Hydroxychloroquine: does prophylaxis work?

Authors

  • Atul Jha 151 Base Hospital, Guwahati, Assam, India
  • Manish Bhartiya 151 Base Hospital, Guwahati, Assam, India
  • Vijay R. Kumar 151 Base Hospital, Guwahati, Assam, India
  • Vimal Upreti 151 Base Hospital, Guwahati, Assam, India
  • Parag Deshmukh 151 Base Hospital, Guwahati, Assam, India
  • Mayank Dudani 151 Base Hospital, Guwahati, Assam, India
  • Arjun Chandru 151 Base Hospital, Guwahati, Assam, India
  • Dharambir Singh 151 Base Hospital, Guwahati, Assam, India

DOI:

https://doi.org/10.18203/2394-6040.ijcmph20214569

Keywords:

SARS-CoV-2, Hydroxychloroquine, Prophylaxis

Abstract

Background: Healthcare workers are front line workers in management of SARS-CoV-2 pandemic. The higher risk of acquiring the infection due to increased contact and exposures has prompted multiple risk mitigation strategies. To assess the role of hydroxychloroquine pre-exposure prophylaxis in prevention of SARS-CoV-2 infection amongst HCWs.

Methods: This retrospective cohort study assessed the effect of HCQS prophylaxis amongst HCWs in a tertiary care hospital in the north-eastern part of India. All HCWs, involved in management of SARS-CoV-2 were enrolled. The subjects were retrospectively divided in two groups on HCQ prophylaxis. Group I (51.8%, n=116) taking HCQ prophylaxis and group II (48.2%, n=108) not taking the prophylaxis. The demographic characteristics, use of PPE, HCQ prophylaxis and side effect profile were noted.

Results: Of the whole cohort, 22.8% (n=51) subjects tested positive. In group I (n=116), 24 subjects (20.7%) tested positive, whereas in Group II (n=108), 27 subjects (25.0%) tested positive. Further analysis of the incidence of SARS-CoV-2 infection amongst the two groups demonstrated that the although the rate of infection was lower (20.7% vs 25%) in Group I as compared to group II [X2 (1, N=224)=0.371, p=0.5] but it was statistically insignificant.

Conclusions: Our study involving HCWs, does not show a statistically significant reduction in the incidence of infection with pre-exposure prophylaxis. Based on our findings and published literature, a prophylaxis of HCQS against the SARS-CoV-2 infection cannot be recommended.

References

Zhu H, Wei L, Niu P. The novel coronavirus outbreak in Wuhan, China. Global Health Res Policy. 2020; 5(6):1-3.

COVID-19 information. Available at: https://www. mohfw.gov.in. Accessed on 10 October 2020.

Nguyen LH, Drew DA, Graham MS. Risk of COVID-19 among front-line health-care workers and the general community: a prospective cohort study. Lancet. 2020;5:e475-83.

Mehta Y, Chaudhry D, Abraham OC. Critical Care for COVID-19 Affected Patients: Position Statement of the Indian Society of Critical Care Medicine. Indian J Crit Care Med. 2020;24 (4):222-41.

Yao X, Ye F, Zhang M. In vitro antiviral activity and projection of optimized dosing design of hydroxychloroquine for the treatment of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Clin Inf Dis. 2020;71:732-9.

Gautret P, Lagier JC, Parola P. Hydroxychloroquine and azithromycin as a treatment of COVID-19: results of an open-label non-randomized clinical trial. Int J Antimicrob Agents. 2020;56:01-06.

Sarma P, Kaur H, Kumar H, Mahendru D, Avti P, Bhattacharyya A. Virological and clinical cure in COVID-19 patients treated with hydroxychloroquine: A systematic review and meta-analysis. J Med Virol. 2020;1-10.

Boulware DR, Pullen MF, Bangdiwala AS et al. A randomized trial of hydroxychloroquine as postexposure prophylaxis for Covid-19. N Engl J Med. 2020;383(6):517-25.

Recommendation on the use of hydroxy-chloroquine as prophylaxis for SARS-CoV-2 infection. Available at:https://icmr.nic.in/sites/default/files/upload_documents/HCQ_Recommendation_22March_final_MM_V2.pdf. Accessed on 22 May 2020.

Interim guidelines for collecting, handling, and testing clinical specimens from persons for coronavirus disease 2019 (COVID-19). Available at: https://www. cdc.gov/coronavirus/2019-nCoV/lab/guidelines-clinical-specimens.html. Accessed on 15 June 2020

Rocklöv J, Sjödin H, Wilder-Smith A. COVID-19 outbreak on the Diamond Princess cruise ship: estimating the epidemic potential and effectiveness of public health countermeasures. J Travel Med. 2020; 27(3):1-7.

Common Toxicity criteria. Available at: https:// ctep.cancer.gov/protocolDevelopment/electronic_applications/ctc.htm. Accessed on 15 Jun 2020.

Abella B, Jolkovsky EL, Biney BT. Efficacy and safety of hydroxychloroquine vs placebo for pre-exposure SARS-CoV-2 prophylaxis among health care workers. A randomized clinical trial. JAMA Intern Med. 2020;24:45-9.

Downloads

Published

2021-11-24

How to Cite

Jha, A., Bhartiya, M., Kumar, V. R., Upreti, V., Deshmukh, P., Dudani, M., Chandru, A., & Singh, D. (2021). Hydroxychloroquine: does prophylaxis work?. International Journal Of Community Medicine And Public Health, 8(12), 5805–5809. https://doi.org/10.18203/2394-6040.ijcmph20214569

Issue

Section

Original Research Articles