Clinical trial protocols of repurposed prophylaxis for COVID-19: A review - 20/02/21

Doi : 10.1016/j.medmal.2020.09.013

E. Sallard ^a,^b,^⁎ , D. Belhadi ^c, F.-X. Lescure ^c,^d, Y. Yazdanpanah ^c,^d, N. Peiffer-Smadja ^c,^d,^e
^a École normale supérieure de Paris, 45, rue D’Ulm, 75005 Paris, France
^b Department of Human Medicine, Faculty of Health, Witten-Herdecke University, 58453 Witten, Germany
^c Université de Paris, INSERM, IAME, 75006 Paris, France
^d Bichat-Claude Bernard University Hospital, AP–HP, 75018 Paris, France
^e National Institute for Health Research Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance, Imperial College London, London, UK

^⁎Corresponding author at: 45, rue D’Ulm, 75005 Paris, France.45, rue D’UlmParis75005France

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Highlights

•	Prophylaxis based on repurposed drugs may help to contain COVID-19 spread.
•	An extensive census of clinical trials on COVID-19 prophylaxis was conducted.
•	62% of trials investigated hydroxychloroquine, and 14% BCG vaccine.
•	Numerous other antivirals and immune system boosters are studied in a few trials.
•	This review analyses the rationale and evidence supporting each treatment.

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Abstract

Efficient therapeutic strategies are needed to counter the COVID-19 pandemic, caused by the SARS-CoV-2 virus. In a context where specific vaccines are not yet available, the containment of the pandemic would be facilitated with efficient prophylaxis. We screened several clinical trials repositories and platforms in search of the prophylactic strategies being investigated against COVID-19 in July 2020. Up to July 5, 2020, only one clinical trial result was published, although we found 112 clinical trial protocols targeting medical workers (n=70, 63%), patients relatives (n=20, 18%) or individuals at risk of severe COVID-19 (n=14, 13%). (Hydroxy)chloroquine was the most frequently evaluated treatment (n=69, 62%), before BCG vaccine (n=12, 11%), this followed by numerous antivirals and immune enhancers. Ninety-eight (88%) clinical trials were randomized with a median of planned inclusions of 530 (IQR 258–1299). Both pre- and post-exposure prophylaxes are investigated.

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Keywords : Prophylaxis, COVID-19, Repurposed chemotherapy, SARS-CoV-2