ABSTRACT
Since the COVID-19 pandemic, the world began a frantic search for possible prophylactic options. We conducted a study to assess the role of hydroxychloroquine for COVID-19 prophylaxis in health-care workers. The study was a prospective cohort with four arms (high, medium, low dose, and control) of HCQ prophylaxis. Participants were grouped as per their opting for any one arm on a voluntary basis as per institute policy. The outcomes studied were COVID-19 positivity by RT-PCR and its severity assessed by WHO COVID-19 severity scale. Total 486 participants were enrolled, of which 29 (6%) opted for low dose, 2 (<1%) medium dose, and none for high dose HCQ while 455 (93.6%) were in the control arm. Of the 164 participants who underwent RT-PCR, 96 (58.2%) tested positive. Out of these 96 positive cases, 79 [82.3%] were ambulatory and were managed conservatively at home. Only 17.7% participants, all from the control group, required hospitalization with the mild-moderate disease. None of the participants had severe disease, COVID-related complications, ICU stay, or death. The difference in the outcome was statistically insignificant (p value >0.05). This single-centre study demonstrated that HCQ prophylaxis in healthcare workers does not cause a significant reduction in COVID-19 as well as mitigating its severity in those infected. At present, most of the trials have not shown any benefit. Though COVID-19 vaccines have reduced the need for prophylaxis, the search for a safe and reasonable chemoprophylaxis should continue until a large population of individuals gets vaccinated, especially in underdeveloped countries.
ABSTRACT
Condition:
Health Condition 1: B972- Coronavirus as the cause of diseases classified elsewhere Health Condition 2: B338- Other specified viral diseasesPrimary outcome:
Incidence of acute myocardial events in COVID-19 population at baselineand during hospital stayTimepoint: Incidence of acute myocardial events in COVID-19 population at baseline
and during hospital stay
Criteria:
Inclusion criteria: Patients with COVID 19 disease confirmed by RTPCRAge greater than 18 years
Exclusion criteria: Not giving informed consent
ABSTRACT
BACKGROUND & AIMS The use of hydroxycholoroquin for COVID 19 treatment and prophylaxis raised issues concerning its cardiac safety owing to possibility of QT prolongation and arrhythmias. 1 There was no study on long term electrocardiographic telemetry monitoring of patients taking hydroxychloroquin and we planned a continuous electrocardiographic holter telemetry of these patients for a period of seven days. Methods Healthcare workers taking hydroxycholoroquin as pre exposure prophylaxis, patients taking hydroxychloroquin were monitored by holter electrocardiographic telemetry with continuous beat to beat analysis for seven days with capacity to report any arrhythmic event or significant QT prolongation instantly to medical faculty. Results 25 participants with mean age 42.4 ± 14.1 years, 40% females. 20% patients needed to stop HCQ. Four patients developed QT prolongation > 500 ms and needed to stop HCQ, one patient had accelerated idioventricular rhythm and stopped treatment. one had short episodes of atrial fibrillation. No malignant arrhythmia or ventricular arrhythmia or torsades were noted. No episode of significant conduction disturbance and arrhythmic death noted. Baseline mean QTc was 423.96 ± 32.18 ms, mean QTc corrected at 24 hours 438.93 ± 37.95, mean QTc 451.879 ± 37.99 at 48 hours, change in baseline mean QTc to max QTc was 30.74 ± 21.75 ms at 48 hours. All those develop QTc prolongation > 500 ms were greater than 50 years of age. Conclusion Ambulatory telemetry ECG monitoring seems to detect early QT prolongation and stopping drug timely prevented malignant arrhythmias. HCQ seems to have less risk of QT prolongation in young healthy individuals.
Subject(s)
Accelerated Idioventricular Rhythm , Arrhythmias, Cardiac , Death , Atrial FibrillationABSTRACT
Intervention:
Intervention1: Curcumin: Oral Curcumin capsule 500 mg twice daily (morning , evening ) for 12 weeksControl Intervention1: Placebo: Placebo Capsule oral twice daily morning evening for 12 weeks
Primary outcome:
1. SARS-CoV 2 infection rate Using RTPCRTimepoint: 12 weeksCriteria:
Inclusion criteria: People at risk of SARS-CoV 2 infection ( healthcare professionals , attendants of COVID patients , non COVID patients admitted in hospitals or his risk groups like elderly , cardiovascular patients , diabetes , obesity )Not having a previous COVID19 diagnosis
Not having experienced COVID19 symptoms since 30 th Jan 2020.
Not having taken any pre-exposure prophylaxis ( HCQ , any other medication or Ayurvedic preparation or food supplement )
Having a negative SARS-CoV 2 test before randomisation
Exclusion criteria: Any chronic infection
Renal failure (CrCl < 60 mL/min/1.73 m2) or need for hemodialysis
Known history of hypersensitivity to the study drug or any of its components
Immune suppressant drugs
Recent vaccination within 2 month
Pregnancy
Primary Immunodeficiency states • Anemia
Leukopenia
Thrombocytopenia
Co morbidities precluding survival required for duration of study follow up
ABSTRACT
Intervention:
Intervention1: Melatonin: Oral melatonin 3 mg at 6 pm daily once x 8 weeksControl Intervention1: Placebo: Placebo for 8 weeks
Primary outcome:
SARS-CoV 2 infection rate : Number of confirmed (positive CRP) symptomatic infections in each treatment groupTimepoint: 8 weeks
Criteria:
Inclusion criteria: High groups for COVID 19 related diseaseElderly : age > 60 years
Diabetes
Obesity
Heart Failure
Immuno supressed patients
Exclusion criteria: Chronic Renal Failure
Chronic Hepatic Failure
Any hospitalisation for past 3 months
Any recent vaccination
Nutrition supplements
Any addiction
Chronic infections live Human immunodeficiency disorder , Hepatitis B,C., etc
Any autoimmune disease
Irregular sleep pattern
Primary immunodeficiency states
Vitamin deficiency states
ABSTRACT
Intervention:
Intervention1: Nil: NilControl Intervention1: Nil: Nil
Primary outcome:
No of patients with QT prolongation by 25 percentage of baselineNo of patients with QT prolongation greater than 500 ms
No of patients with ventricular arrhythmias
Syncope
Sudden cardiac DeathTimepoint: 7 days
Criteria:
Inclusion criteria: people taking pre exposure COVID 19 hydroxychloroquin prophylaxisWritten informed consent
Exclusion criteria: Corrected QT greater than 480 ms
Known congenital Long QT
Co moralities and contraindications to hydroxychloroquin
Retinopathy
Known hypersensitivity to chloroquine
Cardiomyopathy, prolonged QTc, cardiac arrhythmias • History of psoriasis, porphyria cutanea tarda
Epilepsy
Myasthenia gravis, myopathy of any cause
Serious hepatic or renal disease
Known glucose-6-phosphate dehydrogenase deficiency
Current use of medication with known serious hepatotoxic effects or known interaction with chloroquine
Severe depression
Electrolyte imbalance
Anti arrhythmic drugs
Cardiac devices like pacemaker , defibrillators