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0 0.5 1 1.5 2+ Case -88% Improvement Relative Risk Case (b) 8% HCQ for COVID-19  Shahrin et al.  Prophylaxis Is pre-exposure prophylaxis with HCQ beneficial for COVID-19? Retrospective 336 patients in Bangladesh (March - July 2020) More cases with HCQ (not stat. sig., p=0.088) Shahrin et al., Life, December 2022 Favors HCQ Favors control

Hospital-Based Quasi-Experimental Study on Hydroxychloroquine Pre-Exposure Prophylaxis for COVID-19 in Healthcare Providers with Its Potential Side-Effects

Shahrin et al., Life, doi:10.3390/life12122047
Dec 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 422 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.
4,000+ studies for 60+ treatments.
Retrospective 230 low risk healthcare workers taking HCQ prophylaxis, and 106 that declined, showing higher cases without statistical significance. No case severity information is provided. The point estimate favored HCQ when excluding the first 14 days and including participants that worked for at least 16 days. Authors note a significant dose response relationship.
risk of case, 87.8% higher, RR 1.88, p = 0.09, treatment 43 of 230 (18.7%), control 11 of 106 (10.4%), adjusted per study, odds ratio converted to relative risk, multivariable.
risk of case, 8.0% lower, OR 0.92, p = 0.89, adjusted per study, excluding the first 14 days and including participants that worked for at least 16 days, multivariable, RR approximated with OR.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Shahrin et al., 7 Dec 2022, retrospective, Bangladesh, peer-reviewed, median age 34.0, 11 authors, study period 31 March, 2020 - 12 July, 2020. Contact: (corresponding author).
This PaperHCQAll
Hospital-Based Quasi-Experimental Study on Hydroxychloroquine Pre-Exposure Prophylaxis for COVID-19 in Healthcare Providers with Its Potential Side-Effects
Lubaba Shahrin, Mustafa Mahfuz, Md. Waliur Rahman, Md. Rezaul Hossain, Afsana Mim Khandaker, Md Md. Ashraful Alam, Din M M F Osmany, Md Md. Munirul Islam, Mohammod Jobayer Chisti, Chaudhury Meshkat Ahmed, Tahmeed Ahmed
Life, doi:10.3390/life12122047
Considering that it has been more than 24 months since SARS-CoV-2 emerged, it is crucial to identify measures that prevent and control pathogen transmission in workplace settings. Our aim was to report results of a hospital-based program that delivered hydroxychloroquine (HCQ) tablets as COVID-19 prophylaxis to the frontline healthcare workers (HCW)s who cared for COVID-19 patients and to evaluate the efficacy of HCQ. Setting and participants: Quasi-experimental, controlled, single-center study. The included participants were doctors, nurses, health workers, cleaning staff, and non-healthcare supportive staff. The main outcome was contracting COVID-19 anytime during the period of taking the prophylaxis, confirmed by RT-PCR. A total of 336 participants, without any clinical evidence of COVID-19 and without any known contact with family members, were included in the trial; 230 were assigned to HCQ and 106 declined to take any drug. Results: Among the participants, 43 (18.7%) in the HCQ group and 11 (10.4%) participants in the control group developed COVID-19. For the evaluation of side effects, we evaluated 12-lead ECGs of both groups at the baseline and after 4 weeks to monitor QTc interval. A total of 91% (198 of 217) participants in the prophylaxis group and 92% (11 of 12) in the control group had a QTc < 45o msec, which is within normal limits. Conclusions: Although the number of symptomatic infections in health personnel was lower in the control group, the difference was not statistically significant. However, in the absence of any effective pre-exposure prophylaxis medicine for COVID-19, practicing proper infection prevention and control (IPC) and vaccination is the only way forward.
There are a few limitations of our study. The first limitation was that the participants did not have any baseline RT-PCR tests performed to confirm their COVID-19 status before beginning the prophylaxis. The second limitation was that the investigator had no control over the participants regarding practicing IPC properly at the workplace or elsewhere. Finally, as the trial was un-blinded, the control group might have taken extra precautions in practicing IPC measures than the prophylaxis group. Finally, as no pharmacological agents seems to be proved protective as a prophylaxis for COVID-19, we have to reinforce the infection prevention practice and vaccination [32, 33] , which are still considered as the best practice for the prevention of transmission of SARS-CoV-2. Supplementary Materials: The following supporting information can be downloaded at: https: //, Supplementary Table S1 : Decision on baseline ECG; Supplementary Table S2 : Tisdale risk factor assessment score; and Supplementary Table S3 : CONSORT checklist. Informed Consent Statement: Informed consent was obtained from all subjects involved in the study. Data Availability Statement: All data related with this research can be made available under institutional policy. For data access, requests should be made to, Head, Research Administration, icddr, b. Conflicts of Interest: The authors declare no conflict of interest.
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