Incidence of COVID-19 in patients under chronic treatment with hydroxychloroquine ଝ
Francisco Tejada Cifuentes, Ángeles Lloret Callejo, José Tirado Peláez, Olga Rubio Pulido, Marta Ruiz-Morote, Aragón, Rocío Fernández Urrusuno, Isabel María, Mu Ñoz Carreras, Isabel Méndez, Victoria Maestre Sánchez, Antonio García Bonilla, José Manuel Paredero Dominguez, Virginia Arroyo Pineda, Esther Marco Tejón, Gregorio Romero Candel, Ana Isabel Fernández Marchante, José Marco Del Rio, Teresa Ortiz Martín, Piedad López Sánchez, Tejada Cifuentes, Lloret Callejo, MJ Tirado Peláez, Rubio Pulido, Ruiz-Morote Aragón, Covid-19 Coronavirus, Incidencia Hidroxicloroquina Tratamiento
Objective: To analyze the incidence of Covid-19 in patients who are chronic users of hydroxychloroquine. Patients and methods: Cross-sectional retrospective observational multicenter study in health areas and districts from Castilla La-Mancha and Andalucia. Of the 4451 participants included in the first recruitment, 3817 with valid data were selected. The main variable of the study is the presence or absence of Covid-19 infection by clinical, serological or polymerase chain reaction diagnosis. Sociodemographic and clinical variables and treatment and concomitant comorbidities were recorded. Results: 169 (4,45%) patients had Covid-19 infection, of which 12 (7.1 %) died and 32 (18.9%) required hospital admission. Previous respiratory pathology was related to Covid-19 infection (P < .05). Maculopathy appears in 5.3% of patients and is significantly related to the dose of hydroxychloroquine consumed (P < .05). Conclusion: There is no relationship between chronic use of hydroxychloroquine and the incidence of Covid-19.
Authorship The following people have contributed to the review of the data: Sonia Martínez Cruz, Julia de Fez Herráiz, Adriana Arcega Baraza, María Teresa González Zarca, Carolina Payá Giner, Ángel Fernández Mistal, María Dolores Pérez Pacheco, Macarena Flores Dorado, Piedad Reguera Martínez, Olga Rojas Corrales, María Isabel Ibarra Lorente, María Elena Carretero Albi ñana, María Isabel Tofi ño González, Belén de la Hija Díaz, Beatriz de la Calle Riaguas, Juan José Navarro Agüera, Rosario Lara Olivares, Dolores Caniego Rodrigo, Yolanda González Gero, Inmaculada Casa Hidalgo, Aina Tomás Luiz, Eva María García Martínez, Nuria Monteagudo Martínez, Ismael Pérez Alpuente, Francisco Tomás Pagán Nú ñez, Ana Ramírez Córcoles, Rocío Pardo Sánchez, Palmira Quero González, Rocío Pe ña Pou, Alejandro Rodríguez Delgado, Francisco M. Ferrer Soler y Alejandro Rodríguez Delgado.
Conflict of interests The authors declare that they have no conflict of interest.
References
Abajo, Rodríguez-Martín, Lerma, Mejía-Abril, Aguilar et al., Use of renin-angiotensin-aldosterone system inhibitors and risk of COVID-19 requiring admission to hospital: a case-population study, Lancet,
doi:10.1016/PII
Andreani, Bideau, Duflot, Jardot, Rollan et al., In vitro testing of combined hydroxychloroquine and azithromycin on SARS-CoV-2 shows synergistic effect, Microb Pathog,
doi:10.1093/cid/ciaa237
Aquino, Cabrera, Hydroxychloroquine and COVID-19: critiquing the impact of disease public profile on policy and clinical decision-making, J Med Ethics
Bhimraj, Morgan, Shumaker, Lavergne, Baden et al., Infectious diseases Society of America guidelines on the treatment and management of patients with COVID-19, Clin Infect Dis,
doi:10.1093/cid/ciaa478
Cavalcanti, Zampieri, Rosa, Azevedo, Veiga et al., Hydroxychloroquine with or without azithromycin in mild-to-moderate COVID-19, N Engl J Med,
doi:10.7326/M20-2496
Coombes, Markwell, Kubler, Redmond, Mcgurk et al., Principles of ethical prescribing for self and others: hydroxychloroquine in the COVID-19 pandemic, Aust Prescr
Cortegiani, Ingoglia, Ippolito, Giarratno, Einav, A systematic review on the efficacy and safety of chloroquine for the treatment of COVID-19,
doi:10.1093/cid/ciaa478
Fang, Karakiulakis, Roth, Are patients with hypertension and diabetes mellitus at increased risk for COVID-19 infection?, Lancet Respir Med,
doi:10.1016/PII
Hernandez, Roman, Pasupuleti, Barboza, White, Hydroxychloroquine or chloroquine for treatment or prophylaxis of COVID-19: a living systematic review, Ann Intern Med,
doi:10.7326/M20-2496
Juurlink, Safety considerations with chloroquine, hydroxychloroquine and azithromycin in the management of SARS-CoV-2 infection, CMAJ,
doi:10.1503/cmaj.200528
Marmor, Kellner, Lai, Lyons, Mieler, Revised recommendations on screening for chloroquine and hydroxychloroquine retinopathy, Ophthalmology,
doi:10.3390/ijerph17145171
Poblador-Plou, Carmona-Pírez, Ioakeim-Skoufa, Poncel-Falcó, Bliek-Bueno et al., Baseline chronic comorbidity and mortality in laboratory-confirmed COVID-19 cases: results from the PRE-COVID study in Spain, Int J Environ Res Public Health,
doi:10.3390/ijerph17145171
Roden, Harrington, Poppas, Russo, Considerations for drug interactions on QTc in exploratory COVID-19 (coronavirus disease 2019) treatment, Circulation,
doi:10.1161/CIRCULATIONAHA.120.047521
Singh, Singh, Singh, Misra, Hydroxychloroquine in patients with COVID-19: a systematic review and meta-analysis, Diabetes Metab Syn,
doi:10.1503/cmaj.200528
Tang, Cao, Han, Wang, Chen et al., Hydroxychloroquine in patients with mainly mild to moderate coronavirus disease 2019: open label, randomised controlled trial, BMJ,
doi:10.1056/NEJMoa2019014
Wang, Zhang, Du, Du, Zhao et al., Remdesivir in adults with severe COVID-19: a randomised, double-blind, placebo-controlled, multicentre trial, Lancet,
doi:10.1016/S0140-6736(20)31030-8
Yao, Ye, Zhang, Cui, Huang et al., In vitro antiviral activity and projection of optimized dosing design of hydroxychloroquine for the treatment of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), Clin Infect Dis,
doi:10.1093/cid/ciaa237
Ye, Wang, Colunga-Lozano, Prasad, Tangamornsuksan et al., Efficacy and safety of corticosteroids in COVID-19 based on evidence for COVID-19, other coronavirus infections, influenza, community-acquired pneumonia and acute respiratory distress syndrome: a systematic review and meta-analysis, CMAJ,
doi:10.1016/j.ophtha.2010.11.017