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

Authors :
Gecilmara Salviato Pileggi
Gilda Aparecida Ferreira
Ana Paula Monteiro Gomides Reis
Edgard Torres Reis-Neto
Mirhelen Mendes Abreu
Cleandro Pires Albuquerque
Nafice Costa Araújo
Ana Beatriz Bacchiega
Dante Valdetaro Bianchi
Blanca Bica
Eloisa Duarte Bonfa
Eduardo Ferreira Borba
Danielle Christinne Soares Egypto Brito
Ângela Luzia Branco Pinto Duarte
Rafaela Cavalheiro Espírito Santo
Paula Reale Fernandes
Mariana Peixoto Guimarães
Kirla Wagner Poti Gomes
Adriana Maria Kakehasi
Evandro Mendes Klumb
Cristina Costa Duarte Lanna
Claudia Diniz Lopes Marques
Odirlei André Monticielo
Licia Maria Henrique Mota
Gabriela Araújo Munhoz
Eduardo Santos Paiva
Helena Lucia Alves Pereira
José Roberto Provenza
Sandra Lucia Euzébio Ribeiro
Laurindo Ferreira Rocha Junior
Camila Santana Justo Cintra Sampaio
Vanderson Souza Sampaio
Emília Inoue Sato
Thelma Skare
Viviane Angelina de Souza
Valeria Valim
Marcus Vinícius Guimarães Lacerda
Ricardo Machado Xavier
Marcelo Medeiros Pinheiro
Source :
Advances in Rheumatology, Vol 61, Iss 1, Pp 1-11 (2021)
Publication Year :
2021
Publisher :
BMC, 2021.

Abstract

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).

Details

Language :
English
ISSN :
25233106
Volume :
61
Issue :
1
Database :
Directory of Open Access Journals
Journal :
Advances in Rheumatology
Publication Type :
Academic Journal
Accession number :
edsdoj.f2e8d37000264b31848f2fc9fd8090da
Document Type :
article
Full Text :
https://doi.org/10.1186/s42358-021-00217-0