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Hydroxychloroquine Pre-Exposure Prophylaxis for COVID-19 in Healthcare Workers from India: A Meta-Analysis

Stricker et al., Journal of Infection and Public Health, doi:10.1016/j.jiph.2021.08.001
Aug 2021  
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Mortality 75% Improvement Relative Risk Mortality (b) 44% HCQ for COVID-19  Stricker et al.  META ANALYSIS c19hcq.org 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 417 studies, recognized in 46 countries.
No treatment is 100% effective. Protocols combine treatments. * >10% efficacy, ≥3 studies.
4,800+ studies for 102 treatments. c19hcq.org
Meta analysis of 11 HCQ PrEP studies in India covering 7,616 healthcare workers, showing significantly lower cases with treatment.
9 meta analyses show significant improvements with hydroxychloroquine for mortality1-4, hospitalization1, recovery5, combined death/hospitalization/cases6, cases7,8, and viral clearance9.
Currently there are 108 HCQ for COVID-19 pre-exposure prophylaxis studies, showing 31% lower mortality [15‑44%] and 29% fewer cases [21‑36%].
risk of death, 75.0% lower, RR 0.25, p < 0.001, treatment 1,273, control 4,127, >=6 doses.
risk of death, 44.0% lower, RR 0.56, p = 0.004, treatment 3,489, control 4,127, any number of doses.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Stricker et al., 5 Aug 2021, peer-reviewed, 2 authors.
This PaperHCQAll
Hydroxychloroquine Pre-Exposure Prophylaxis for COVID-19 in Healthcare Workers from India: A Meta-Analysis
MD Raphael B Stricker, Melissa C Fesler
Journal of Infection and Public Health, doi:10.1016/j.jiph.2021.08.001
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.
Conflicts of Interest and Funding The authors have no conflicts of interest to declare. There was no funding for the study.
References
Badyal, Chandy, Chugh, Hydroxychloroquine for SARS CoV2 prophylaxis in healthcare workers -A multicentric cohort study assessing effectiveness and safety, J Assoc Physicians India
Behera, Patro, Singh, Chandanshive, Pradhan, Role of ivermectin in the prevention of SARS-CoV-2 infection among healthcare workers in India: A matched case-control study, PLoS ONE, doi:10.1371/journal.pone.0247163
Bhattacharya, Chowdhury, Mukherjee, Pre exposure hydroxychloroquine use is associated with reduced COVID19 risk in healthcare workers, MedRxiv, doi:10.1101/2020.06.09.2011680640
Chatterjee, Anand, Singh, Healthcare workers and SARS-CoV-2 infection in India: a case-control investigation in the time of COVID-19, Indian J Med Res, doi:10.4103/ijmr.IJMR_2234_2039
Datta, Ghosal, Sinha, No role of HCQ in COVID-19 prophylaxis: A survey amongst Indian doctors, J Vaccines Vaccin
Dev, Meena, Gupta, Gupta, Sankar, Risk factors and frequency of COVID-19 among healthcare workers at a tertiary care centre in India: a case-control study, Trans Royal Soc Trop Med Hyg, doi:10.1093/trstmh/trab047
Goenka, Afzalpurkar, Goenka, Seroprevalence of COVID-19 amongst health care workers in a tertiary care hospital of a metropolitan city from India, J Assoc Physicians India
Haynes, Corey, Fernandes, Prospects for a safe COVID-19 vaccine, Sci Transl Med, doi:https://doi.org.10.1126/scitranslmed.abe0948
J O U R N A L P R E, -p r o o f, doi:10.1371/journal.pone.0247163
Kadnur, Aggarwal, Soneja, Hydroxychloroquine pre-exposure prophylaxis for COVID-19 among healthcare workers: Initial experience from India, Lancet Preprints, doi:10.2139/ssrn.3622350
Khurana, Kaushal, Gupta, Verma, Sharma et al., Prevalence and clinical correlates of COVID-19 outbreak among health care workers in a tertiary level hospital in Delhi, Am J Infect Dis, doi:10.3844/ajidsp.2021.107.119
Lofgren, Nicol, Bangdiwala, Safety of hydroxychloroquine among outpatient clinical trial participants for COVID-19, Open Forum Infect Dis
Mathai, Behera, Hande, Hydroxychloroquine as pre-exposure prophylaxis against COVID-19 in health-care workers: A single-center experience, J Mar Med Soc, doi:10.4103/jmms.jmms_115_20
Mutambudzi, Niedwiedz, Macdonald, Occupation and risk of severe COVID-19: prospective cohort study of 120 075 UK Biobank participants, Occup Environ Med, doi:https://doi.org.10.1136/oemed-2020-106731
Sogut, Can, Guven, Safety and efficacy of hydroxychloroquine in 152 outpatients with confirmed COVID-19: A pilot observational study, Am J Emerg Med
Stricker, Fesler, Flattening the risk: Pre-exposure prophylaxis for COVID-19, Infect Drug Resist
Yadav, Pate, Shankarkumar, Sero-survey for health-care workers provides corroborative evidence for the effectiveness of Hydroxychloroquine prophylaxis against J o u r n a l P r e -p r o o f COVID-19 infection, J Epidemiol Global Health, doi:https://doi.org.10.1136/oemed-2020-106731
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