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LETTER TO THE EDITOR
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Year : 2021  |  Volume : 53  |  Issue : 5  |  Page : 420--421

Sharing experience: Hydroxychloroquine in preexposure prophylaxis against COVID-19

Chanda Kulkarni1, Adil Sadiq2, Arya Gigi1, Ambili Devassia1, Georgeena George1,  
1 Department of Clinical Pharmacology, SAKRA World Hospital, Bengaluru, Karnataka, India
2 Department of Cardiac Surgery, SAKRA World Hospital, Bengaluru, Karnataka, India

Correspondence Address:
Dr. Chanda Kulkarni
Department of Clinical Pharmacology, SAKRA World Hospital, Bengaluru, Karnataka
India




How to cite this article:
Kulkarni C, Sadiq A, Gigi A, Devassia A, George G. Sharing experience: Hydroxychloroquine in preexposure prophylaxis against COVID-19.Indian J Pharmacol 2021;53:420-421


How to cite this URL:
Kulkarni C, Sadiq A, Gigi A, Devassia A, George G. Sharing experience: Hydroxychloroquine in preexposure prophylaxis against COVID-19. Indian J Pharmacol [serial online] 2021 [cited 2022 Dec 3 ];53:420-421
Available from: https://www.ijp-online.com/text.asp?2021/53/5/420/331081


Full Text



Sir,

Hydroxychloroquine (HCQ), use is well-known to treat or prevent malaria and is approved by Food and Drug Administration. It is also approved for the treatment of autoimmune disorders like rheumatoid arthritis, chronic discoid lupus erythematosus, and systemic lupus erythematosus. In early 2020, during the outbreak of pandemic with severe acute respiratory syndrome coronavirus 2 (SARS–CoV-2) infection, the advisory released by the Indian Council of Medical Research (ICMR) and Ministry of Health and Family Welfare which constituted the National Task Force, Government of India, recommended the use of HCQ, against SARS–CoV-2 infection for prophylaxis and treatment to reduce the morbidity and mortality. Although, an established century-old antimalarial drug the advisory from ICMR was based on its proposed in-vitro anti-Covid activity. In this context, HCQ was distributed to Health Care Workers (HCWs) free of cost considering their high risk of exposure to COVID-19.[1]

The HCWs of all categories of our hospital included–doctors, nursing, and paramedical staff including support staff, who volunteered and consented were subjected to routine general clinical examination by physicians for known contraindications to HCQ. They were then distributed a single, course of HCQs free of cost as a prophylactic measure against COVID-19 by our hospital.

Subsequently, a retrospective survey was carried out using questionnaire on the mobile phone WhatsApp platform among HCWs who had collected the HCQ tablets. The primary objective of this quick retrospective survey was to assess the extent of compliance to HCQ and adverse events (AEs) if any to HCQ. This was felt important since it is reported that HCQ has a wide range of adverse reactions.[2],[3] The questionnaire was designed to capture the level of compliance to HCQs as well as the pattern, extent, and severity of AEs through responses to ten-item questionnaires. These responses were analyzed descriptively to assess the level of compliance and profile of AEs to HCQ.

The survey forms were sent through WhatsApp to 245 HCWs of which 170 (69.38%) responded of which 56.47% had completed the single course of HCQs. There were 49/51 self–reported AEs which were mild to moderate and 2/51 (1.17%) were severe which resolved after discontinuation of HCQ along with appropriate pharmacological treatment, but none were hospitalized. This report is being submitted to add evidence to the existing AE profile observed among non-Covid otherwise healthy subjects who had received HCQ for COVID-19 prophylaxis.

The present survey showed the extent of nonadherence to HCQ prophylaxis among healthy HCWs was close to 50% and was influenced by factors such as mild–severe AEs. While mild AEs were found to be self-limiting the moderately severe cardiac event in one necessitated discontinuation of HCQ. Further, a severe dermatological AE in another subject warranted discontinuation along with pharmacological intervention. However, there was no mortality and none required hospitalization. Therefore, it may be suggested that careful monitoring should be a part of routine management of patients with SARS–CoV-2 infection receiving HCQ either for prophylaxis or treatment in a resource-limited country like India. Further, the studies in more number of subjects, over a longer duration of treatment may help in considering HCQ as a cheaper option for the prophylaxis and/or treatment of SARS–CoV-2 infection.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

References

1Advisory on the Use of Hydroxychloroquine – The National Task Force for COVID-19 Constituted by Indian Council of Medical Research Recommends the Use of Hydroxychloroquine – MoHFW; March 22, 2020.
2Eurosurveillance Editorial Team. Note from the editors: World Health Organization declares novel coronavirus (2019-nCoV) sixth public health emergency of international concern. Euro Surveill 2020;25:200131e.
3Hydroxychloroquine Side Effects Medically Reviewed by Drugs.com. Available from: www.sakraworldhospital.com. [Last updated on 2020 Apr 26].