From AIIMS, Raipur, and AIIMS, New Delhi, two groups of doctors have raised the questions on the methodology of the Indian Council of Medical Research (ICMR) study that had specified that hydroxychloroquine or HCQ might help to lower the risk of contracting coronavirus among healthcare workers.

The ICMR had issued an advisory in March to start using HCQ, but later had drawn criticism towards itself for lacking scientific evidence showing that the drug works against the coronavirus. There were no studies available to show that the anti-malarial drug can prevent COVID-19.

Later in May, the ICMR had again announced that consuming HCQ’s reduces the chances of contracting COVID-19. It has released an advisory that recommends the expansion of the usage of HCQ as a preventive treatment against the coronavirus. The complete study was published on 20^th June.

However, last Saturday, in a correspondence published in the Indian Journal of Medical Research (IJMR), Dr. Habib M.R. Karim and Dr. Ghazal Ahmed from AIIMS, Raipur, have questioned the methodology of the study.

They wrote that the authors had included only symptomatic healthcare workers (HCWs) tested positive or negative in cases and controls. A large number of individuals with SARS-CoV-2 infection are asymptomatic, the inclusion of only symptomatic HCWs is questionable to represent that the entire HCWs were taking and/or not taking HCQ as prophylaxis.

Both the doctors argued that the findings were supposed to be analyzed with respect to the work environment and procedures —whether healthcare workers in the intensive care units attending for confirmed patients and carrying out procedures are putting them at higher risk of coronavirus infection than the healthcare workers in general, equally protected from COVID-19 with HCQ. They argued that such evidence should be presented for better acceptance of the outcomes.

Authors of the ICMR study, including epidemiologist Raman Gangakhedar and Balram Bhargava. Director-General of the apex research body, defended the study design, stating that adherence to only symptomatic participants in the study can help to reduce biases. However, they did not elaborate further. They also said that the evidence from randomized controlled trials are awaited to support further actions concerning the use of HCQ.

Source : The Print