The effect of hydroxychloroquine against SARS-CoV-2 infection in rheumatoid arthritis patients
Okan Küçükakkaş, Teoman Aydın
doi:10.21203/rs.3.rs-43812/v1
INTRODUCTION: The effectiveness of hydroxychloroquine in SARS-CoV-2 prophylaxis and treatment is still controversial. In this study, our aim is to investigate the potential effects of hydroxychloroquine therapy on patients with diagnosed with rheumatoid arthritis and a con rmed SARS-CoV-2 infection. METHOD: We included patients who were followed up with a diagnosis of rheumatoid arthritis and whose SARS-CoV-2 infection was con rmed. The patients were divided into two groups as those who previously used hydroxychloroquine and those who did not, and were compared in terms of clinical and laboratory data. RESULTS: Our study included 17 patients with adequate data (2 males, 15 females). The mean age of the patients was 57.2 ± 11.6 years. 7 (41.2%) patients were receiving hydroxychloroquine regularly for the last 6 months. When the effect of hydroxychloroquine on clinical and laboratory parameters of patients was examined, there was no signi cant difference between the groups of patients using and not using hydroxychloroquine. The patients using and not using hydroxychloroquine were compared for the presence of typical SARS-CoV-2 infection ndings on computed tomography images, admission to the hospital and intensive care. No signi cant differences were observed between these two groups. CONCLUSIONS: Many studies on the effectiveness of hydroxychloroquine use in SARS-CoV-2 infection are still ongoing. Due to its importance in rheumatology practice, it is very important to clarify the position of hydroxychloroquine in SARS-CoV-2 therapy. Our ndings suggest that having previously used hydroxychloroquine does not have any negative or positive effect on the infection.
Declarations Compliance with ethical standards Disclosures: None. Financial support received for the study: None. Ethical approval: Approval has been received by the Institutional Review Board. Competing interests: The declare no competing interests. A statement on participant consent: Ethical was obtained from the institutional ethical committee and no patient consent form was required due to the use of retrospective data.
References
Alia, Jm, Does hydroxychloroquine combat COVID-19? A timeline of evidence, J Am Acad Dermatol
Ben-Zvi, Kivity, Langevitz, Shoenfeld, Hydroxychloroquine: From malaria to autoimmunity, Clin Rev Allergy Immunol
Blumentals, Arreglado, Napalkov, Toovey, Rheumatoid arthritis and the incidence of in uenza and in uenza-related complications: a retrospective cohort study, BMC Musculoskelet Disord
Boulos, Rolain, Raoult, Antibiotic susceptibility of Tropheryma whipplei in MRC5 cells, Antimicrob Agents Chemother
Colson, Rolain, Lagier, Brouqui, Raoult, Chloroquine and hydroxychloroquine as available weapons to ght COVID-19, Int J Antimicrob Agents
Cortegiani, Ingoglia, Ippolito, Giarratano, Einav, A systematic review on the e cacy and safety of chloroquine for the treatment of COVID-19, J Crit Care,
doi:10.1016/j.jcrc.2020.03.005
Dahly, Gates, Morris, Statistical review of hydroxychloroquine and azithromycin as a treatment of COVID-19: results of an openlabel non-randomized clinical trial, Zenodo,
doi:10.5281/zenodo.3724167
Devaux, Rolain, Colson, Raoult, New insights on the antiviral effects of chloroquine against coronavirus: what to expect for COVID-19?, Int J Antimicrob Agents,
doi:10.1016/j.ijantimicag.2020.105938
Gao, Tian, Yang, Breakthrough: chloroquine phosphate has shown apparent e cacy in treatment of COVID-19 associated pneumonia in clinical studies, Biosci Trends
Gautret, Lagier, Parola, Hydroxychloroquine and azithromycin as a treatment of COVID-19: results of an open-label non-randomized clinical trial, Int J Antimicrob Agents,
doi:10.1016/j.ijantimicag.2020.105949
Kapoor, Kapoor, Role of chloroquine and hydroxychloroquine in the treatment of COVID-19 infection: a systematic literature review, medRxiv,
doi:10.1101/2020.03.24.20042366
Listing, Gerhold, Zink, The risk of infections associated with rheumatoid arthritis, with its comorbidity and treatment, Rheumatology
Michaud, Wip Er, Shaw, Simon, Cornish et al., Experiences of Patients With Rheumatic Diseases in the United States During Early Days of the COVID-19 Pandemic, ACR Open Rheumatol
Raoult, Drancourt, Vestris, Bactericidal effect of doxycycline associated with lysosomotropic agents on Coxiella burnetii in P388D1 cells, Antimicrob Agents Chemother
Raoult, Houpikian, Tissot, Riss, Arditi-Djiane et al., Treatment of Q fever endocarditis: comparison of 2 regimens containing doxycycline and o oxacin or hydroxychloroquine, Arch Intern Med,
doi:10.1001/archinte.159.2.167
Rolain, Colson, Raoult, Recycling of chloroquine and its hydroxyl analogue to face bacterial, fungal and viral infection in the 21st century, Int J Antimicrob Agents
Song, Kang, Choi, Seo, Lee et al., Coronavirus Disease 19 (COVID-19) complicated with pneumonia in a patient with rheumatoid arthritis receiving conventional diseasemodifying antirheumatic drugs, Rheumatol Int
Song, Kang, Choi, Seo, Lee et al., Coronavirus Disease 19 (COVID-19) complicated with pneumonia in a patient with rheumatoid arthritis receiving conventional diseasemodifying antirheumatic drugs, Rheumatol Int
Vinogradova, Hippisley-Cox, Coupland, Identi cation of new risk factors for pneumonia: population-based casecontrol study, Br J Gen Pract
Vinogradova, Hippisley-Cox, Coupland, Identi cation of new risk factors for pneumonia: population-based casecontrol study, Br J Gen Pract
Wang, Cao, Zhang, Yang, Liu et al., Remdesivir and chloroquine effectively inhibit the recently emerged novel coronavirus (2019-nCoV) in vitro, Cell Res
Wu, Chang, Kor, Yang, Chiu et al., Hydroxychloroquine Use and Risk of CKD in Patients with Rheumatoid Arthritis, Clin J Am Soc Nephrol
Yao, Ye, Zhang, 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
Yazdany, Kim, Use of hydroxychloroquine and chloroquine during the COVID-19 pandemic: what every clinician should know, Ann Intern Med
{ 'institution': [{'name': 'Research Square'}],
'indexed': {'date-parts': [[2022, 4, 3]], 'date-time': '2022-04-03T21:16:52Z', 'timestamp': 1649020612300},
'posted': {'date-parts': [[2020, 7, 20]]},
'group-title': 'In Review',
'reference-count': 0,
'publisher': 'Research Square Platform LLC',
'license': [ { 'start': { 'date-parts': [[2020, 7, 20]],
'date-time': '2020-07-20T00:00:00Z',
'timestamp': 1595203200000},
'content-version': 'unspecified',
'delay-in-days': 0,
'URL': 'https://creativecommons.org/licenses/by/4.0/'}],
'content-domain': {'domain': [], 'crossmark-restriction': False},
'accepted': {'date-parts': [[2020, 7, 15]]},
'abstract': '<jats:title>Abstract</jats:title>\n'
' <jats:p>INTRODUCTION: The effectiveness of hydroxychloroquine in SARS-CoV-2 '
'prophylaxis and treatment is still controversial. In this study, our aim is to investigate '
'the potential effects of hydroxychloroquine therapy on patients with diagnosed with '
'rheumatoid arthritis and a confirmed SARS-CoV-2 infection.METHOD: We included patients who '
'were followed up with a diagnosis of rheumatoid arthritis and whose SARS-CoV-2 infection was '
'confirmed. The patients were divided into two groups as those who previously used '
'hydroxychloroquine and those who did not, and were compared in terms of clinical and '
'laboratory data.RESULTS: Our study included 17 patients with adequate data (2 males, 15 '
'females). The mean age of the patients was 57.2 ± 11.6 years. 7 (41.2%) patients were '
'receiving hydroxychloroquine regularly for the last 6 months. When the effect of '
'hydroxychloroquine on clinical and laboratory parameters of patients was examined, there was '
'no significant difference between the groups of patients using and not using '
'hydroxychloroquine. The patients using and not using hydroxychloroquine were compared for the '
'presence of typical SARS-CoV-2 infection findings on computed tomography images, admission to '
'the hospital and intensive care. No significant differences were observed between these two '
'groups.CONCLUSIONS: Many studies on the effectiveness of hydroxychloroquine use in SARS-CoV-2 '
'infection are still ongoing. Due to its importance in rheumatology practice, it is very '
'important to clarify the position of hydroxychloroquine in SARS-CoV-2 therapy. Our findings '
'suggest that having previously used hydroxychloroquine does not have any negative or positive '
'effect on the infection.</jats:p>',
'DOI': '10.21203/rs.3.rs-43812/v1',
'type': 'posted-content',
'created': {'date-parts': [[2020, 7, 20]], 'date-time': '2020-07-20T16:14:01Z', 'timestamp': 1595261641000},
'source': 'Crossref',
'is-referenced-by-count': 0,
'title': 'The effect of hydroxychloroquine against SARS-CoV-2 infection in rheumatoid arthritis patients',
'prefix': '10.21203',
'author': [ { 'ORCID': 'http://orcid.org/0000-0001-6971-4229',
'authenticated-orcid': False,
'given': 'Okan',
'family': 'Küçükakkaş',
'sequence': 'first',
'affiliation': [{'name': 'Bezmialem Vakıf University'}]},
{ 'ORCID': 'http://orcid.org/0000-0002-0902-6771',
'authenticated-orcid': False,
'given': 'Teoman',
'family': 'Aydın',
'sequence': 'additional',
'affiliation': [{'name': 'Bezmialem Vakıf University'}]}],
'member': '8761',
'container-title': [],
'original-title': [],
'link': [ { 'URL': 'https://www.researchsquare.com/article/rs-43812/v1',
'content-type': 'text/html',
'content-version': 'vor',
'intended-application': 'text-mining'},
{ 'URL': 'https://www.researchsquare.com/article/rs-43812/v1.html',
'content-type': 'unspecified',
'content-version': 'vor',
'intended-application': 'similarity-checking'}],
'deposited': { 'date-parts': [[2021, 3, 17]],
'date-time': '2021-03-17T17:47:07Z',
'timestamp': 1616003227000},
'score': 1,
'resource': {'primary': {'URL': 'https://www.researchsquare.com/article/rs-43812/v1'}},
'subtitle': [],
'short-title': [],
'issued': {'date-parts': [[2020, 7, 20]]},
'references-count': 0,
'URL': 'http://dx.doi.org/10.21203/rs.3.rs-43812/v1',
'relation': {},
'published': {'date-parts': [[2020, 7, 20]]},
'subtype': 'preprint'}