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Safety and Tolerability of Hydroxychloroquine in healthcare workers and first responders for the prevention of COVID-19: WHIP COVID-19 Study

McKinnon et al., International Journal of Infectious Diseases, doi:10.1016/j.ijid.2021.12.343, WHIP COVID-19, NCT04341441
Dec 2021  
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Symp. case 2% Improvement Relative Risk Symp. case (b) 0% Symp. case (c) 5% Symp. case (d) 53% Case 51% Case (b) 50% Case (c) 52% Case (d) 70% HCQ  WHIP COVID-19  Prophylaxis  DB RCT Is pre-exposure prophylaxis with HCQ beneficial for COVID-19? Double-blind RCT 543 patients in the USA (April - December 2020) Trial underpowered to detect differences c19hcq.org McKinnon et al., Int. J. Infectious Di.., Dec 2021 FavorsHCQ Favorscontrol 0 0.5 1 1.5 2+
HCQ for COVID-19
1st treatment shown to reduce risk in March 2020, now with p < 0.00000000001 from 419 studies, recognized in 46 countries.
No treatment is 100% effective. Protocols combine treatments.
5,100+ studies for 109 treatments. c19hcq.org
HCQ prophylaxis RCT with 201 weekly HCQ patients, 197 daily HCQ patients, and 200 control patients, concluding the prophylaxis is safe. There were no grade 3 or 4 AEs, SAEs, ER visits, or hospitalizations. There was only 4 confirmed cases, 2 in the placebo arm and one in each HCQ arm. 60% of patients had exposure at baseline.
HCQ 400mg weekly or HCQ 200mg daily after a loading dose of 400mg on day 1.
risk of symptomatic case, 2.5% lower, RR 0.98, p = 1.00, treatment 2 of 365 (0.5%), control 1 of 178 (0.6%), NNT 7219, daily and weekly HCQ combined.
risk of symptomatic case, no change, RR 1.00, p = 1.00, treatment 1 of 178 (0.6%), control 1 of 178 (0.6%), daily HCQ.
risk of symptomatic case, 4.8% lower, RR 0.95, p = 1.00, treatment 1 of 187 (0.5%), control 1 of 178 (0.6%), NNT 3698, weekly HCQ.
risk of symptomatic case, 53.3% lower, RR 0.47, p = 1.00, treatment 0 of 25 (0.0%), control 1 of 178 (0.6%), NNT 178, relative risk is not 0 because of continuity correction due to zero events (with reciprocal of the contrasting arm), AD patients.
risk of case, 51.2% lower, RR 0.49, p = 0.60, treatment 2 of 365 (0.5%), control 2 of 178 (1.1%), NNT 174, daily and weekly HCQ combined.
risk of case, 50.0% lower, RR 0.50, p = 1.00, treatment 1 of 178 (0.6%), control 2 of 178 (1.1%), NNT 178, daily HCQ.
risk of case, 52.4% lower, RR 0.48, p = 0.61, treatment 1 of 187 (0.5%), control 2 of 178 (1.1%), NNT 170, weekly HCQ.
risk of case, 69.5% lower, RR 0.30, p = 1.00, treatment 0 of 25 (0.0%), control 2 of 178 (1.1%), NNT 89, relative risk is not 0 because of continuity correction due to zero events (with reciprocal of the contrasting arm), AD patients.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
McKinnon et al., 23 Dec 2021, Double Blind Randomized Controlled Trial, USA, peer-reviewed, 10 authors, study period 7 April, 2020 - 15 December, 2020, trial NCT04341441 (history) (WHIP COVID-19).
This PaperHCQAll
Safety and tolerability of hydroxychloroquine in health care workers and first responders for the prevention of COVID-19: WHIP COVID-19 Study
MD, MSc John E Mckinnon, Dee Dee Wang, Marcus Zervos, Matt Saval, Laurie Marshall-Nightengale, Paul Kilgore, Pardeep Pabla, Ed Szandzik, Kathleen Maksimowicz-Mckinnon, Safety William W O'neill
International Journal of Infectious Diseases, doi:10.1016/j.ijid.2021.12.343
This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.
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