Preventive use of HCQ in frontline healthcare workers: ICMR study

A new study by the Indian Council of Medical research (ICMR), which examined the prophylactic role of Hydroxychloroquine (HCQ) to prevent SARS-nCOV2, found that the risk of healthcare workers (HCWs) contracting the infection was much lower if a sustained dose was taken along with use of personal protective equipment (PPE).

“Biologically, it appears plausible that HCQ prophylaxis, before onset of infection, may inhibit the virus from gaining a foothold,” stated ‘Healthcare workers & SARS-CoV-2 infection in India: A case-control investigation in the time of COVID-19’, a study published recently in the Indian Journal of Medical Research.

Healthcare workers are at an elevated risk of contracting COVID-19 and the study findings come close on the heels of the revised guidelines which recommend the use of hydroxychloroquine as a preventive medication for asymptomatic health care workers working in non-Covid-19 hospitals, frontline staff on surveillance duty in containment zones and paramilitary/police personnel involved in related actitivies.

While ICMR has cautioned that the intake of the medicine should not instill a sense of false security, the study, whose main emphasis was on the prevention of infection among HCWs, has said simply initiating HCQ prophylaxis did not reduce the odds of acquiring SARS-CoV-2 infection among HCWs.

“However, with the intake of four or more maintenance doses of HCQ, the protective effect started emerging,” Dr Samiran Panda, director of ICMR- National AIDS Research Institute (NARI) and one of the study authors, told The Indian Express. “A significant reduction (more than 80%) in the odds of SARS-CoV-2 infection in the HCWs was identified with the intake of six or more doses of HCQ prophylaxis,” Dr Panda added.

Hydroxychloroquine, a repurposed antimalarial drug, was empirically recommended as prophylaxis by the National COVID-19 Task Force in India to cover healthcare workers (HCWs). The ability of this compound to inhibit the infection by SARS-CoV-2, as well as viral replication in cell cultures in a time and dose-dependent manner, made it a primary choice.

Data collection for this investigation was done from May 8 to 23, 2020. HCWs tested between the first week of April 2020 and the end of first week of May 2020 formed the sample pool, from which cases were drawn.

The ICMR data portal contained the results and contact details of 23,898 symptomatic HCWs who were tested for SARS-CoV-2 infection. From this database, 21,402 records were obtained, with 1,073 (5 per cent) confirmed SARS-CoV-2-infected HCWs. Only 624 and 549 individuals could be contacted in the case and control groups, respectively and interview schedules of 378 cases and 373 controls could be done. Of the 172 cases and 193 controls reporting HCQ intake, no significant difference in the occurrence of adverse drug reactions was noted. – The Indian Express

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