Chronic use of hydroxychloroquine did not protect against covid-19 in a large cohort of patients with rheumatic diseases in brazil
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Universidade Federal de Minas Gerais
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Artigo de periódico
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Membros da banca
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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 hydroxychlo‑roquine 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 fac‑tor 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.
Abstract
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COVID‑19, Hydroxycloroquine, Rheumatic Diseases
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COVID‑19, Hydroxycloroquine, Rheumatic Diseases
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https://doi.org/10.1186/s42358-021-00217-0