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COVID-19 infection in a northern-Italian cohort of systemic lupus erythematosus assessed by telemedicine

Cassione et al., Annals of the Rheumatic Diseases, doi:10.1136/annrheumdis-2020-217717

May 2020

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HCQ for COVID-19

1st treatment shown to reduce risk in March 2020, now with p < 0.00000000001 from 419 studies, recognized in 46 countries.

Lower risk for mortality, hospitalization, progression, recovery, cases, and viral clearance.

No treatment is 100% effective. Protocols combine treatments.

5,100+ studies for 109 treatments. c19hcq.org

Survey of 165 SLE patients, 127 on HCQ. 8 patients with suspected COVID-19 and 4 confirmed cases. No mortality, one ICU case. 7 patients had no symptoms despite contact with a COVID-19 patient.

No adjustment for concomitant medications or severity of SLE. Confounding by indication.

This study is excluded in the after exclusion results of meta analysis: not fully adjusting for the different baseline risk of systemic autoimmune patients.

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risk of case, 49.6% higher, RR 1.50, p = 0.59, treatment 10 of 127 (7.9%), control 2 of 38 (5.3%).

Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates

Cassione et al., 12 May 2020, retrospective, Italy, peer-reviewed, survey, median age 52.5, 6 authors.

This Paper HCQ All

COVID-19 infection in a northern-Italian cohort of systemic lupus erythematosus assessed by telemedicine

Emanuele Bozzalla Cassione, Giovanni Zanframundo, Alessandro Biglia, Veronica Codullo, Professor Carlomaurizio Montecucco, Lorenzo Cavagna

Annals of the Rheumatic Diseases, doi:10.1136/annrheumdis-2020-217717

Handling editor Josef S Smolen Acknowledgements The authors wish to thank Dr Luciano Perotti from the ICU department of our Hospital for his invaluable contribution to the good outcome of the admitted SLE patient.

References

Ferner, Aronson, Chloroquine and hydroxychloroquine in covid-19, BMJ, doi:10.1136/bmj.m1432

Hollander, Carr, Virtually perfect? telemedicine for Covid-19, N Engl J Med, doi:10.1056/NEJMp2003539

Joob, Wiwanitkit, Sle, hydroxychloroquine and NO SLE patients with COVID-19: a comment, Ann Rheum Dis, doi:10.1136/annrheumdis-2020-217506

Mathian, Mahevas, Rohmer, Clinical course of coronavirus disease 2019 (COVID-19) in a series of 17 patients with systemic lupus erythematosus under longterm treatment with hydroxychloroquine, Ann Rheum Dis, doi:10.1136/annrheumdis-2020-217566

Monti, Balduzzi, Delvino, Clinical course of COVID-19 in a series of patients with chronic arthritis treated with immunosuppressive targeted therapies, Ann Rheum Dis, doi:10.1136/annrheumdis-2020-217424

Remuzzi, Remuzzi, COVID-19 and Italy: what next?, Lancet, doi:10.1016/S0140-6736(20)30627-9

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