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