Retrospective 3,074 patients with antimalarial prescriptions and 58,955 matched controls, showing no significant differences with antimalarial prophylaxis for PCR+ cases (99% HCQ). Authors provide only PCR+ and mortality outcomes, and do not provide intermediate clinical outcomes that may show a statistically significant benefit. Authors do not adjust for the very different baseline risk for systemic autoimmune disease patients. Other research shows that the risk of COVID-19 for systemic autoimmune disease patients is much higher overall, Ferri et al. show OR 4.42,
p<0.001
Ferri (for symptomatic disease).
Although the 31% lower mortality is not statistically significant, it is consistent with the significant 24% lower mortality
[19‑28%] from meta analysis of the
244 mortality results to date.
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risk of death, 30.6% lower, RR 0.69, p = 0.80, treatment 3 of 3,074 (0.1%), control 83 of 58,995 (0.1%), NNT 2320.
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risk of case, 5.9% higher, RR 1.06, p = 0.70, treatment 51 of 3,074 (1.7%), control 973 of 58,995 (1.6%), odds ratio converted to relative risk.
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Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
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Klebanov et al., 1 Jul 2023, retrospective, USA, peer-reviewed, 10 authors.
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Antimalarials are not Effective as Pre-Exposure Prophylaxis for COVID-19: A Retrospective Matched Control Study
MD Nikokai Klebanov, MD MBA Vartan Pahalyants, MD Jordan T Said, William. S Murphy, MD Nicholas Theodosakis, MA Joseph Scarry, Stacey Duey, DDS Monina Klevens, MD Evelyn Lilly, MD Yevgeniy R Semenov
Journal of Drugs in Dermatology, doi:10.36849/jdd.6593
exposure impact on SARS-CoV-2 risk is of great importance to the practicing dermatologist. We investigated the efficacy of antimalarial drugs as pre-exposure SARS-CoV-2 prophylaxis in a US tertiary-care center.
MATERIALS AND METHODS We included all adult patients with at least one prescription for chloroquine, hydroxychloroquine, or quinacrine from July 1, 2019 to February 29, 2020 (limiting prescriptions to those started before the pandemic onset) in the MassGeneral Brigham Enterprise Data Warehouse and Research Patient Data Registry. We exactmatched antimalarial-treated study patients with controls on age, sex, race, and Charleston Comorbidity Index. Additional collected variables included zip codes (used to estimate income using 2010 US Census), and medical history using ICD-9/ICD-10
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Hooijberg, Boekel, Vogelzang, Leeuw, Boers et al., Patients with rheumatic diseases adhere to COVID-19 isolation measures more strictly than the general population, Lancet Rheumatol
Kuderer, Choueiri, Shah, Shyr, Rubinstein et al., Clinical impact of COVID-19 on patients with cancer (CCC19): a cohort study, Lancet
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Schreiber, Sciascia, Bruce, Giles, Cuadrado et al., Hydroxychloroquine in patients with rheumatic diseases during the COVID-19 pandemic: a letter to clinicians, Lancet Rheumatol
