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Short Communication - (2020) Volume 0, Issue 0

No Role of HCQ in COVID-19 Prophylaxis: A Survey amongst Indian Doctors
Debasis Datta1, Samit Ghosal2*, Binayak Sinha3, Sujata Datta4, Twisha Chakraborty5, Kalyan Kumar Gangopadhyay6 and Arup Ratan Dutta7
 
1Department of Gastroenterology, Fortis Hospitals, Kolkata, India
2Department of Endocrinology, Nightingale Hospital, Kolkata, India
3Department of Diabetes and Endocrinology, AMRI Hospitals, Kolkata, India
4Department of Gynecology, Peerless Hospitals, Kolkata, India
5Department of Gastroenterology, Fortis Hospitals, Kolkata, India
6Department of Endocrinology, Peerless Hospitals, Kolkata, India
7Department of Nephrology, Fortis Hospitals, Kolkata, India
 
*Correspondence: Samit Ghosal, Department of Endocrinology, Nightingale Hospital, Kolkata, India, Tel: 919674328281, Email:

Received: 15-Oct-2020 Published: 06-Nov-2020, DOI: 10.35248/2157-7560.20.S6.002

Abstract

The COVID-19 pandemic is being tackled on two fronts-prevention and treatment. In addition to behavioural strategies and vaccines (eagerly awaited), pharmacotherapy is also being employed in certain regions as a preventive strategy. In India, hydroxychloroquine (HCQ), ivermectin, a variety of vitamin supplements are being used, with HCQ being the most popular among healthcare professionals. In addition to the evidence-based recommendations, it is important to ascertain the situation on the ground. We conducted a multicentric survey among physicians from a wide range of specialities to ascertain the usage on HCQ and its effects of COVID-19 prevention. We did not find any significant impact of HCQ on the prevention of COVID-19 (p=0.54) independent of the duration of its usage. This pilot project has the potential to act as a backbone for a larger study exploring the impact of pharmacological intervention on COVID-19 prevention.

Keywords

COVID-19; Survey; Physicians; HCQ

Introduction

Hydroxychloroquine (HCQ), a drug traditionally used to treat malaria and rheumatoid disorders has been proposed as a prophylaxis for SARS-COV-2 infection, in view of its anti-viral properties in vitro. The Indian Council of Medical Research announced advisories recommending the prophylactic use of HCQ for all asymptomatic healthcare workers [1]. Though many Indian Healthcare Professionals (HCP) regarded this advisory as useful, many HCP were apprehensive not only about the lack of evidence indicating its beneficial role in prophylaxis of SARS-COV-2 infection but also about the side effects of HCQ, particularly cardiac as cautioned by the US FDA [2]. In light of recent randomised trials and meta-analysis failing to document any positive impact of HCQ on SARS-COV-2 infection and related outcomes both as preand post-exposure strategy , a real-life data on health-care providers would help complement the existing database [3-7].

Objective

We conducted a pilot study of Indian doctors to try and assess the benefit of HCQ in COVID 19 prophylaxis.

Methods and Findings

After ethical committee approval, a survey questionnaire was sent to 300 doctors working in five tertiary care hospitals in Kolkata, India treating both COVID and non-COVID patients regarding HCQ prophylaxis and its effect if any on the incidence of COVID infection amongst them.

Data was entered into an excel sheet and then converted to a Comma Separated Values (CSV) format prior to analysis. Analysis was performed using python 3.8.6 software (Windows 10 64 bit, USA). A total of 281 responses were obtained of whom 146 physicians (51.96%) were on HCQ prophylaxis, while 135 (48.04%) were not.

The risk of contracting COVID-19 was significantly higher amongst doctors from medical specialties compared to those from non-medical specialties (p<0.001, level of significance (α) =0.95). HCQ prophylaxis was not associated with a reduction in the risk of contracting COVID-19 (p=0.54); lebel of significance (α) =0.95). Duration of HCQ prophylaxis had no impact in preventing COVID infection (Table 1).

Physicians on HCQS Prophylaxis?
Yes (n=146) No (n=135)
Developed COVID? Developed COVID?
  Yes No   Yes No
  32 132   3 114
percentage 19.51% 80.49% percentage 2.56% 97.44%
Hypothesis testing:
H0: HCQS prophylaxis has no effect on contracting COVID-19 infection
HA: HCQS prophylaxis influences development of COVID-19 infection
Chi square value (χ2) Critical value Level of significance (α) P-value Degree of freedom
0.37 3.84 0.95 0.54 1
Impact of Speciality on contracting COVID-19
Medicine (n=164) Non-Medicine (117)
Developed COVID? Developed COVID?
  Yes No   Yes No
  32 132   3 114
Percentage 19.51% 80.49% Percentage 2.56% 97.44%
Hypothesis testing:
H0: Medical speciality has no effect on contracting COVID-19 infection
HA: Type of medical speciality influences development of COVID-19 infection
Chi square value (χ2) Critical value Level of significance (α) P-value Degree of freedom
16.47 3.84 0.95 <0.001 1

Table 1: Physicians on HCQ Prophylaxis.

Discussion and Conclusion

This unique pilot study of Indian doctors provides a strong indication that HCQ has no role in COVID 19 prophylaxis. This is a call to all physicians who are unfortunately lulled into a false sense of security by using HCQ, that until robust scientific data becomes available, they should put their faith on non-pharmaceutical prophylaxis for COVID 19.

The incidence of COVID 19 was higher in medical specialties as surgical specialties had less exposure to infected patients due to cancellation of routine surgeries. However larger studies are required amongst HCP deployed in COVID and non COVID areas. As of now the available data as well as recommendations from CDC do not support the use of HCQ as a pre-exposure prophylaxis for COVID-19.

Acknowledgements

We would like to acknowledge Mr. Milan Majumdar for helping us with the statistical analysis. In addition, we would like to thank all the physicians who took out their valuable time to fill up the survey.

References

Citation: Datta D, Ghosal S, Sinha B, Datta S, Chakraborty T, Kalyan Kumar G, et al. (2020) No Role of HCQ in COVID-19 Prophylaxis: A Survey amongst Indian Doctors. J Vaccines Vaccin. S6:002

Copyright: © 2020 Datta D, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited