Impact of Hydroxychloroquine Used as DMARD on SARS CoV-2 Tests and COVID-19 Evolution

Abstract

Objectives: Data remain scarce on the impact of long-term hydroxychloroquine (HCQ) treatment on infection with SARS CoV-2. Our aim was to analyse the data of COVID-19 patients with inflammatory rheumatic and musculoskeletal diseases (iRMD-COVID-19 patients), and to compare those receiving HCQ as disease-modifying anti-rheumatic drug (DMARD) with those not receiving the drug.Methods: From the French iRMD-COVID-19 cohort, data on COVID-19 in patients receiving HCQ were compared to those of patients not receiving HCQ at the time of infection. Matching criteria were age, gender, comorbidities, immunosuppressive treatment and use of nasopharyngeal PCR test.Results: Among the 871 patients, 71 treated with HCQ prior to COVID-19 were matched with and compared to 191 controls. There was no significant difference between cases and controls in terms of nasopharyngeal PCR-positive rate (85% vs 81%; absolute standardized difference = 6.0%), clinical symptoms, rate of hospitalization (33.8% vs 27.7%; OR=1.75 (0.86-3.56); p=0.12), rate of severe form (admission to intensive care unit/death) (11.3% vs 9.4%; OR=1.94 (0.69-5.41); p=0.21).Conclusions: In a cohort of patients with iRMD, treatment with HCQ as DMARD did not modify either the SARS-CoV-2 nasopharyngeal PCR-positive rate or the clinical presentation and did not reduce the occurrence of severe forms of SARS CoV-2 infection, compared to patients not receiving HCQ.Trial Registration: ClinicalTrials.gov (NCT04353609).Funding Statement: This study was not supported by research funding, but FAI2R is funded by the French Ministry of Social Affairs and Health (ministère des solidarités et de la santé).Declaration of Interests: The authors have no competing interests.Ethics Approval Statement: Under French law, ethics committee approval was not required. The study was performed in compliance with MR-004, received permission from Lille University Hospital, and was declared to the Commission Nationale de l’Informatique et des Libertés (reference DEC20-107).