After some promising results on the efficacy of prophylactic use of Hydroxychloroquine (HCQ) against coronavirus (Covid-19) infection, the central government on Friday revised the advisory on the use of hydroxychloroquine as prophylactic for Covid-19 infections, expanding the use of the medicine for asymptomatic healthcare and frontline workers deployed in non-Covid and Covid-19 areas.
The revised advisory issued by the Indian Council of Medical Research (ICMR) has recommended the use of hydroxychloroquine as a preventive medication for asymptomatic healthcare professionals working in non-Covid-19 hospitals, frontline staff on surveillance duty in containment zones and paramilitary/police personnel involved in coronavirus infection related activities.
However, the council cautioned that the intake of the medicine should not instil a sense of false security.
The decision came after the National Task Force (NTF) for Covid-19 constituted by the ICMR reviewed the use of HCQ for prophylaxis of SARS-CoV-2 infection for high-risk population based on the emerging evidence on its safety and efficacy.
The Joint Monitoring Group under the Chairmanship of Directorate General of Health Services (DGHS) and including representatives from AIIMS, ICMR, National Centre for Disease Control, National Disaster Management Authority, WHO and experts drawn from central government hospitals reviewed the prophylactic use of hydroxychloroquine (HCQ) in the context of expanding it to healthcare and other frontline workers deployed in non-Covid-19 and Covid-19 areas.
Three new categories — all asymptomatic healthcare workers working in non-Covid hospitals/areas of Covid hospitals/blocks, asymptomatic frontline workers such as surveillance workers deployed in containment zones and paramilitary/police personnel involved in Covid-19 related activities —have now been included.
According to the revised advisory, at NIV, Pune, the report of the in-vitro testing of HCQ for antiviral efficacy showed reduction of infectivity and log reduction in viral RNA copy of SARs-CoV2.
The drug is contraindicated in persons with known case of retinopathy, hypersensitivity to HCQ and cardiac rhythm disorders, it said. The drug is not recommended for prophylaxis in children under 15 years of age and in pregnancy and lactation, the advisory said. Rarely the drug causes cardiovascular side effects such as cardiomyopathy and rhythm (heart rate) disorders, it said.
"In that situation the drug needs to be discontinued. The drug can rarely cause visual disturbance including blurring of vision which is usually self-limiting and improves on discontinuation of the drug," the revised advisory said.
The drug has to be given under strict medical supervision with an informed consent, it stated.
The National Task force (NTF) for Covid-19 constituted by the ICMR reviewed the use of HCQ for prophylaxis of SARS-CoV-2 infection for high risk population based on the emerging evidence on its safety and efficacy.
The data on assessment of HCQ prophylaxis among 1,323 healthcare workers indicated mild adverse effects such as nausea (8.9 per cent), abdominal pain (7.3 per cent), vomiting (1.5 per cent), hypoglycemia (1.7 per cent) and cardio-vascular effects (1.9 per cent), the advisory said.