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

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.

Keywords: COVID-19; SARS-CoV-2; hydroxychloroquine.; novel coronavirus; post-exposure prophylaxis; prevention.