Impact of the long-term hydroxychloroquine use on COVID-19 severity in patients with autoimmune rheumatic disease

Abstract

Background-Aim: After the numerous studies, the clinical effectiveness of hydroxychloroquine (HCQ) against SARS-CoV-2 is now accepted limited. Besides this, HCQ has still been the first option in most rheumatology practices. To evaluate the frequency, severity and complication of COVID-19 in patients with autoimmune rheumatologic disease (ARD) receiving and not receiving long-term HCQ. Methods: A total of 309 ARD patients were retrospectively evaluated for COVID-19 disease with a SARS-CoV-2 RT-PCR and IgM/IgG antibody.Patients were grouped as HCQ or non-HCQ groups. COVID-19 clinical symptoms development of viral pneumonia, rates of hospitalization, mortality due to COVID-19 and time from initial symptom to viral pneumonia, clinical recovery and RT-PCR negativity were evaluated. Results: During the 13 month study period, 54 (17.4%) were diagnosed with COVID-19, the frequency of COVID-19 was similar between the HCQ (17.9%) and non-HCQ groups (16.7%), p=0.793. The frequency of the myalgia, arthralgia and sore throat were higher in the non-HCQ group, the frequency of other clinical signs and symptoms were higher in the HCQ group but none of them reached statistical significance. In all patients, viral pneumonia was diagnosed in 9 (16.7%), requiring hospitalization in 8 (14.8%), requiring oxygen therapy in 4 (7.4 %) patients and these severe COVID-19 clinical features were similar between groups. COVID-19 complications were seen in 2 patients, 1 of whom was mortality due to ARDS and one was supraventricular tachycardia but thromboembolism or rheumatologic disease activation were not observed. Conclusions: As with the frequency of COVID-19, severity of COVID19 were similar between patients with and without long-term HCQ use in ARD. COVID 19 complications were found to be rare in our study.