학술논문
Chronic use of hydroxychloroquine did not protect against COVID-19 in a large cohort of patients with rheumatic diseases in Brazil
Document Type
article
Author
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)
Subject
Language
English
ISSN
2523-3106
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).