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.
【저자키워드】 COVID-19, Efficacy, Hydroxychloroquine, Safety, Prophylaxis, 【초록키워드】 Randomized controlled trial, Meta-analysis, Intervention, outcome, Prophylactic, abdominal pain, diarrhea, RT-PCR, RCT, adverse events, outcomes, Cohort, COVID-19 infection, Quality, COVID-19 symptoms, RCTs, positive RT-PCR, Evidence, no effect, 95% CI, Secondary outcomes, usual care, COVID-19 infections, no difference, worsening, all-cause mortality, compatible symptoms, vomiting, Effect, FIVE, controls, defined, performed, searched, did not reduce, increased the risk, 【제목키워드】 review, Impact,