<p>Flattening the Risk: Pre-Exposure Prophylaxis for COVID-19</p>

Abstract

To date, more than 35 million people worldwide have been infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the agent of coronavirus disease 2019 (COVID-19), and more than one million have died in the COVID-19 pandemic. International economies are stalled and social isolation based on palpable fear of death remains the order of the day. The United States and other countries are moving toward resuming work activities and social interaction to boost economic recovery. While this makes financial sense, from a medical perspective our population has already suffered and will continue to suffer severe losses in the absence of a viable aggressive prophylaxis strategy for SARS-CoV-2. Herein, we present a plan to address this problem.

Pre-Exposure Prophylaxis for COVID-19 in Pregnant Women

“… 1 In a retrospective cohort study of 32,109 rheumatic disease patients from the United States Veterans Administration, the incidence of SARS-CoV-2 infection was extremely low regardless of chronic HCQ use (0.3% in users versus 0.4% in non-users), but mortality was significantly decreased in patients taking HCQ (odds ratio 0.70, p=0.0031). 1 …”

“…Multiple studies demonstrate that HCQ has antiviral properties. 1 , 17 Chloroquine analogs such as HCQ have been shown to exhibit non-specific antiviral activity in vitro against viruses such as Ebola, HIV, dengue, chikungunya, Zika, MERS, SARS and influenza, and more recently SARS-CoV-2. 16 Additionally, HCQ has been shown to protect mouse fetuses from infection with Zika virus, a property that could prove beneficial during the SARS-CoV-2 pandemic.…”

“…HCQ treatment has met with failure in SARS-CoV-2-infected hospitalized patients, and HCQ PEP has also shown variable efficacy. 1 In contrast, HCQ PrEP prior to exposure or infection has shown positive safety and efficacy results. A recent British study of 120,075 healthcare workers (HCWs) found that these subjects had a 7–8 fold greater risk of developing severe COVID-19 compared to non-HCWs.…”

“…To date, SARS-CoV-2 has caused more than 96 million cases of COVID-19 and more than two million deaths worldwide. 1 The United States has witnessed a steady increase in cases, with a recent record of more than 500,000 cases reported in one week of October 2020. Despite such gloomy news, new COVID-19 vaccines have completed or are nearing completion of Phase 3 clinical trials.…”

Pre-Exposure Prophylaxis for COVID-19 in Pregnant Women.

“…16 Multiple studies demonstrate that HCQ has antiviral properties. 1,17 Chloroquine analogs such as HCQ have been shown to exhibit non-specific antiviral activity in vitro against viruses such as Ebola, HIV, dengue, chikungunya, Zika, MERS, SARS and influenza, and more recently SARS-CoV-2. 16 Additionally, HCQ has been shown to protect mouse fetuses from infection with Zika virus, a property that could prove beneficial during the SARS-CoV-2 pandemic.…”