Effect of hydroxychloroquine pre-exposure on infection with SARS-CoV-2 in rheumatic disease patients: A population-based cohort study
Jung et al.
, Effect of hydroxychloroquine pre-exposure on infection with SARS-CoV-2 in rheumatic disease patients: A..
, Clinical Microbiology and Infection, doi:10.1016/j.cmi.2020.12.003
Retrospective cohort study of RA and SLE patients not showing a significant difference in PCR+ cases. PCR+ does not distinguish asymptomatic cases or severity. There was only one death which was in the control group. No other information on severity is provided.
33% of the control group used HCQ within the last year. Remaining confounding by differences in the nature and severity of rheumatic disease is likely.
risk of death, 59.3% lower, RR 0.41, p = 1.00, treatment 0 of 649 (0.0%), control 1 of 1,417 (0.1%), NNT 1417, relative risk is not 0 because of continuity correction due to zero events (with reciprocal of the contrasting arm).
risk of case, 13.1% higher, RR 1.13, p = 0.86, treatment 15 of 649 (2.3%), control 31 of 1,417 (2.2%), adjusted per study.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Jung et al., 11 Dec 2020, retrospective, South Korea, peer-reviewed, 6 authors.
Abstract: Clinical Microbiology and Infection 27 (2021) 611e617
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Clinical Microbiology and Infection
journal homepage: www.clinicalmicrobiologyandinfection.com
Effect of hydroxychloroquine pre-exposure on infection with SARSCoV-2 in rheumatic disease patients: a population-based cohort study
Sun-Young Jung 1, 2, Myo-Song Kim 1, 2, Min-Chul Kim 3, Seong-Ho Choi 3, *,
Jin-Won Chung 3, Sang Tae Choi 4, **
College of Pharmacy, Chung-Ang University, Seoul, Republic of Korea
Department of Global Innovative Drugs, Graduate School of Chung-Ang University, Seoul, Republic of Korea
Division of Infectious Diseases, Department of Internal Medicine, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul,
Republic of Korea
Division of Rheumatology, Department of Internal Medicine, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Republic of
a r t i c l e i n f o
a b s t r a c t
Received 25 September 2020
Received in revised form
29 November 2020
Accepted 5 December 2020
Available online 11 December 2020
Objectives: Early in vitro studies have suggested that hydroxychloroquine (HCQ) is a potentially useful
drug against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections. This study was
conducted to determine whether HCQ had a preventive effect on coronavirus disease 2019 (COVID-19) in
rheumatic disease patients who were taking HCQ.
Methods: We conducted a population-based retrospective cohort study using the records of the Korean
Health Insurance Review and Assessment (HIRA) claim records. The clinical data of patients with
rheumatoid arthritis (RA) or systemic lupus erythematosus (SLE) who were tested for SARS-CoV-2 were
investigated. We compared the attack rate of COVID-19 between those who underwent HCQ therapy
within 14 days before the test for SARS-CoV-2 (HCQ users) and HCQ non-users. Data were analysed using
logistic regression models, c2, and Student's t-tests.
Results: As of 15th May 2020, 2066 patients with RA or SLE were tested for COVID-19. Among them,
31.4% (649/2066) were treated with HCQ. Most HCQ users (93.7%, 608/649) were taking 200e400 mg/
day recommended for the treatment of rheumatic diseases. The attack rate of COVID-19 in the HCQ users
(2.3%, 15/649) did not differ from that in the HCQ non-users (2.2%, 31/1417) (p 0.86).
Conclusions: HCQ prophylactic use at a usual dose did not prevent COVID-19 in patients with rheumatic
disease. Sun-Young Jung, Clin Microbiol Infect 2021;27:611
© 2020 The Authors. Published by Elsevier Ltd on behalf of European Society of Clinical Microbiology and
Infectious Diseases. This is an open access article under the CC BY-NC-ND license (http://
Editor: L. Scudeller
Severe acute respiratory syndrome
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