Continuous Hydroxychloroquine or Colchicine Therapy Does Not Prevent Infection With SARS-CoV-2: Insights From a Large Healthcare Database Analysis
Gendelman et al.
, Continuous Hydroxychloroquine or Colchicine Therapy Does Not Prevent Infection With SARS-CoV-2: Insights From..
, Autoimmunity Reviews, 19:7, July 2020, doi:10.1016/j.autrev.2020.102566
Very small study of rheumatic disease/autoimmune disorder patients showing no significant difference but with only 3 chronic HCQ patient cases. Only considers people tested at a time when primarily symptomatic cases were tested.
Other research shows that the risk of COVID-19 for systemic autoimmune disease patients is much higher overall, Ferri et al. show OR 4.42, p
, which is the observed real-world risk, taking into account factors such as these patients potentially being more careful to avoid exposure.
Adjusting for the difference in baseline risk using the result in Ferri et al. shows substantial benefit for HCQ, RR 0.211, but with only 3 HCQ cases the result is inconclusive. More recent studies with rheumatic disease/autoimmune condition patients provide higher confidence.
This study is excluded in the after exclusion results of meta
not fully adjusting for the different baseline risk of systemic autoimmune patients.
risk of case, 8.1% lower, RR 0.92, p = 0.88, treatment 3 of 36 (8.3%), control 1,314 of 14,484 (9.1%), NNT 135.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Gendelman et al., 5 May 2020, retrospective, database analysis, Israel, peer-reviewed, 5 authors.
Abstract: Autoimmunity Reviews 19 (2020) 102566
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journal homepage: www.elsevier.com/locate/autrev
Continuous hydroxychloroquine or colchicine therapy does not prevent
infection with SARS-CoV-2: Insights from a large healthcare database
Omer Gendelmana,b,1, Howard Amitala,b,1,⁎, Nicola Luigi Bragazzic, Abdulla Watada,b,
Department of Medicine ‘B', Sheba Medical Center, Tel-Hashomer, Israel
Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
Department of Mathematics and Statistics, Laboratory for Industrial and Applied Mathematics (LIAM), York University, Toronto, ON M3J 1P3, Canada
Maccabitech, Maccabi Healthcare Services, Tel Aviv, Israel
Background: Some disease-modifying agents commonly used to treat patients with rheumatic diseases/autoimmune disorders, such as hydroxychloroquine and colchicine, are under investigation as potential therapies for
the “coronavirus disease 2019” (COVID-19). However, the role of such agents as prophylactic tools is still not
Methods: This is a retrospective study based on a large healthcare computerized database including all patients
that were screened for the “Severe Acute Respiratory Syndrome Coronavirus type 2” (SARS-CoV-2) in the study
period from February 23rd 2020 to March 31st 2020. A comparison was conducted between subjects tested
positive for SARS-CoV-2 and those found negative in terms of rate of administration of hydroxychloroquine/
Results: An overall sample of 14,520 subjects were screened for SARS-CoV-2 infection and 1317 resulted positive. No significant difference was found in terms of rates of usage of hydroxychloroquine or colchicine between
those who were found positive for SARS-CoV-2 and those who were found negative (0.23% versus 0.25% for
hydroxychloroquine, and 0.53% versus 0.48% for colchicine, respectively).
Conclusion: These findings raise doubts regarding the protective role of these medications in the battle against
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