Thread by @Mudit_Agrwal

Correspondence justifying ICMR's guideline for using #HCQ for prophylaxis in healthcare workers, in @TheLancet by AIIMS medicine department. My first thought: "They're the experts, so there must be some good science behind it!" To convince myself, I dig a little deeper
1/n

Ref 4: open-label, non-randomized trial. 26 received HCQ (but 6 lost to follow up), 16 controls. Adjusted for age and sex. NO DATA ON CO-MORBIDITIES. Result-HCQ led to significant reduction of viral carriage ar D6. Azithromycin if added more efficient. sciencedirect.com/science/articl…
2/n

Counter-evidence: study published in @TheLancet two days back. 671 hospital, 6 continents. 81k control group. 3k received HCQ, 6k HCQ + Azithro. Controlled for comorbidities. HCQ and HCQ + Azithro independently associated w/ inc risk of mortality and ventricular arrhythmia.
3/n

Ref 5: Pre-print, double blind RCT. 62 patients. Only controlled for age and sex . NO DATA ON COMORBIDITIES. Result - TTCR for body temp recovery and cough remission shortened in HCQ group
medrxiv.org/content/10.110…
4/n

Ref 6: Post-exposure prophylaxis for #COVID using HCQ. Study form South Korea, 211 individuals given PEP with HCQ after an exposure event. All individuals who completed PEP had a negative follow-up RT-PCR. NO CONTROL ARM.
sciencedirect.com/science/articl…
5/n

Three references used to justify the use of HCQ. Even if we ignore the fact that none of them were for pre-exposure prophylaxis, all three suffer major major methodological flaws. There is increasing evidence that HCQ does more harm than good when used for treatment.
6/n

Apparently ICMR has done studies finding HCQ effective. The media knows about it, but the scientific community doesn't. Nothing published yet.
theprint.in/health/hcq-bre…

7/n

Conclusion: I still can't wrap my head around why HCQ prophylaxis is recommended. But, I'm just a student. The experts at my institute say otherwise
So, when not long from now I'll have COVID-19 duties, will I be taking HCQ? I don't know. I hope I'm less confused then.
8/n
End.

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#MedTwitter #COVIDー19 #HCQ

@VPrasadMDMPH

The executive group of WHO's #SolidarityTrial temporarily suspends the HCQ arm because of safety concerns.
who.int/dg/speeches/de…