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Rapid Development and Implementation of a Remote ECG-monitored Prospective Randomized Clinical Trial During a Pandemic: Hydroxychloroquine Prophylaxis in COVID-19 Household Contacts

Phase 4
Completed
Conditions
Prophylaxis
Covid19
Coronavirus Infection
Hydroxychloroquine
Transmission
Interventions
Registration Number
NCT04652648
Lead Sponsor
Bryn Mawr Hospital
Brief Summary

* organizing an entirely no in-person contact clinical trial is feasible during a 22 COVID-19 pandemic 23

* Remote smartphone 6-lead ECG monitoring is possible even in a group unfamiliar 24 with the technology 25

* Hydroxychloroquine used prophylactically at 200 mg BID had no observable 26 cardiotoxicity 27

* Additional study using this technique is warranted to look at reliability and cost-28 effectiveness

Detailed Description

Household members were contacted by telephone and provided consent forms via E-mail electronic signatures. Randomization was 2:1 to HCQ 200 mg BID or observation for 10 days with total follow-up of 14 days. COVID status was determined by home saliva PCR assay on days 1 and 14. Study drug was shipped to participants. Data of daily symptoms and 6-lead ECGs using a smartphone KardiaMobile® 6L application were collected.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
54
Inclusion Criteria
  • exposure to a COVID-19-infected individual in the same household within five days of diagnosis;
  • age >18 years;
  • ability to give informed consent to participate in a clinical study;
  • ability to swallow oral medications;
  • access to a smartphone
Exclusion Criteria
  • allergy or intolerance to hydroxychloroquine (PlaquenilR);
  • weight less than 85 pounds;
  • eye disease affecting the retina;
  • severe kidney or liver disease;
  • G6PD-deficiency;
  • porphyria;
  • long QTc EKG abnormality or family history of this;
  • other major EKG abnormalities;
  • taking medications that can affect the QT interval including flecainide, amiodarone, digoxin, procainamide, propafenone, sotalol, quinidine, dofetilide, levofloxacin, ciprofloxacin, azithromycin, erythromycin, amitriptyline, doxepin, desipramine, imipramine, fluoxetine, sertraline, venlafaxine, quetiapine, haloperidol, droperidol, thioridazine, ziprasidone, furosemide, sumatriptan or zolmitriptan, cisapride, arsenic, dolasetron, or methadone;
  • current pregnancy;
  • current hospitalization;
  • symptomatic with fever or cough;
  • lack of access to a smartphone

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
HydroxychloroquineHydroxychloroquineRandomization was 2:1 to HCQ 200 mg BID for 10 days
Primary Outcome Measures
NameTimeMethod
COVID-19 symptom development with positive PCR testwithin 14 days

The primary endpoint was development of COVID-19 symptoms with a positive coronavirus PCR test by Day 14.

Secondary Outcome Measures
NameTimeMethod
Hospital admission for COVID-19within 14 days of study entry

hospital admission for COVID-19 symptoms by Day 14

Positive coronavirus PCR test without symptomsBy Day 14 (end of study)

Development of a positive coronavirus PCR test without symptoms by Day 14

Death by Day 14within 14 days of study entry

Death due to COVID-19 within 14 days of study entry

Symptom severity at specified time pointsat Day 7 and at Day 14 from study entry

overall symptom severity at Day 7 and Day 14

COVID -19 rate at study entryDay 1 of study

household attack rate at study entry

HCQ discontinuation or study withdrawalwithin 14 days of study entry

All-cause discontinuation of study medication or study withdrawal by Day 14

EKG changes during studyDay 1 thru Day 14 of study

documentation of EKG changes such as QTc prolongation on HCQ compared with no drug therapy

Trial Locations

Locations (3)

Lankenau Medical Center

🇺🇸

Wynnewood, Pennsylvania, United States

Bryn Mawr Hospital

🇺🇸

Bryn Mawr, Pennsylvania, United States

Paoli Hospital

🇺🇸

Paoli, Pennsylvania, United States

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