Post-Exposure Prophylaxis for COVID-19: A Systematic Review.

Afsaneh Ghasemzadeh, Omid Dadras, Esmaeil Mehraeen, Amir Masoud Afsahi, Mohsen Dashti, Mehrdad Mahalleh, Ava Amiri, Alireza Shojaei, Alireza Noroozi, Ghazal Arjmand, Amirali Karimi, Nazanin Janfaza, Parnian Shobeiri, Zahra Pashaei, SeyedAhmad SeyedAlinaghi, Farzane Behnezhad, Ahmadreza Shamsabadi, Farzin Vahedi, Alireza Barzegary

Journal: Infectious disorders drug targets 2023;23(5):e130423215723

PMID: 37069717

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Abstract

INTRODUCTION

SARS-CoV-2 cause pneumonia can spread across the lung and lead to acute respiratory distress syndrome (ARDS) in severe cases. Post-exposure prophylaxis has shown great potential to prevent the transmission of some viral infections; however, such results for COVID-19 are still inconclusive.

METHODS

Therefore, the aim of this study was to systematically review the resources that utilized postexposure prophylaxis (PEP) for COVID-19 and the possible clinical benefits of such drugs. An organized search of relevant literature was done using the keywords and search queries on public databases of Cochrane, PubMed, Web of Science and Scopus from December 2019 to August 23, 2021. Original resources that had the inclusion criteria were included after two-phase title/abstract and full-text screenings. This review adhered to the Preferred Reporting Items for Systematic Reviews and Meta- Analysis (PRISMA) statement.

RESULTS

Out of 841 retrieved records 17 resources were appropriate to include in the systematic review. Hydroxychloroquine with a daily dose of 400-800 mg and a duration of 5-14 days was the most frequently used agent for PEP. Chloroquine was recommended to use to control treatment in patients with mild to severe COVID-19 pneumonia. Other agents like Lopinavir-ritonavir (LPV/r), angiotensinconverting enzyme inhibitors (ACEIs), Angiotensin receptor blockers (ARBs), Vitamin D, arbidol, thymosin drugs, and Xin guan no.1 (XG.1, a Chinese formula medicine) have also been applied in some studies.

CONCLUSION

Current evidence demonstrated no established clinical benefits of any drug as PEP in individuals with COVID-19. However, scarce indication occurs for the beneficial effects of some agents, but more studies are needed to explore such effects.

Address: Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High-Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran.; School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.; Internal Medicine Department, Imam Khomeini Hospital Complex, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.; Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.; Department of Radiology, Tabriz University of Medical Sciences, Tabriz, Iran.; School of Medicine, Islamic Azad University, Tehran, Iran.; School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.; Department of Health Information Technology, Esfarayen Faculty of Medical Sciences, Esfarayen, Iran.; Department of Radiology, School of Medicine, University of California, San Diego (UCSD), California, USA.; Department of Health Information Technology, Khalkhal University of Medical Sciences, Khalkhal, Iran.; Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.

DOI: 10.2174/1871526523666230413082721

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MeSH Terms: Humans, COVID-19, Antiviral Agents, SARS-CoV-2, Post-Exposure Prophylaxis, Angiotensin Receptor Antagonists, Angiotensin-Converting Enzyme Inhibitors