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HyPE 研究:COVID-19 大流行期间医护人员中羟氯喹预防相关不良事件分析:一个日益引起公众关注的公共卫生问题。

HyPE study: hydroxychloroquine prophylaxis-related adverse events' analysis among healthcare workers during COVID-19 pandemic: a rising public health concern.

机构信息

Department of Internal Medicine, Bowring and Lady Curzon Hospital, Bangalore 560001, India.

Department of Neurology, National Institute of Mental Health and Neurosciences, Bangalore 560029, India.

出版信息

J Public Health (Oxf). 2020 Aug 18;42(3):493-503. doi: 10.1093/pubmed/fdaa074.

Abstract

BACKGROUND

The rising burden of Coronavirus disease (COVID-19) has led to the mass use of hydroxychloroquine by healthcare workers (HCWs). Adverse event profile of this drug when used as prophylaxis is not well known in the literature.

METHODS

A retrospective, cross-sectional study was conducted across the country using semi-structured web-based questionnaire among COVID-19 negative and asymptomatic healthcare workers, taking hydroxychloroquine prophylaxis. Descriptive and multivariate logistic-regression models were applied for analysis.

RESULTS

Of the 166 participants, at least one adverse event was experienced by 37.9% participants, gastrointestinal being the most common (30.7%). Risk was higher in participants <40 years age (odd's ratio (OR): 2.44, 95% confidence interval (CI): 1.18-5.05) and after first dose of hydroxychloroquine (51.2%, OR: 2.38, 95%CI: 1.17-4.84). Hydroxychloroquine prophylaxis was initiated without electrocardiography by 80.1% of HCWs. Only 21.6% of those with cardiovascular disease could get prior ECG.

CONCLUSIONS

A higher incidence of adverse events was observed when results were compared with studies involving patients on long-term hydroxychloroquine therapy. Younger age and first dose were associated with greater incidence of adverse events though all were self-limiting. Monitoring prior and during prophylaxis was inadequate even among those with cardiovascular disease and risk-factors. However, no serious cardiovascular events were reported.

摘要

背景

由于冠状病毒病(COVID-19)负担不断增加,医护人员(HCWs)大量使用羟氯喹。该药物用作预防药物时的不良事件概况在文献中尚不清楚。

方法

使用 COVID-19 阴性和无症状医护人员的半结构式网络问卷,在全国范围内进行回顾性横断面研究,接受羟氯喹预防。采用描述性和多变量逻辑回归模型进行分析。

结果

在 166 名参与者中,至少有 37.9%的参与者出现了不良事件,胃肠道不良事件最常见(30.7%)。<40 岁的参与者风险更高(比值比(OR):2.44,95%置信区间(CI):1.18-5.05),以及服用羟氯喹第一剂后(51.2%,OR:2.38,95%CI:1.17-4.84)。80.1%的 HCWs 在没有心电图的情况下开始使用羟氯喹预防。仅有 21.6%的心血管疾病患者能够进行之前的心电图检查。

结论

与涉及长期接受羟氯喹治疗的患者的研究结果相比,观察到不良事件的发生率更高。尽管所有不良事件均为自限性,但年龄较小和第一剂与不良事件发生率较高相关。即使在心血管疾病和危险因素患者中,预防前和预防期间的监测也不足。但是,没有报告严重的心血管事件。

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