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On 15-16 Dec, COPCOV investigators from around the world met in Bangkok to review study results and plan next steps. Led by co-PIs Prof Sir Nick White and Dr Will Schilling, and funded by the Wellcome Trust, the MORU-led COPCOV ( Chloroquine prevention of coronavirus disease (COVID-19) in the healthcare setting) is the world’s largest multinational trial of COVID-19 prevention.

Group photo of the COPCOV Investigator meeting, 15-16 December 2022 © MORU 2022. Photographer: Yvan Cohen/Lightrocket.

A double-blind placebo controlled evaluation of chloroquine (CQ) or hydroxychloroquine (HCQ) chemoprophylaxis in the prevention of COVID-19, COPCOV has been a huge and difficult effort that ended up enrolling 4,652 participants in 11 countries and 26 sites.

Nick White and Will Schilling traded MC duties throughout the 2 days, kicking things off with a review of COPCOV’s scientific rationale and COVID-19 therapeutics. James Watson followed with a sobering review of the political polarisation surrounding HCQ, the fraudulent Surgisphere data used in Mehra et al’s The Lancet paper that has had a chilling impact on COPCOV ever since - even though The Lancet retracted the publication within 2 weeks of its publication. James concluded with thoughts on how to redress the damage that the rush to publish often underpowered or fraudulent COVID-19 studies has had on scientific publishing.

That first morning set the stage for Prof Mavuto Mukaka who presented the COPCOV study results. University of Oxford historian Dr Janelle Winters closed the day with a detailed, thought-provoking review of COPCOV’s history titled, A risky business: COPCOV, bureaucracy & the commercialisation of the global clinical trial.

On Day 2, participants engaged in a broad, thoughtful discussion of COPCOV following a review of COPCOV study results by Will Schilling and Dr James Callery, who noted that an examination of serious adverse events (SAEs) in the study reaffirmed the very reassuring safety of HCQ and CQ. Nick White noted the importance of this reassuring safety evidence, as the WHO living guideline that recommend against HCQ is based partly on the supposition that HCQ is poorly tolerated with side effects.

Before lunch, Will Schilling and Cintia Cruz reviewed the current MORU study PLATCOV and encouraged participants to consider future MORU-supported collaborations and research. Nick White closed the meeting with a discussion of next steps and the presentation of Smarties to an attendee for guessing the correct trial results. Following discussion, participants agreed to support publication of results, on an accelerated schedule.

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Running continuously since Sept 2021, the PLATCOV trial has randomised over 1700 patients presenting with COVID19 infections. Work by PLATCOV’s Dr Phrutsamon Wongnak published in the Lancet Infectious Diseases has shown that rates of oropharyngeal viral clearance have accelerated dramatically since the trial started: A SARS CoV2 viral clearance half-life in untreated patients of around 16 hours In Sept 2021 had reduced to around 9 hours by Oct 2023. The results highlight the importance of pharmacometric platform trials like PLATCOV, so that we are prepared for the next pandemic.