 19.9 per cent (n=259) reporting AEs, 1.5 per cent (n=20) took treatment for AE, none were hospitalized and three discontinued HCQ. Gastrointestinal AEs were the most common (172, 13.2%), with less in older [odds ratio (OR) 0.56, 95% confidence interval (CI) 0.35-0.89], with more in females (OR 2.46, 95% CI 1.78-3.38) and in those taking a total dose of 800 mg on day one compared to a lower dose. Hypoglycaemia (1.1%, n=14), cardiovascular events (0.7%, n=9) and other AEs were minimal. Interpretation & conclusions: HCQ prophylaxis first dose was well tolerated among HCWs as evidenced by a low discontinuation. For adverse effects, a small number required treatment, and none required hospitalization. The study had limitations of convenience sampling and lack of laboratory and electrocardiography confirmation of AEs.

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