In a bid to find the efficacy of hydroxychloroquine (HCQ), a joint study was conducted by researchers from infectious disease teams at Samsung Medical Center in Seoul and Pusan National University Hospital at a long-term care hospital in the southern port city of Busan after a social worker was diagnosed with COVID-19 on February 23.
A preventive dose of hydroxychloroquine was used once a day for 184 patients and 21 careworkers who were not infected with COVID-19. Most hospital staff were at low-risk exposure, but the study showed that all did not develop COVID-19 eventually after 14 days of quarantine.
"This is the first study to use PEP (post-exposure prophylaxis) with HCQ as outbreak response against COVID-19" in a long-term care hospital, the researchers said in a paper published through the peer-reviewed International Journal of Antimicrobial Agents.
No patients were diagnosed with COVID-19 additionally, but "randomized clinical studies are needed to evaluate if PEP is an effective option for outbreak response" against COVID-19 in long-term care hospitals, which are especially vulnerable to cluster outbreaks, the paper said.
Because old patients were at risk from adverse outcomes, 400mg was used once a day to avoid adverse events, the paper said, suggesting that several different regimens of hydroxychloroquine are recommended to treat COVID-19 patients.
"In this study, hydroxychloroquine was associated with mild adverse events," the paper said. One patient having skin rash needed steroids for control without discontinuation, while PEP was discontinued in 5 patients due to gastrointestinal upset, bradycardia and fasting.
The paper said that 92 hospital staff including physicians and nurses tested negative after 14-day quarantine even though they did not receive PEP. "From these results, we could not conclude PEP is effective for the prevention of COVID-19 in close contacts."
Researchers in other countries also found that hydroxychloroquine treatment was associated with viral load reduction or disappearance in COVID-19 patients. However, some experts cautioned that it was premature to conduct clinical research on high-risk patients at a time when hydroxychloroquine was not administered officially in the U.S. and Europe to prevent COVID-19.
Hydroxychloroquine is also used to treat rheumatoid arthritis. Side effects include vomiting, headache, changes in vision, muscle weakness, allergic reactions, vision problems, and heart problems.
South Korea researchers have tested anti-viral drugs including ciclesonide, remdesivir and chloroquine. Remdesivir is a novel antiviral drug in the class of nucleotide analogs. Kaletra is a prescription medicine approved for the treatment of HIV infection.
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