Design of the healthcare worker exposure response and outcomes (HERO) research platform

Friedland, Anne; Hernandez, Adrian F.; Anstrom, Kevin J.; Chen-Lim, Mei Lin; Cohen, Lauren W.; Currier, Judith S.; Forrest, Christopher B.; Fraser, Ryan; Fraulo, Elizabeth; George, Anoop; Handberg, Eileen; Jackman, Jennifer; Koellhoffer, Jayne; Lawrence, Daryl; Leverty, Renee; McAdams, Patty; McCourt, Brian; Mickley, Brenda; Naqvi, Syed Hasan; O'Brien, Emily C.; Olson, Rachel; Prater, Clyde; Rothman, Russell L.; Shenkman, Elizabeth; Shostak, Jack; Turner, Kisha Batey; Webb, Laura; Woods, Chris; Naggie, Susanna

Background The SARS CoV-2 virus has caused one of the deadliest pandemics in recent history, resulting in over 170 million deaths and global economic disruption. There remains an urgent need for clinical trials to test therapies for treatment and prevention. Design An online research platform was created to support a registry community of healthcare workers (HCWs) to understand their experiences and conduct clinical studies to address their concerns. The first study, HERO-HCQ, was a double-blind, multicenter, randomized, pragmatic trial to evaluate the superiority of hydroxychloroquine (HCQ) vs placebo for pre-exposure prophylaxis (PrEP) of COVID-19 clinical infection in HCWs. Secondary objectives were to assess the efficacy of HCQ in preventing viral shedding of COVID-19 among HCWs and to assess the safety and tolerability of HCQ. Methods HCWs joined the Registry and were pre-screened for trial interest and eligibility. Trial participants were randomized 1:1 to receive HCQ or placebo. On-site baseline assessment included a COVID-19 nasopharyngeal PCR and blood serology test. Weekly follow-up was done via an online portal and included screening for symptoms of COVID-19, self-reported testing, adverse events, and quality of life assessments. The on-site visit was repeated at Day 30. Discussion The HERO research platform offers an approach to rapidly engage, screen, invite and enroll into clinical studies using a novel participant-facing online portal interface and remote data collection, enabling limited onsite procedures for conduct of a pragmatic clinical trial. This platform may be an example for future clinical trials of common conditions to enable more rapid evidence generation.