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Should you take hydroxychloroquine as a preventive measure?

Should you take hydroxychloroquine as a preventive measure?

Last Reviewed : 12/16/2020
Should you take hydroxychloroquine as a preventive measure?

Non-pharmacological preventive measures for COVID-19 include social distancing, regular hand washing, and wearing a mask when outside. Other measures that are under development include vaccination, anti-viral drugs and hydroxychloroquine. Recently, hydroxychloroquine created lot of interest all across the globe, especially after the president of the United States requested a large quantity of supplies from India. In this article, we review all the existing evidence regarding hydroxychloroquine as a preventive measure for COVID-19.

So far, there are only two published studies that included clinical trials. Some review articles have also been published. The first clinical trial published in Zhejiang University Journals included 30 patients. 15 patients received hydroxychloroquine and 15 patients received supportive care. There is no much difference between the two groups.

The second study that recently gained prominence included hydroxycloroquine and azithromycin combination to treat COVID-19. Twenty-six patients participated in the study but six patients dropped out. After 6 days of treatment, there was a significant reduction in the viral load.

A retrospective review published in the journal Bioscience Trends, looked at 15 Chinese studies that included more than 100 patients with COVID-19 associated pneumonia. The review concluded that chloroquine is superior to the control treatment to shorten the disease course and inhibit exacerbation of pneumonia.

Based on these studies, Indian Council of Medical Research (ICMR), recommended hydroxychloroquine as prophylaxis (preventive measure) only for

a) asymptomatic healthcare providers who take care of COVID-19 patients and

b) asymptomatic household contacts of confirmed COVID-19 patients.

ICMR clearly stated that these individuals taking medication prophylaxis should take all other necessary preventive measures.

As of now, hydroxychloroquine is used as prophylaxis only in India and China. It is not approved as prophylaxis by Centers of Disease Control and Prevention (CDC), World Health Organization (WHO) or any other European society.

According to a study published by Agrawal et al., there are at least eight ongoing studies to look at hydroxychloroquine and other drugs as preventive measures. We may have to wait for the results of these studies before using hydroxychloroquine as prophylaxis on a larger scale. Few cardiac deaths were already reported in India among doctors taking hydroxychloroquine as prophylaxis.

In conclusion, hydroxychloroquine is not approved as a preventive measure except in India and China. Even in these countries, it is recommended only for healthcare providers and close contacts of COVID-19 patients. Cardiac deaths are being reported in individuals taking hydroxychloroquine as a preventive measure. We may have to wait until the results of research studies are available before taking this drug as prevention on a larger scale for the general population.

 

References:

  1. Chen J, et al. (2020) A pilot study of hydroxychloroquine in treatment of patients with common coronavirus disease-19 (COVID-19). Journal of ZheJiang University (Medical Sciences) 49(1)
  • Gautret P et al. Hydroxychloroquine and azithromycin as a treatment of COVID-19: results of an open-label non-randomized clinical trial. Int J Antimicrob Agents. 2020 Mar 20:105949. doi: 10.1016/j.ijantimicag.2020.105949.
  1. Gao J, et al. Breakthrough: chloroquine phosphate has shown apparent efficacy in treatment of COVID-19 associated pneumonia in clinical studies. Biosci Trends2020;14:72-3. doi:10.5582/bst.2020.01047 pmid:32074550
  2. Indian Council of Medical Research. Advisory on the use of hydroxychloroquine as prophylaxis for SARS-CoV-2 infection.
  3. Agrawal S et al. Emerging prophylaxis strategies against COVID-19. Monaldi Arch Chest Dis. 2020 Mar 30;90(1). doi: 10.4081/monaldi.2020.1289.
  4. India Today. Coronavirus in India: Guwahati doctor dies after allegedly taking hydroxychloroquine. March 30, 2020.

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