Revised advisory on the use of Hydroxychloroquine (HCQ) as prophylaxis for SARS-CoV-2 infection
ICMR, Indian Council of Medical Research (News)
ICMR, Revised advisory on the use of Hydroxychloroquine (HCQ) as prophylaxis for SARS-CoV-2 infection, , Indian Council of Medical Research (News)
Healthcare workers on HCQ prophylaxis less likely to get COVID. Significant dose-response relationship. Extends recommended HCQ prophylaxis to asymptomatic household contacts of cases and frontline workers. Degree of benefit not quantified.
ICMR et al., 22 May 2020, preprint, 1 author.
Abstract: भारतीय आयुर्विज्ञान अनुसंधान पर्रषद
स्वास््य अनुसंधान र्वभाग, स्वास््य और पर्रवार
कल्याण मंत्रालय, भारत सरकार
Revised advisory on the use of Hydroxychloroquine (HCQ) as prophylaxis for
SARS-CoV-2 infection (in supersession of previous advisory dated 23rd
The Joint Monitoring Group under the Chairmanship of DGHS and including representatives
from AIIMS, ICMR, NCDC, NDMA, WHO and experts drawn from Central Government
hospitals reviewed the prophylactic use of Hydroxychloroquine (HCQ) in the context of
expanding it to healthcare and other front line workers deployed in non-COVID and COVID
The National Task force (NTF) for COVID-19 constituted by Indian Council of Medical
Research also reviewed the use of HCQ for prophylaxis of SARS-CoV-2 infection for high risk
population based on the emerging evidence on its safety and efficacy. The NTF reviewed the
data on in-vitro testing of HCQ for antiviral efficacy against SARS-CoV-2, safety profile of
HCQ reported to the pharmacovigilance program of India, and data on the use of HCQ for the
prophylaxis of SARS-CoV-2 infection among health care workers (HCWs) and reported its
findings as detailed below:
At NIV, Pune, the report of the in-vitro testing of HCQ for antiviral efficacy showed reduction of
infectivity /log reduction in viral RNA copy of SARs-CoV2.
Safety Profile of HCQ
The data on assessment of HCQ prophylaxis among 1323 HCWs indicated mild adverse effects
such as nausea (8.9%), abdominal pain (7.3%), vomiting (1.5%), hypoglycemia (1.7%) and
cardio-vascular effects (1.9%).However, as per the data from the Pharmacovigilance program of
India, there have been 214 reported instances of adverse drug reactions associated with
prophylactic HCQ use. Of these, 7 were serious individual case safety reports with prolongation
of QT interval on ECG in 3 cases.
Studies on prophylaxis of SARS-CoV-2 infection
A retrospective case-control analysis at ICMR has found that there is a significant doseresponse relationship between the number of prophylactic doses taken and frequency of
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occurrence of SARS-CoV-2 infection in symptomatic healthcare workers who were tested
for SARS-CoV-2 infection.
Another investigation from 3 central government hospitals in New Delhi indicates that
amongst healthcare workers involved in COVID-19 care, those on HCQ prophylaxis were
less likely to develop SARS-CoV-2 infection, compared to those who were not on it. The
benefit was less pronounced in healthcare workers caring for a general patient population.
An observational prospective study of 334 healthcare workers at AIIMS, out of which 248
took HCQ prophylaxis (median 6 weeks of follow up) in New Delhi also showed that those
taking HCQ prophylaxis had lower incidence of SARS-CoV-2 infection than those not taking
Eligibility criteria for HCQ prophylaxis
oV2infection.pdf), provided placing the high risk population (asymptomatic Healthcare Workers
involved in the care of suspected or confirmed cases of COVID-19 and asymptomatic household
contacts of laboratory confirmed cases of COVID-19) under chemoprophylaxis with HCQ.
In light of all of the above, the Joint Monitoring Group and NTF have now recommended the
prophylactic use of HCQ in the following..
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