ICMR Issues Revised Advisory on Use of Hydroxychloroquine

New Delhi: A revised government Aide on Friday Recommended use of hydroxychloroquine as a preventative medicine for psychiatric health care workers working in non-COVID-19 hospitals, frontline staff on surveillance responsibility in containment zones and paramilitary/police personnel involved with coronavirus disease related activities.

As they said in the earlier advisory, the medication against the disease is also recommended for all asymptomatic health workers involved with containment and treatment of COVID-19 and household contacts of laboratory confirmed cases.

The revised advisory issued from the ICMR, however, cautioned the intake of this medicine should not instill a sense of false safety. The recommendation was made following the Joint Monitoring Group.

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Three new categories –all asymptomatic health employees Working in non-COVID hospitals/areas of all COVID hospitals/blocks, asymptomatic frontline workers like surveillance employees deployed in containment zones along with paramilitary/police employees involved in COVID-19 related activities –have now been contained.

According to the revised advisory, in NIV, Pune, the accounts Of the in-vitro testing of HCQ for antiviral efficacy revealed reduction of infectivity and log decrease in viral RNA replica of SARs-CoV2″.

Retinopathy, hypersensitivity into HCQ and cardiac rhythm disorders,” it stated. The medication isn’t suggested for prophylaxis in children under 15years.

Rarely the drug causes cardiovascular side effects such as Cardiomyopathy and rhythm (heartbeat ) disorders, it said.

In this situation the drug has to be stopped. The medication can infrequently induce visual disturbance including blurring of vision which is usually self-limiting and improves on discontinuation of the drug,” the revised physician said.

The medication needs to be given under strict medical supervision with an informed consent, ” it said.

The ICMR reviewed the use of HCQ for prophylaxis of SARS-CoV-2 disease for elevated risk population according to the emerging evidence because of its safety and efficacy.

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The information on assessment of HCQ prophylaxis among 1,323 Healthcare employees indicated mild adverse effects like nausea (8.9 per cent), abdominal pain (7.3 per cent), nausea (1.5 percent ), hypoglycemia (1.7 percent ) and cardiovascular effects (1.9 per cent), the respondents said.

However, as per the information in the Pharma covigilance Programme of India, there were 214 reported cases of adverse drug reactions related to prophylactic HCQ use, it said.

Of these, seven were serious individual case safety reports using prolongation of QT interval on ECG in three instances, it included.

Highlighting the research on prophylaxis of SARS-CoV-2 Infection, the advisory said that a retrospective case-control investigation at ICMR has found that there is a substantial dose-response relationship between the amount of prophylactic doses obtained and frequency of occurrence of SARSCoV-2 disease in naturopathic health care workers who were tested for coronavirus disease.

Another evaluation from three central authorities Physicians in New Delhi indicates that amongst health care workers involved in COVID-19 care, those around HCQ prophylaxis were not as likely to develop SARS-CoV-2 infection, in contrast to those who were not on it.

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The advantage was less conspicuous in healthcare workers caring For an overall patient population.

Anyway, an observational prospective study of 334 Healthcare employees at AIIMS, out of that 248 took HCQ prophylaxis in New Delhi also showed that those taking HCQ prophylaxis had lower incidence of SARS-CoV-2 disease than those not taking it.

The prescription of a registered physician and it’s recommended to talk to a physician for any negative event or potential drug interaction prior to initiation of drug, it stated.

Front line workers should utilize PPEs in Compliance with the Guidelines issued by the health ministry and they should be advised to consult their doctor (within their hospital/surveillance team/security organisation) for any negative event or possible drug interaction before initiation of medication, the advisory said.

If anybody becomes Lively while on prophylaxis, he/she Should immediately get into the health facility, get tested as per national guidelines and follow the conventional treatment protocol,” it stated.

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Aside from the Indicators of COVID-19 (fever, nausea, breathing Difficulty), if the individual on chemoprophylaxis develops some other symptoms, he should immediately look for medical care in the naturopathic medical practitioner, it said.

All asymptomatic connections of lab confirmed cases Should stay in house quarantine in accordance with the national guidelines, even if they Are on prophylactic therapy, the advisory additional.