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0 0.5 1 1.5 2+ Symp. case 51% primary Improvement Relative Risk Case 27% HCQ  EPICOS  Prophylaxis  DB RCT Is pre-exposure prophylaxis with HCQ beneficial for COVID-19? Double-blind RCT 435 patients in Spain (April 2020 - July 2021) Fewer cases with HCQ (not stat. sig., p=0.31) Polo et al., Clinical Microbiology and.., Aug 2022 Favors HCQ Favors control

Daily tenofovir disoproxil fumarate/emtricitabine and hydroxychloroquine for pre-exposure prophylaxis of COVID-19: a double-blind placebo controlled randomized trial in healthcare workers

Polo et al., Clinical Microbiology and Infection, doi:10.1016/j.cmi.2022.07.006, EPICOS, NCT04334928
Aug 2022  
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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.
Early terminated healthcare worker prophylaxis RCT in Spain, showing lower risk of symptomatic cases with HCQ prophylaxis, without statistical significance due to the small number of events.
risk of symptomatic case, 51.0% lower, RR 0.49, p = 0.79, treatment 3 of 224 (1.3%), control 5 of 211 (2.4%), NNT 97, Kaplan–Meier, primary outcome.
risk of case, 27.0% lower, RR 0.73, p = 0.31, treatment 21 of 224 (9.4%), control 23 of 211 (10.9%), Kaplan–Meier.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Polo et al., 5 Aug 2022, Double Blind Randomized Controlled Trial, placebo-controlled, Spain, peer-reviewed, median age 38.0, 189 authors, study period 15 April, 2020 - 11 July, 2021, trial NCT04334928 (history) (EPICOS). Contact:
This PaperHCQAll
Daily tenofovir disoproxil fumarate/emtricitabine and hydroxychloroquine for pre-exposure prophylaxis of COVID-19: a double-blind placebo-controlled randomized trial in healthcare workers
Rosa Polo, Xabier García-Albéniz, Carolina Terán, Miguel Morales, David Rial-Crestelo, M Angeles Garcinuño, Miguel García Del Toro, César Hita, Juan Luis Gómez-Sirvent, Luis Buzón, Alberto Díaz De Santiago, Jose Pérez Arellano, Jesus Sanz, Pablo Bachiller, Elisa Martínez Alfaro, Vicente Díaz-Brito, Mar Masiá, Alicia Hernández-Torres, Jose M Guerra, Jesús Santos, Piedad Arazo, Leopoldo Muñoz, Jose Ramon Arribas, Pablo Martínez De Salazar, Santiago Moreno, Miguel A Hernán, Julia Del Amo, Julia Del Amo, Rosa Polo, Santiago Moreno, Juan Berenguer, Esteban Martínez, Miguel A Hernán, Pablo Martínez De Salazar, Xabier García De Albéniz
Clinical Microbiology and Infection, doi:10.1016/j.cmi.2022.07.006
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.
Abella, Jolkovsky, Biney, Uspal, Hyman et al., Efficacy and Safety of Hydroxychloroquine vs Placebo for Pre-exposure SARS-CoV-2
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Causalab, Chan, School of Public Health
Chien, Anderson, Jockusch, Tao, Li et al., Nucleotide Analogues as Inhibitors of SARS-CoV-2 Polymerase, a Key Drug Target for COVID
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García-Albéniz, Amo, Polo, Morales-Asencio, Hernán et al., Hydroxychloroquine for pre-exposure prophylaxis of COVID-19 in health care workers: a randomized, multicenter, placebo-controlled trial (HERO-HCQ), European Journal of Epidemiology
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