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0 0.5 1 1.5 2+ Seropositive 20% Improvement Relative Risk HCQ for COVID-19  Yadav et al.  Prophylaxis Is pre-exposure prophylaxis with HCQ beneficial for COVID-19? Retrospective 2,224 patients in India (August - November 2020) Lower seropositivity with HCQ (not stat. sig., p=0.1) c19hcq.org Yadav et al., Indian J. Community Medi.., Jul 2022 Favors HCQ Favors control

Hydroxychloroquine/chloroquine prophylaxis among health-care workers: Was it really preventive? – Evidence from a multicentric cross-sectional study

Yadav et al., Indian Journal of Community Medicine, doi:10.4103/ijcm.ijcm_684_21
Jul 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. c19hcq.org
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.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
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: arunyadavpsm@gmail.com.
This PaperHCQAll
Hydroxychloroquine/chloroquine prophylaxis among health-care workers: Was it really preventive? – Evidence from a multicentric cross-sectional study
Arunkumar Yadav, Atul Kotwal, Subhadeep Ghosh
Indian Journal of Community Medicine, doi:10.4103/ijcm.ijcm_684_21
Original Article 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 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 issues and the likelihood of imparting a false sense of security it was 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..
Conflicts of interest There are no conflicts of interest.
References
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Baicus, Pinte, Stoichitoiu, Badea, Hydroxychloroquine for prophylaxis of COVID-19 physicians survey: Despite lack of evidence, many would take or give to dear ones, and despite the perceived necessity of an RCT, few would participate, J Eval Clin Pract
Bhattacharya, Chowdhury, Mukherjee, Kulshrestha, Ghosh et al., Pre exposure hydroxychloroquine prophylaxis for COVID-19 in healthcare workers: A retrospective cohort, medRxiv, doi:10.1101/2020.06.09.20116806
Boulware, Pullen, Bangdiwala, Pastick, Lofgren et al., A Randomized trial of hydroxychloroquine as postexposure prophylaxis for COVID-19, N Engl J Med
Chatterjee, Anand, Singh, Rasaily, Singh et al., Healthcare workers & SARS-CoV-2 infection in India: A case-control investigation in the time of COVID-19, Indian J Med Res
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Lee, Son, Peck, Can post-exposure prophylaxis for COVID-19 be considered as an outbreak response strategy in long-term care hospitals?, Int J Antimicrob Agents
Liu, Cao, Xu, Wang, Zhang et al., Hydroxychloroquine, a less toxic derivative of chloroquine, is effective in inhibiting SARS-CoV-2 infection in vitro, Cell Discov
Meo, Klonoff, Akram, Efficacy of chloroquine and hydroxychloroquine in the treatment of COVID-19, Eur Rev Med Pharmacol Sci
Nagaraja, Ramesh, Dhar, Mondal, Dey et al., HyPE study: Hydroxychloroquine prophylaxis-related adverse events' analysis among healthcare workers during COVID-19 pandemic: A rising public health concern, J Public Health Oxf Engl
Rajasingham, Bangdiwala, Nicol, Skipper, Pastick et al., Hydroxychloroquine as Pre-exposure Prophylaxis for Coronavirus Disease 2019 (COVID-19) in Healthcare Workers: A Randomized Trial, Clin Infect Dis, doi:10.1093/cid/ciaa1571
Shah, Das, Jain, Misra, Negi, A systematic review of the prophylactic role of chloroquine and hydroxychloroquine in coronavirus disease-19 (COVID-19), Int J Rheum Dis
Singh, Ryan, Kredo, Chaplin, Fletcher, Chloroquine or hydroxychloroquine for prevention and treatment of COVID-19, Cochrane Database Syst Rev
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