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0 0.5 1 1.5 2+ Case 30% Improvement Relative Risk Case (b) 19% Case (c) 30% Case (d) 40% HCQ for COVID-19  Bae et al.  Prophylaxis Is pre-exposure prophylaxis with HCQ beneficial for COVID-19? PSM retrospective 3,441 patients in South Korea Fewer cases with HCQ (not stat. sig., p=0.18) Bae et al., Viruses 2021, February 2021 Favors HCQ Favors control

Recent Hydroxychloroquine Use Is Not Significantly Associated with Positive PCR Results for SARS-CoV-2: A Nationwide Observational Study in South Korea

Bae et al., Viruses 2021, doi:10.3390/v13020329
Feb 2021  
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HCQ for COVID-19
1st treatment shown to reduce risk in March 2020
*, now known with p < 0.00000000001 from 421 studies, recognized in 42 countries.
No treatment is 100% effective. Protocols combine complementary and synergistic treatments. * >10% efficacy in meta analysis with ≥3 clinical studies.
3,800+ studies for 60+ treatments.
Retrospective database analysis of prior HCQ usage in South Korea, showing non-statistically significantly lower mortality and cases with treatment.
Although the 30% fewer cases is not statistically significant, it is consistent with the significant 28% fewer cases [20‑35%] from meta analysis of the 81 cases results to date.
risk of case, 30.3% lower, RR 0.70, p = 0.18, treatment 16 of 743 (2.2%), control 91 of 2,698 (3.4%), NNT 82, odds ratio converted to relative risk, PSM.
risk of case, 19.5% lower, RR 0.81, p = 0.50, treatment 16 of 743 (2.2%), control 91 of 2,698 (3.4%), odds ratio converted to relative risk, PSM, adjusted for region.
risk of case, 30.3% lower, RR 0.70, p = 0.30, treatment 16 of 743 (2.2%), control 91 of 2,698 (3.4%), NNT 82, odds ratio converted to relative risk, PSM, adjusted for immunosuppresant use.
risk of case, 40.2% lower, RR 0.60, p = 0.09, odds ratio converted to relative risk, PSM, HCQ >= 6 months.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Bae et al., 20 Feb 2021, retrospective, propensity score matching, South Korea, peer-reviewed, 8 authors.
This PaperHCQAll
Recent Hydroxychloroquine Use Is Not Significantly Associated with Positive PCR Results for SARS-CoV-2: A Nationwide Observational Study in South Korea
Seongman Bae, Byeongzu Ghang, Ye-Jee Kim, Joon Seo Lim, Sung-Cheol Yun, Yong-Gil Kim, Sang-Oh Lee, Sung-Han Kim
Viruses, doi:10.3390/v13020329
Background: To evaluate the role of hydroxychloroquine (HCQ) as pre-exposure prophylaxis against coronavirus disease 2019 (COVID-19), we investigated the prevalence of positive test results for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) testing according to recent HCQ use in patients who had been tested using nationwide health-insurance data of South Korea. Methods: All adults tested for SARS-CoV-2 from 20 January 2020 to 15 May 2020 were identified. HCQ users were defined as patients who had been pretreated with HCQ for at least 30 days until the date of SARS-CoV-2 testing. The prevalence of positive PCR results for SARS-CoV-2 was compared between HCQ users and nonusers. Results: Of a total of 216,686 individuals who had been tested for SARS-CoV-2, 743 (0.3%) were pretreated with HCQ. The prevalence of positive results was not significantly different between HCQ users (2.2%) and nonusers (2.7%; P = 0.35), with an odds ratio of 0.79 (95% confidence interval (CI), 0.48-1.30). Propensity score-matched-cohort analysis showed similar results in terms of the prevalence of positive results (2.2% in HCQ users vs. 3.1% in nonusers; P = 0.18), with an odds ratio of 0.69 (95% CI, 0.40-1.19). The rate of positive PCR was not significantly different in long-term HCQ users (more than 3 or 6 months) compared with nonusers. Conclusions: In this population-based study, recent exposure to HCQ was not significantly associated with a lower risk of SARS-CoV-2 infection. Our data do not support the use of HCQ as pre-exposure prophylaxis against COVID-19.
Supplementary Materials: The following are available online at 5/13/2/329/s1, Table S1 . Diagnostic codes and drug codes used in this study. Conflicts of Interest: The authors have no potential conflicts of interest.
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