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Review

Impact of Prophylactic Hydroxychloroquine on People at High Risk of COVID-19: A Systematic Review and Meta-Analysis

1
Health Outcomes, Policy and Evidence Synthesis (HOPES) Group, University of Connecticut School of Pharmacy, Storrs, CT 06269, USA
2
Unidad de Revisiones Sistemáticas y Meta-Análisis (URSIGET), Vicerrectorado de Investigación, Universidad San Ignacio de Loyola (USIL), Lima 15024, Peru
3
Scientific Communications, Cello Health, Yardley, PA 19067, USA
4
Department of Research Administration, Hartford Hospital, Hartford, CT 06102, USA
*
Author to whom correspondence should be addressed.
Academic Editor: Giuseppe La Torre
J. Clin. Med. 2021, 10(12), 2609; https://doi.org/10.3390/jcm10122609
Received: 10 May 2021 / Revised: 1 June 2021 / Accepted: 9 June 2021 / Published: 13 June 2021
(This article belongs to the Section Epidemiology & Public Health)
There are no proven prophylactic interventions for COVID-19. We systematically reviewed the efficacy of prophylactic hydroxychloroquine for COVID-19. Studies evaluating hydroxychloroquine for prophylaxis of COVID-19 were searched in several engines until 8 December 2020. Primary outcomes included RT-PCR positivity, COVID-19 infections (positive RT-PCR or compatible COVID-19 symptoms), and all-cause mortality. Random effects meta-analyses were performed for all outcomes. Five randomized controlled trials (RCTs) (n = 5579) and one cohort (n = 106) were included. Placebo was the comparator in four RCTs, and usual care in one RCT. Compared to the controls, five RCTs showed that hydroxychloroquine prophylaxis did not reduce RT-PCR positivity (RR 1.01, 95% CI 0.88–1.16), COVID-19 infection (RR 0.98, 95% CI 0.78–1.22), or all-cause mortality (RR 0.73, 95% CI 0.27–1.99). There were no differences of effects by pre- or post-exposure prophylaxis. Prophylaxis with hydroxychloroquine increased the risk of diarrhea, abdominal pain, or vomiting (RR 4.56, 95% CI 1.58–13.19). There were no effects of hydroxychloroquine on other secondary outcomes. Quality of evidence was low to very low for all outcomes. Hydroxychloroquine was not efficacious as a prophylaxis for COVID-19 infections, defined either as RT-PCR positivity or as a composite of RT-PCR positivity or compatible symptoms. Hydroxychloroquine did not reduce all-cause mortality, clinical worsening, or adverse events. View Full-Text
Keywords: hydroxychloroquine; COVID-19; efficacy; safety; prophylaxis hydroxychloroquine; COVID-19; efficacy; safety; prophylaxis
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MDPI and ACS Style

Hernandez, A.V.; Ingemi, J., III; Sherman, M.; Pasupuleti, V.; Barboza, J.J.; Piscoya, A.; Roman, Y.M.; White, C.M. Impact of Prophylactic Hydroxychloroquine on People at High Risk of COVID-19: A Systematic Review and Meta-Analysis. J. Clin. Med. 2021, 10, 2609. https://doi.org/10.3390/jcm10122609

AMA Style

Hernandez AV, Ingemi J III, Sherman M, Pasupuleti V, Barboza JJ, Piscoya A, Roman YM, White CM. Impact of Prophylactic Hydroxychloroquine on People at High Risk of COVID-19: A Systematic Review and Meta-Analysis. Journal of Clinical Medicine. 2021; 10(12):2609. https://doi.org/10.3390/jcm10122609

Chicago/Turabian Style

Hernandez, Adrian V., John Ingemi III, Michael Sherman, Vinay Pasupuleti, Joshuan J. Barboza, Alejandro Piscoya, Yuani M. Roman, and Charles M. White 2021. "Impact of Prophylactic Hydroxychloroquine on People at High Risk of COVID-19: A Systematic Review and Meta-Analysis" Journal of Clinical Medicine 10, no. 12: 2609. https://doi.org/10.3390/jcm10122609

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