Hydroxychloroquine/chloroquine prophylaxis among health-care workers: Was it really preventive? – Evidence from a multicentric cross-sectional study
Yadav et al.,
Hydroxychloroquine/chloroquine prophylaxis among health-care workers: Was it really preventive? – Evidence..,
Indian Journal of Community Medicine, doi:10.4103/ijcm.ijcm_684_21
Retrospective 2,224 healthcare workers in India, showing lower risk of seropositivity with HCQ prophylaxis, without statistical significance.
risk of seropositive, 20.0% lower, OR 0.80, p = 0.10, treatment 1,255, control 969, adjusted per study, multivariable, RR approximated with OR.
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Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
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Yadav et al., 11 Jul 2022, retrospective, India, peer-reviewed, mean age 34.1, 3 authors, study period 21 August, 2020 - 20 November, 2020.
Contact:
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Abstract: Original Article
Hydroxychloroquine/Chloroquine Prophylaxis among
Health‑care Workers: Was it Really Preventive? – Evidence
from a Multicentric Cross‑sectional Study
Arun Kumar Yadav, Atul Kotwal1, Subhadeep Ghosh2
Department of Community Medicine, Armed Forces Medical College, Pune Maharashtra, 1Executive Director, NHSRC, 2Department of Community Medicine, ACMS,
New Delhi, India
Abstract
Background: Despite the low level of clinical evidence in hydroxychloroquine (HCQ) favor, it was prescribed for pre‑ and post‑exposure
prophylaxis in India and worldwide. In absence of a large randomized control trial, the evidence needs to be generated through observation
study, hence the study was conducted to find the evidence for prophylaxis of HCQ. Materials and Methods: A multi‑centric cross‑sectional
study involving government hospitals was chosen for serosurvey conducted from August 21, 2020, to November 20, 2020. Questionnaire was
adopted from WHO. Data about chloroquine (CQ) use among health‑care workers (HCWs) were added and the duration of CQ intake was also
noted. Results: A total of 2,224 HCWs were recruited. The mean duration of time of taking HCQ was 7.1 weeks (standard deviation ± 6.1 weeks,
median = 4 weeks with IQR, 3–10 weeks). Training on personal protective equipment (PPE), knowledge of handwashing, direct care to the
patient, availability of alcohol hand rub, close contact with the patient, duration of contact, and usage of PPE were associated with HCQ intake.
The antibody formation in group taking HCQ was 16.9% compared to 19.8% not taking it (P = 0.08). The Chi‑square for linear trend for weeks
of HCQ intake and antibody formation. However, the same was not statistically significant (Chi‑square = 3.61, P = 0.06). Conclusion: Our
study did not find a statistically significant association in the large multicentric study. The absolute difference of 2.9% in the two groups may
not be sufficient to warrant its widespread use for prophylaxis.
Keywords: Chemo‑prophylaxis, COVID‑19, hydroxychloroquine
Hydroxychloroquine (HCQ), the widely used drug for
rheumatologic conditions, attracted widespread interest
for the prevention of severe acute respiratory syndrome
coronavirus‑2 (SARS‑CoV‑2) infection. Despite a low level
of clinical evidence in its favor, the necessity of coronavirus
disease (COVID‑19) pandemic, saw it being officially
prescribed for pre‑ and post‑exposure prophylaxis in India
as well as worldwide. The in‑vitro, as well as observational
studies, provided scant evidence regarding the effectiveness
of HCQ in the prophylaxis of SARS‑CoV‑2 infection.[1,2] An
observational study in South Korea at the beginning of the
pandemic, using postexposure prophylaxis with HCQ after
a large COVID‑19 exposure event in a hospital, showed all
follow‑up PCR tests as negative.[3]
The Indian National Task Force for COVID‑19 on
March 22, 2020, recommended HCQ on the basis of
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DOI:
10.4103/ijcm.ijcm_684_21
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in vitro and preclinical data for prophylaxis of health‑care
workers (HCWs) and household contacts with caution and
strict advisory for extensive reporting of adverse reactions.[4,5]
A systematic review showed the prophylactic effects
of chloroquine (CQ) and HCQ against SARS‑CoV‑2. [6]
Although preclinical results were promising, to date there is
a dearth of evidence to support the efficacy of CQ or HCQ
in preventing COVID‑19. Considering potential safety..
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