The ‘myth of Hydroxychloroquine (HCQ) as post-exposure prophylaxis (PEP) for the prevention of COVID-19’ is far from reality

• Published in: Scientific reports Vol. 13; no. 1; p. 378
• Main Authors: Dhibar, Deba Prasad, Arora, Navneet, Chaudhary, Deepak, Prakash, Ajay, Medhi, Bikash, Singla, Neeraj, Mohindra, Ritin, Suri, Vikas, Bhalla, Ashish, Sharma, Navneet, Singh, Mini P., Lakshmi, P. V. M., Goyal, Kapil, Ghosh, Arnab
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 07.01.2023; Nature Publishing Group; Nature Portfolio
• Subjects: 692/308/2779/777; 692/699/255/2514; 692/700/478/174; Asymptomatic; Clinical trials; Coronaviruses; COVID-19; COVID-19 - prevention & control; COVID-19 Drug Treatment; Disease prevention; Humanities and Social Sciences; Humans; Hydroxychloroquine; Hydroxychloroquine - therapeutic use; multidisciplinary; Pharmacovigilance; Placebos; Post-Exposure Prophylaxis; Prevention; Prophylaxis; SARS-CoV-2; Science; Science (multidisciplinary); Severe acute respiratory syndrome coronavirus 2; Treatment Outcome
• ISSN: 2045-2322; 2045-2322
• DOI: 10.1038/s41598-022-26053-w

The efficacy of Hydroxychloroquine (HCQ) as post-exposure prophylaxis (PEP) for the prevention of COVID-19 was contentious. In this randomized control double-blind clinical trial, asymptomatic individuals with direct contact with laboratory-confirmed COVID-19 cases were randomized into PEP/HCQ (N = 574) and control/placebo (N = 594) group. The PEP/HCQ group received tablet HCQ 400 mg q 12 hourly on day one followed by 400 mg once weekly for 3 weeks, and the control/Placebo group received matching Placebo. The incidence of COVID-19 was similar (p = 0.761) in PEP [N = 24 out of 574, (4.2%)] and control [N = 27 out of 594, (4.5%)] groups. Total absolute risk reduction for the incidence of new-onset COVID-19 was -0.3% points with an overall relative risk of 0.91 (95% confidence interval, 0.52 to 1.60) and the number needed to treat (NNT) was 333 to prevent the incident of one case of COVID-19. The study found that, PEP with HCQ was not advantageous for the prevention of COVID-19 in asymptomatic individuals with high risk for SARS-CoV-2 infection. Though HCQ is a safer drug, the practice of irrational and indiscriminate use of HCQ for COVID-19 should be restrained with better pharmacovigilance.