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

• Autor(a) principal: Gecilmara Salviatopileggi
• Data de Publicação: 2021
• Outros Autores: 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, Gilda Aparecida Ferreira, 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, Ana Paula Monteiro Gomides Reis, 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, Edgard Torres Reis-neto, Mirhelen Mendes Abreu, Cleandro Pires Albuquerque, Nafice Costa Araújo, Ana Beatriz Bacchiega, Dante Valdetaro Bianchi
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Repositório Institucional da UFMG
• Texto Completo: http://hdl.handle.net/1843/63085
• topic: COVID‑19; Hydroxycloroquine; Rheumatic Diseases; COVID‑19; Hydroxycloroquine; Rheumatic Diseases

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.