NETEC Resource Library

A Randomized Trial of Hydroxychloroquine as Postexposure Prophylaxis for Covid-19

Item

Click for External Resource*


Click to read full article*


*The link above may share a zip file (.zip) hosted on repository.netecweb.org. Zip files will download automatically.
*All other links are external and will open in a new window. If you click an external link, you are leaving the NETEC site, and we do not maintain, review, or endorse these materials. See our terms of use.


Item Type

Publication

Terms of Use

By accessing these materials you are agreeing to our terms of use, which may be found here: Terms of Use.

Share this page:

Was this resource helpful?


Title

A Randomized Trial of Hydroxychloroquine as Postexposure Prophylaxis for Covid-19

Subject

Description

This reports on a randomized, double-blind, placebo-controlled trial across the United States and parts of Canada testing hydroxychloroquine as postexposure prophylaxis.

Date

2020-08-06

Citation

Boulware, David R., Matthew F. Pullen, Ananta S. Bangdiwala, Katelyn A. Pastick, Sarah M. Lofgren, Elizabeth C. Okafor, Caleb P. Skipper, Alanna A. Nascene, Melanie R. Nicol, Mahsa Abassi, Nicole W. Engen, Matthew P. Cheng, Derek LaBar, Sylvain A. Lother, Lauren J. MacKenzie, Glen Drobot, Nicole Marten, Ryan Zarychanski, Lauren E. Kelly, Ilan S. Schwartz, Emily G. McDonald, Radha Rajasingham, Todd C. Lee, and Kathy H. Hullsiek. 2020. "A Randomized Trial of Hydroxychloroquine as Postexposure Prophylaxis for Covid-19." New England Journal of Medicine 383 (6):517-25.

Abstract

Background

Coronavirus disease 2019 (Covid-19) occurs after exposure to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). For persons who are exposed, the standard of care is observation and quarantine. Whether hydroxychloroquine can prevent symptomatic infection after SARS-CoV-2 exposure is unknown.

Methods

We conducted a randomized, double-blind, placebo-controlled trial across the United States and parts of Canada testing hydroxychloroquine as postexposure prophylaxis. We enrolled adults who had household or occupational exposure to someone with confirmed Covid-19 at a distance of less than 6 ft for more than 10 minutes while wearing neither a face mask nor an eye shield (high-risk exposure) or while wearing a face mask but no eye shield (moderate-risk exposure). Within 4 days after exposure, we randomly assigned participants to receive either placebo or hydroxychloroquine (800 mg once, followed by 600 mg in 6 to 8 hours, then 600 mg daily for 4 additional days). The primary outcome was the incidence of either laboratory-confirmed Covid-19 or illness compatible with Covid-19 within 14 days.

Results

We enrolled 821 asymptomatic participants. Overall, 87.6% of the participants (719 of 821) reported a high-risk exposure to a confirmed Covid-19 contact. The incidence of new illness compatible with Covid-19 did not differ significantly between participants receiving hydroxychloroquine (49 of 414 [11.8%]) and those receiving placebo (58 of 407 [14.3%]); the absolute difference was −2.4 percentage points (95% confidence interval, −7.0 to 2.2; P=0.35). Side effects were more common with hydroxychloroquine than with placebo (40.1% vs. 16.8%), but no serious adverse reactions were reported.

Conclusions

After high-risk or moderate-risk exposure to Covid-19, hydroxychloroquine did not prevent illness compatible with Covid-19 or confirmed infection when used as postexposure prophylaxis within 4 days after exposure. (Funded by David Baszucki and Jan Ellison Baszucki and others; ClinicalTrials.gov number, NCT04308668. opens in new tab.)

Accessibility

Free online on NEJM

Collection

Related Resource Topic Exhibits