ICMR revises guidelines for use of hydroxychloroquine: Study says the drug can increase death risk

By bringing in the new guidelines, the ICMR has expanded the use of hydroxychloroquine as a preventive treatment against COVID-19. Meanwhile, a global study has linked the anti-malaria drug with an increased risk of serious heart problems and death.

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Written By: Longjam Dineshwori | Published : May 24, 2020 11:36 AM IST

Despite some studies suggesting that hydroxychloroquine (HCQ) is ineffective and harmful, many countries continue to use the anti-malaria drug as a preventive medication for COVID-19.

US President Donald Trump and many scientists around the world still believe that hydroxychloroquine could be a potential cure for COVID-19 disease. Trump even revealed in a media briefing recently that he is taking the drug as a preventive measure against COVID-19 infection.

On Saturday, the Indian Council of Medical Research (ICMR) also issued revised guidelines for use of hydroxychloroquine as a preventive medication for a group of asymptomatic people, especially for those who are on the frontline war against COVID-19.

As per the new guidelines, prophylactic use of HCQ is recommended for:

  • asymptomatic surveillance workers deployed in containment zones and paramilitary/police personnel involved in COVID-19 related activities
  • asymptomatic household contacts of laboratory confirmed cases
  • asymptomatic healthcare workers involved in containment and treatment of COVID-19 and working in non- COVID hospitals

The ICMR brought changes in the guidelines to expand the use of this anti-malarial drug as a preventive treatment against COVID-19.

Is it safe to use HCQ as a preventive medication for COVID-19?

The apex health research body noted that HCQ is relatively safe, when certain contra-indications are avoided. It also stated that the drug had some beneficial effect as a prophylactic option.

However, the ICMR noted that the drug should be given on the prescription of a registered medical practitioner with an informed consent.

Electrocardiogram (ECG) is a must before prescribing HCQ prophylaxis and in case any new cardiovascular symptom is detected, the drug would be made mandatory, the advisory said.

The drug is not recommended for children under 15 years of age and pregnant and lactating women, it said.

Hydroxychloroquine increases deaths: Study

Meanwhile, a global study has linked hydroxychloroquine to increased deaths in patients treated with it in hospitals around the world.

The paper, published online in the Lancet medical journal, raised concern on the use of hydroxychloroquine and its older version, chloroquine, in different continents without clinical trials.

The scientists have also warned that the drug should no longer be given to COVID-19 patients except in proper research settings.

While many claim hydroxychloroquine is safe as it has been used treating malaria for long, the study cautioned the drug can cause heart irregularities. Hydroxychloroquine is considered to be less toxic than its original version chloroquine, both used for treating malaria.

The study acknowledged that these drugs are fairly safe for patients being treated for malaria, but it said COVID-19 is a very different disease.

The authors of the paper evaluated data of more than 96,000 patients in 671 hospitals, taking one of the drugs, with or without an antibiotic such as azithromycin, between 20 December and 14 April.

As per their findings, the death rate was higher among patients taking the drugs than those who were not given the medication. The data revealed that one in six of those taking one of the drugs died. Among patients not taking the drugs, the death rate was one in 11.

Taking chloroquine with an antibiotic was found to be more deadly than taking hydroxychloroquine and an antibiotic.

The team also found that serious cardiac arrhythmias were more common in the group treated with hydroxychloroquine in combination with an antibiotic. Cardiac arrhythmias cause the lower chamber of the heart to beat rapidly and irregularly.

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