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Four years after being derailed by scientific fraud and politicised science in the first year of the pandemic, COPCOV, the world’s largest COVID-19 chemoprevention study, finally published results today that showed that hydroxychloroquine (HCQ) does have a moderate benefit in preventing COVID-19.

© MORU
COPCOV patient recruitment Day 1 at the Hospital for Tropical Diseases, Mahidol University, Bangkok, April 2020.

Published in PLOS Medicine, COPCOV found a 15% reduction in symptomatic COVID-19 in those taking the medication vs those taking a placebo. The study also showed a significant reduction in all-cause respiratory illness, as well as fewer days lost to work because of illness. Importantly, hydroxychloroquine was well tolerated and safe.

Professor Sir Nick White, Director of NDM's Mahidol Oxford Tropical Medicine Research Unit (MORU) in Bangkok and COPCOV study co-Principal Investigator, said: 'No drug excited as much controversy during the COVID-19 pandemic as hydroxychloroquine. It was both widely recommended and widely reviled as a preventive without enough scientific evidence for either position. While trials in hospitals showed subsequently that hydroxychloroquine was not effective in severely ill patients, its role in prevention remained uncertain, and the toxic atmosphere compromised the studies needed to find out whether it worked or not.' 

Sponsored by the University of Oxford and funded by Wellcome’s COVID-19 Therapeutics Accelerator, COPCOV was a double-blind placebo-controlled evaluation of hydroxychloroquine and chloroquine COVID-19 chemoprevention that recruited 4,652 participants in 26 sites in 11 countries in the UK, Africa and Asia from 2020 to 2022.

In May 2020 a widely publicized fraudulent claim that hydroxychloroquine was killing patients hospitalised with COVID-19 further fuelled the highly politicised controversy surrounding this medication, and led regulatory authorities to issue safety warnings and revoke use authorisations in COVID-19. The COPCOV study and other preventive studies evaluating hydroxychloroquine were stopped. Many study sites were unable to recover, and recruitment difficulties drastically delayed results for those that remained. 

Dr Will Schilling, Research Physician at MORU and COPCOV study co-Principal Investigator, said: 'Thankfully, there is no need to take hydroxychloroquine today to prevent COVID-19. The effective vaccines and natural infections have made us immune so that the disease has become mild. It was a different story early in the pandemic, however. Thanks to the research we now know hydroxychloroquine might have been able to do some good.'

Prof White said: 'Completing this study was hard, but fighting a pandemic is like fighting a war. Good intelligence is crucial. Clinical research and good science need to be protected.'

Read the study on the PLOS Medicine website: https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1004428