Chronic use of hydroxychloroquine did not protect against COVID-19 in a large cohort of patients with rheumatic diseases in Brazil

Abstract Background: There is a lack of information on the role of chronic use of hydroxychloroquine during the SARS-CoV-2 outbreak. Our aim was to compare the occurrence of COVID-19 between rheumatic disease patients on hydroxychloroquine with individuals from the same household not taking the drug during the first 8 weeks of community viral transmission in Brazil. Methods: This baseline cross-sectional analysis is part of a 24-week observational multi-center study involving 22 Brazilian academic outpatient centers. All information regarding COVID-19 symptoms, epidemiological, clinical, and demographic data were recorded on a specific web-based platform using telephone calls from physicians and medical students. COVID-19 was defined according to the Brazilian Ministry of Health (BMH) criteria. Mann-Whitney, Chi-square and Exact Fisher tests were used for statistical analysis and two binary Final Logistic Regression Model by Wald test were developed using a backward-stepwise method for the presence of COVID-19. Results: From March 29th to May 17st, 2020, a total of 10,443 participants were enrolled, including 5166 (53.9%) rheumatic disease patients, of whom 82.5% had systemic erythematosus lupus, 7.8% rheumatoid arthritis, 3.7% Sjögren’s syndrome and 0.8% systemic sclerosis. In total, 1822 (19.1%) participants reported flu symptoms within the 30 days prior to enrollment, of which 3.1% fulfilled the BMH criteria, but with no significant difference between rheumatic disease patients (4.03%) and controls (3.25%). After adjustments for multiple confounders, the main risk factor significantly associated with a COVID-19 diagnosis was lung disease (OR 1.63; 95% CI 1.03-2.58); and for rheumatic disease patients were diagnosis of systemic sclerosis (OR 2.8; 95% CI 1.19-6.63) and glucocorticoids above 10 mg/ day (OR 2.05; 95% CI 1.31-3.19). In addition, a recent influenza vaccination had a protective effect (OR 0.674; 95% CI 0.46-0.98). Conclusion: Patients with rheumatic disease on hydroxychloroquine presented a similar occurrence of COVID-19 to household cohabitants, suggesting a lack of any protective role against SARS-CoV-2 infection. Trial registration Brazilian Registry of Clinical Trials (ReBEC; RBR - 9KTWX6).

Bibliographic Details

Main Authors:	Pileggi,Gecilmara Salviato, Ferreira,Gilda Aparecida, Gomides Reis,Ana Paula Monteiro, Reis Neto,Edgard Torres, Abreu,Mirhelen Mendes, Albuquerque,Cleandro Pires, Araújo,Nafice Costa, Bacchiega,Ana Beatriz, Bianchi,Dante Valdetaro, Bica,Blanca, Bonfa,Eloisa Duarte, Borba,Eduardo Ferreira, Brito,Danielle Christinne Soares Egypto, Duarte,Ângela Luzia Branco Pinto, Santo,Rafaela Cavalheiro Espírito, Fernandes,Paula Reale, Guimarães,Mariana Peixoto, Gomes,Kirla Wagner Poti, Kakehasi,Adriana Maria, Klumb,Evandro Mendes, Lanna,Cristina Costa Duarte, Marques,Claudia Diniz Lopes, Monticielo,Odirlei André, Mota,Licia Maria Henrique, Munhoz,Gabriela Araújo, Paiva,Eduardo Santos, Pereira,Helena Lucia Alves, Provenza,José Roberto, Ribeiro,Sandra Lucia Euzébio, Rocha Junior,Laurindo Ferreira, Sampaio,Camila Santana Justo Cintra, Sampaio,Vanderson Souza, Sato,Emília Inoue, Skare,Thelma, de Souza,Viviane Angelina, Valim,Valeria, Lacerda,Marcus Vinícius Guimarães, Xavier,Ricardo Machado, Pinheiro,Marcelo Medeiros
Format:	Digital revista
Language:	English
Published:	Sociedade Brasileira de Reumatologia 2021
Online Access:	http://old.scielo.br/scielo.php?script=sci_arttext&pid=S2523-31062021000100252
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