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1. This is a thread on the pre-exposure prophylaxis (PrEP) use of HCQ to protect from SARS-CoV-2. First, note that if HCQ is antiviral and has a long half-life in the body (38 to 60 days), then HCQ is almost certainly effective as PrEP.
2. Next, if HCQ is effective as PrEP, either for contraction of the virus or developing the COVID-19 disease stage, then it is highly likely that HCQ is working as an antiviral. So, the "HCQ as PrEP" and "HCQ as antiviral" hypotheses are seemingly very well linked.
3. Now, let's take the HCQ as PrEP studies in order of publication, starting with two that were quick literature reviews not specific to SARS-CoV-2, which retrieved extremely small sample sizes.
4. This retrospective (May 5) found a tiny sample of patients taking HCQ, which was not enough data to work with: https://c19study.com/gendelman.html
5. A similar study (May 16) was similarly inconclusive and short on relevant data: https://c19study.com/macias.html
6. Now we get to more interesting studies directly related to SARS-CoV-2. This peer reviewed study (May 28; June 20 final) out of India found with high confidence that Health Care Workers (HCWs) benefited from HCQ PrEP:
http://www.ijmr.org.in/article.asp?issn=0971-5916;year=2020;volume=151;issue=5;spage=459;epage=467;aulast=Chatterjee
http://www.ijmr.org.in/article.asp?issn=0971-5916;year=2020;volume=151;issue=5;spage=459;epage=467;aulast=Chatterjee
7. The effect grew for HCWs who continued to take a more full course of HCQ. This study was used to inform health policy in India, which now encourages widespread use of HCQ as PrEP for SARS-CoV-2 among HCWs.
8. It is worth noting that the Indian subcontinent has fared better than the rest of the world, despite a seemingly vulnerable population, densely concentrated:
9. This next study (June 9 preprint), also out of India, found a greater than 80% reduction in the development of COVID-19 among HCWs taking HCQ as PrEP. https://www.medrxiv.org/content/10.1101/2020.06.09.20116806v2.full.pdf+html
10. Next, this study (June 19) of 4,300 HCWs given PrEP found that only 1% contracted SARS-CoV-2, and every single one recovered. https://health.economictimes.indiatimes.com/news/diagnostics/hcq-beneficial-as-preventive-drug-sms-doctors-told-icmr/76464620
11. This study analyzed data from Portugese patients taking HCQ chronically for various ailments such as lupus and found them significantly less likely to contract SARS-CoV-2: https://www.medrxiv.org/content/10.1101/2020.06.26.20056507v1.full.pdf+html
12. This peer reviewed retrospective (July 3) of the Hubei, China population similarly found that rheumatoid arthritis patients taking HCQ were less likely to contract COVID-19. https://www.thelancet.com/journals/lanrhe/article/PIIS2665-9913(20)30227-7/fulltext
13. It's worth noting at this point that study after study shows that many or even most people, including those with serious conditions, don't take their medicine, so any PrEP effect found in such studies likely under-estimates the overall effect. https://epilepsyresearch.org.uk/poll-shows-that-almost-50-of-people-forget-to-take-their-medication-at-least-once-a-month/
14. Another study (July 24) out of India found that a full course of HCQ was highly preventative of COVID-19, specifically noting an effect greater than that of using M-95 masks: https://www.medrxiv.org/content/10.1101/2020.07.21.20159301v1.full.pdf+html
15. I found no studies in which HCQ failed as PrEP for SARS-CoV-2, so the "HCQ as PrEP" hypothesis looks good, and as a consequence, the "HCQ as antiviral" hypothesis therefore also looks good.
16. Finally, as an observational note, let's check the case fatality rates of the nations on the Indian subcontinent that is producing hundreds of millions of HCQ pills per month as of April. (Each nation here aside from the U.S. using HCQ as PrEP and for early stage C-19.)
#Hydroxychloroquine PrEP efficacy thread
#HCQ
#SARS #COVID #COVID19 #coronavirus #CoronavirusPandemic
#KeepYourSenseOfHumor and #RunAroundInTheSunshine
#HCQ
#SARS #COVID #COVID19 #coronavirus #CoronavirusPandemic
#KeepYourSenseOfHumor and #RunAroundInTheSunshine
There is an unconfirmed report that the Italian Society of Rheumatology found that only 20 of 65,000 patients taking HCQ developed COVID-19 while on HCQ, and none died.
https://www.msn.com/en-ae/news/other/italian-scientist-says-she-discovered-main-mechanism-behind-covid-19/ar-BB13Cgi8
However...
https://www.msn.com/en-ae/news/other/italian-scientist-says-she-discovered-main-mechanism-behind-covid-19/ar-BB13Cgi8
However...
This small study out of Italy seems to contradict that report:
@CovidAnalysis @HcqInvestigator https://ard.bmj.com/content/early/2020/05/23/annrheumdis-2020-217717
@CovidAnalysis @HcqInvestigator https://ard.bmj.com/content/early/2020/05/23/annrheumdis-2020-217717
A second small study in Belgium found no PrEP effect for HCQ: https://ard.bmj.com/content/early/2020/06/25/annrheumdis-2020-218244
One more small study (U.S.) found no PrEP effect from chronic HCQ takers: https://ard.bmj.com/content/early/2020/08/19/annrheumdis-2020-218500?fbclid=IwAR0UMrfy27-L_SQVXft9YEJr5zoolftFxbTaghE3J8PMg3ywyt28MPF_Ih4
