Hydroxychloroquine Pre-Exposure Prophylaxis for COVID-19 in Healthcare Workers from India: A Meta-Analysis
Stricker et al.,
Hydroxychloroquine Pre-Exposure Prophylaxis for COVID-19 in Healthcare Workers from India: A Meta-Analysis,
Journal of Infection and Public Health, doi:10.1016/j.jiph.2021.08.001 (meta analysis)
Meta analysis of 11 HCQ PrEP studies in India covering 7,616 healthcare workers, showing significantly lower cases with treatment.
Currently there are
90 HCQ pre-exposure prophylaxis studies and meta analysis shows:
risk of death, 75.0% lower, RR 0.25, p < 0.001, treatment 1,273, control 4,127, >=6 doses.
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risk of death, 44.0% lower, RR 0.56, p = 0.004, treatment 3,489, control 4,127, any number of doses.
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Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
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Stricker et al., 5 Aug 2021, peer-reviewed, 2 authors.
Abstract: Journal Pre-proof
Hydroxychloroquine Pre-Exposure Prophylaxis for COVID-19 in
Healthcare Workers from India: A Meta-Analysis
Raphael B. Stricker, Melissa C. Fesler
PII:
S1876-0341(21)00219-7
DOI:
https://doi.org/10.1016/j.jiph.2021.08.001
Reference:
JIPH 1661
To appear in:
Journal of Infection and Public Health
Received Date:
25 March 2021
Revised Date:
12 July 2021
Accepted Date:
1 August 2021
Please cite this article as: Stricker RB, Fesler MC, Hydroxychloroquine Pre-Exposure
Prophylaxis for COVID-19 in Healthcare Workers from India: A Meta-Analysis, Journal of
Infection and Public Health (2021), doi: https://doi.org/10.1016/j.jiph.2021.08.001
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© 2020 Published by Elsevier.
Hydroxychloroquine Pre-Exposure Prophylaxis for COVID-19 in Healthcare
Workers from India: A Meta-Analysis.
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Square Medical Associates, San Francisco, CA, USA.
Correspondence:
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1Union
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Raphael B. Stricker, MD,1 and Melissa C. Fesler, FNP-BC.1
Raphael B Stricker
Union Square Medical Associates
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450 Sutter Street, Suite 1504
San Francisco, CA 94108, USA
Tel +1 415-399-1035
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Email rstricker@usmamed.com
Key Words: COVID-19; SARS-CoV-2; Pre-exposure prophylaxis; Hydroxychloroquine;
Vaccine
Word count: 435
Running Title: Hydroxychloroquine PrEP Meta-Analysis
To date, the COVID-19 pandemic has resulted in more than 180 million cases of SARS-CoV-2
infection and more than four million deaths world-wide.1 Although novel COVID-19 vaccines
have become clinically available, the safety and efficacy of these vaccines remains open to
question.2 Alternate approaches to prevention of disease have received little attention, and one
medication, hydroxychloroquine (HCQ), has been attacked and dismissed based on flawed
studies and political controversy that obscured the value of this treatment as pre-exposure
prophylaxis (PrEP) for SARS-CoV-2 infection.
of
A British study of 120,075 healthcare workers (HCWs) found that these subjects had a 7-8 fold
greater risk of developing severe COVID-19 compared to non-HCWs.3 With this background,
ro
the Indian Council of Medical Research (ICMR) National Taskforce for COVID-19 formulated
guidelines for weekly HCQ PrEP in high-risk HCWs.4 We used internet search engines to
-p
identify 11 cohort studies of weekly HCQ PrEP in HCWs from India based on the ICMR
protocol.5-15 These case-control studies enrolled a total of 7,616 high-risk HCWs who were
re
tested for SARS-CoV-2 infection as an endpoint after varying lengths of time following weekly
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HCQ PrEP or no treatment.
We have performed a preliminary meta-analysis of these studies, as shown in Table 1. In the 11
studies that included HCWs who used any HCQ PrEP, the infection rate was significantly
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na
decreased (RR 0.56, p=0.0040). In the five studies that included HCWs who took at least six
doses of weekly HCQ PrEP, the infection rate was reduced even further (RR 0.25,..
Please send us corrections, updates, or comments. Vaccines and
treatments are complementary. All practical, effective, and safe means should
be used based on risk/benefit analysis. No treatment, vaccine, or intervention
is 100% available and effective for all current and future variants. We do not
provide medical advice. Before taking any medication, consult a qualified
physician who can provide personalized advice and details of risks and
benefits based on your medical history and situation.
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