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0 0.5 1 1.5 2+ Pneumonia 30% Improvement Relative Risk Case -19% HCQ for COVID-19  Gönenli et al.  Prophylaxis Is pre-exposure prophylaxis with HCQ beneficial for COVID-19? Retrospective 564 patients in Turkey (May - June 2020) More cases with HCQ (not stat. sig., p=0.58) c19hcq.org Gönenli et al., Infectious Diseases an.., Dec 2020 Favors HCQ Favors control

Analysis of the Prophylactic use of Hydroxychloroquine at the Beginning of the COVID-19 Pandemic Among Physicians

Gönenli et al., Infectious Diseases and Clinical Microbiology, doi:10.36519/idcm.2022.111 (date from preprint)
Dec 2020  
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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. c19hcq.org
Small prophylaxis survey showing lower, but not statistically significant, progression to pneumonia (3 of 148 HCQ, 12 of 416 control), RR 0.70, p = 0.77. There was a higher incidence of cases with HCQ, OR 1.19, p = 0.58, which may be due to survey bias, treatment self-selection, and inconsistent regimens. Improvement on severity may be related to the higher HCQ concentration in lung tissue, and also reflect that binary PCR does not distinguish replication-competence. Details of the pneumonia numbers for treatment/control are from the author, it's unclear why the lower progression to pneumonia was not reported in the paper.
risk of pneumonia, 29.7% lower, RR 0.70, p = 0.77, treatment 3 of 148 (2.0%), control 12 of 416 (2.9%), NNT 117.
risk of case, 18.9% higher, RR 1.19, p = 0.58, treatment 8 of 148 (5.4%), control 20 of 416 (4.8%), odds ratio converted to relative risk.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Gönenli et al., 16 Dec 2020, retrospective, Turkey, peer-reviewed, survey, mean age 36.0, 9 authors, study period 14 May, 2020 - 13 June, 2020. Contact: ikayi@ku.edu.tr.
This PaperHCQAll
Analysis of the Prophylactic use of Hydroxychloroquine at the Beginning of the COVID-19 Pandemic Among Physicians
Mehmet Gokhan Gonenli, Ilker Kayi, Nilufer Alpay-Kanitez, Tuba Baydas, Murat Kose, Emine Ayca Nalbantoglu, Mirac Vural Keskinler, Timur Selcuk Akpinar, Onder Ergonul
Infectious Diseases and Clinical Microbiology, doi:10.36519/idcm.2022.111
Objective: Throughout the pandemic, physicians working at the frontlines have embarked on various quests to protect themselves, and many physicians preferred using hydroxychloroquine (HQN) as a prophylactic agent. This study aimed to investigate the reasons leading physicians to use HQN and its effects on them. Materials and Methods: This study is cross-sectional with a target population of physicians working in pandemic hospitals in İstanbul, Turkey. We invited participants from seven hospitals via email between May 14 and June 13, 2020. An online questionnaire, including 57 questions, was sent to physicians. Results: A total of 148 (26%) physicians out of 564 participants had used hydroxychloroquine for prevention. Older physicians and those with a history of exposure to COVID-19 patients without protection used prophylactic HQN more frequently. The use of HQN did not differ statistically in terms of being infected among the exposed physicians (p=0.52). Nineteen (13%) physicians using HQN developed side effects related to the drug. Diarrhea and nausea were the most common. Conclusion: Prophylactic HQN use was more common among physicians older than 40 years and with higher exposure rates to a COVID-19 patient without protection. The physicians working on the front line had the highest rate of infection. HQN was not effective in the prophylaxis of COVID-19 among the exposed physicians.
Conflict of Interest: The authors declare no conflict of interest. Financial Disclosure: The authors declared that this study has received no financial support.
References
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Skipper, Pastick, Engen, Bangdiwala, Abassi et al., Hydroxychloroquine in nonhospitalized adults with early COVID-19: a randomized trial, Ann Intern Med, doi:10.7326/M20-4207
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Zengin, Sarıkaya, Karadağ, Çuhadaroğlu, Ergönül et al., Adverse cardiac events related to hydroxychloroquine prophylaxis and treatment of COVID-19, Infect Dis Clin Microbiol, doi:10.36519/idcm.2020.0012
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