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

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningfagfællebedømt

  • Peter Kamstrup
  • Pradeesh Sivapalan
  • Josefin Eklöf
  • Nils Hoyer
  • Lars Pedersen
  • Therese S. Lapperre
  • Zitta Barrella Harboe
  • Uffe Bodtger
  • Rasmus Dahlin Bojesen
  • Kjell E.J. Håkansson
  • Casper Tidemandsen
  • Karin Armbruster
  • Andrea Browatzki
  • Christian Niels Meyer
  • Kristoffer Grundtvig Skaarup
  • Mats Christian Højbjerg Lassen

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.

TidsskriftInternational Journal of Infectious Diseases
Sider (fra-til)370-376
Antal sider7
StatusUdgivet - 2021

Bibliografisk note

Funding Information:
This work was supported by the Novo Nordisk Foundation (Grant No. NNF20SA0062834 ). The research salary of PS was sponsored by Copenhagen University Hospital-Herlev and Gentofte. The trial was not supported in any way by the pharmaceutical industry. The funding sources have not had and will not have any influence on trial design, data collection, analysis or reporting.

Funding Information:
PS reports personal fees from Boehringer Ingelheim outside the submitted work. CT reports personal fees from TEVA outside the submitted work. KEJH reports personal fees from AstraZeneca , personal fees from TEVA and personal fees from Chiesi outside the submitted work. CSU reports personal fees from AstraZeneca; personal fees and non-financial support from GSK; personal fees from Chiesi; personal fees from TEVA; grants and personal fees from Sanofi Genzyme ; personal fees from Orion Pharma ; personal fees from Actelion ; grants and personal fees from Boehringer-Ingelheim; grants and personal fees from Mundipharma ; and grants, personal fees and non-financial support from Novartis outside the submitted work. TBS reports personal fees from Amgen , grants from Sanofi Pasteur , grants from GE Healthcare , personal fees from Sanofi Pasteur, and personal fees from Novartis outside the submitted work.

Publisher Copyright:
© 2021 The Authors

ID: 273644613