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0 0.5 1 1.5 2+ Hospitalization 80% Improvement Relative Risk Case 43% HCQ  Chouhdari et al.  Prophylaxis  DB RCT Is pre-exposure prophylaxis with HCQ beneficial for COVID-19? Double-blind RCT 1,000 patients in Iran (August - October 2020) Fewer cases with HCQ (p=0.005) Chouhdari et al., Social Determinants .., Jan 2024 Favors HCQ Favors control

The prophylactic effect of hydroxychloroquine on the severity of COVID-19 infection in an asymptomatic population: A randomized clinical trial

Chouhdari et al., Social Determinants of Health, doi:10.22037/sdh.v10i1.43032, IRCT20200421047153N1
Jan 2024  
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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.
RCT of 1,000 people showing lower risk of COVID-19 infection with HCQ prophylaxis. There was no significant difference in side effects or adherence, no severe side effects, and blinding was well maintained.
There are now 13 PrEP RCTs, showing significant efficacy for COVID-19 cases with p = 0.00023
risk of hospitalization, 80.1% lower, RR 0.20, p = 0.25, treatment 0 of 439 (0.0%), control 2 of 432 (0.5%), NNT 216, relative risk is not 0 because of continuity correction due to zero events (with reciprocal of the contrasting arm).
risk of case, 42.8% lower, RR 0.57, p = 0.005, treatment 36 of 439 (8.2%), control 61 of 432 (14.1%), NNT 17, adjusted per study, inverted to make RR<1 favor treatment, odds ratio converted to relative risk, multivariable.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Chouhdari et al., 21 Jan 2024, Double Blind Randomized Controlled Trial, Iran, peer-reviewed, 1 author, study period 20 August, 2020 - 20 October, 2020, dosage 800mg day 1, 200mg day 8, 200mg day 15, 200mg day 22, 200mg day 29, 200mg day 36, 200mg day 43, trial IRCT20200421047153N1.
This PaperHCQAll
The prophylactic effect of hydroxychloroquine on the severity of COVID-19 infection in an asymptomatic population: A randomized clinical trial
Termeh Tarjoman, Mahnaz Valizadeh, Parisa Shojaei, Behnam Farhoo, Mehrangi Zange, Masood Naj, Seyed Hamid Jamaldi, Masoumeh Mesgar, Za Hanifezadeh, Fae Abdollahi, Hamidreza Massumi Naini, Mohsen Alijani, Hasti Ziaee, Dr Arezoo Chouhdari
Background: Laboratory and observational data suggest that hydroxychloroquine (HCQ) has biological activity against SARS-CoV-2, potentially permitting its use for disease prevention. This study aimed to evaluate the hydroxychloroquine effect as prophylaxis for SARS-CoV-2 infection. Methods: This double-blind randomized controlled trial was performed on 1000 people between 18-65 who were not suspected of having COVID-19 symptoms at the time of enrollment and had no positive COVID-19 virus test. Hydroxychloroquine or placebo tablets (800 mg/d for the first day followed by 200 mg/d for 6 weeks) were prescribed randomly for participants in 2 groups and followed for 10 weeks. Results: Among 871 participants who were followed within 10 weeks 97(11.1%) became SARS-CoV-2 positive. there were statistically significant differences between infected or noninfected in the hydroxychloroquine (36 of 97 [37.1%]) and placebo (61 of 97 [62.9 %]) groups with a risk ratio of 2.1 (95% confidence interval (CI) 1.01 -3.21; p = 0.005). The incidence of severe forms of COVID-19 (i.e., hospitalized in the coronavirus ward or the ICU) was 2 of 97 (0.02 %) in participants who received a placebo compared to hydroxychloroquine. The proportion of non-infected people who received hydroxychloroquine prophylaxis was nearly twice higher than that of placebo users (1.87, 95% CI: 1.19 -2.84, p = 0.05). There were no significant differences between the two groups regarding side effects (1.1% vs. 0.9%), and no severe adverse reactions were observed. Conclusion: Pre-exposure therapy with hydroxychloroquine appears to prevent moderate and severe illness caused by COVID-19 in asymptomatic persons.
Author's contribution data analysis and interpretation: Arezoo Chouhdari; statistical analysis: Arezoo Chouhdari; supervision or mentorship: Termeh Tarjoman, Arezoo Chouhdari; write the first draft of the manuscript: Termeh Tarjoman, Arezoo Chouhdari; All authors contributed to the intellectual content, and manuscript editing and read and approved the final manuscript. Ethical considerations Questionnaires were filled with the participants' satisfaction and written consent was obtained from the participants in this study. Conflicts of interest All authors declare no conflict of interest.
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