Chronic use of hydroxychloroquine did not protect against COVID-19 in a large cohort of patients with rheumatic diseases in Brazil

{ 'indexed': {'date-parts': [[2024, 6, 15]], 'date-time': '2024-06-15T22:34:39Z', 'timestamp': 1718490879586}, 'reference-count': 82, 'publisher': 'Springer Science and Business Media LLC', 'issue': '1', 'license': [ { 'start': { 'date-parts': [[2021, 10, 7]], 'date-time': '2021-10-07T00:00:00Z', 'timestamp': 1633564800000}, 'content-version': 'tdm', 'delay-in-days': 0, 'URL': 'https://creativecommons.org/licenses/by/4.0'}, { 'start': { 'date-parts': [[2021, 10, 7]], 'date-time': '2021-10-07T00:00:00Z', 'timestamp': 1633564800000}, 'content-version': 'vor', 'delay-in-days': 0, 'URL': 'https://creativecommons.org/licenses/by/4.0'}], 'funder': [{'name': 'CNPQ', 'award': ['403442/2020-6']}], 'content-domain': {'domain': ['link.springer.com'], 'crossmark-restriction': False}, 'published-print': {'date-parts': [[2021, 12]]}, 'abstract': '<jats:title>Abstract</jats:title><jats:sec>\n' ' <jats:title>Background</jats:title>\n' ' <jats:p>There is a lack of information on the role of chronic use of ' 'hydroxychloroquine during the SARS-CoV-2 outbreak. Our aim was to compare the occurrence of ' 'COVID-19 between rheumatic disease patients on hydroxychloroquine with individuals from the ' 'same household not taking the drug during the first 8\xa0weeks of community viral ' 'transmission in Brazil.\n' '</jats:p>\n' ' </jats:sec><jats:sec>\n' ' <jats:title>Methods</jats:title>\n' ' <jats:p>This baseline cross-sectional analysis is part of a 24-week ' 'observational multi-center study involving 22 Brazilian academic outpatient centers. All ' 'information regarding COVID-19 symptoms, epidemiological, clinical, and demographic data were ' 'recorded on a specific web-based platform using telephone calls from physicians and medical ' 'students. COVID-19 was defined according to the Brazilian Ministry of Health (BMH) criteria. ' 'Mann–Whitney, Chi-square and Exact Fisher tests were used for statistical analysis and two ' 'binary Final Logistic Regression Model by Wald test were developed using a backward-stepwise ' 'method for the presence of COVID-19.</jats:p>\n' ' </jats:sec><jats:sec>\n' ' <jats:title>Results</jats:title>\n' ' <jats:p>From March 29th to May 17st, 2020, a total of 10,443 participants ' 'were enrolled, including 5166 (53.9%) rheumatic disease patients, of whom 82.5% had systemic ' 'erythematosus lupus, 7.8% rheumatoid arthritis, 3.7% Sjögren’s syndrome and 0.8% systemic ' 'sclerosis. In total, 1822 (19.1%) participants reported flu symptoms within the 30\xa0days ' 'prior to enrollment, of which 3.1% fulfilled the BMH criteria, but with no significant ' 'difference between rheumatic disease patients (4.03%) and controls (3.25%). After adjustments ' 'for multiple confounders, the main risk factor significantly associated with a COVID-19 ' 'diagnosis was lung disease (OR 1.63; 95% CI 1.03–2.58); and for rheumatic disease patients ' 'were diagnosis of systemic sclerosis (OR 2.8; 95% CI 1.19–6.63) and glucocorticoids above ' '10\xa0mg/ day (OR 2.05; 95% CI 1.31–3.19). In addition, a recent influenza vaccination had a ' 'protective effect (OR 0.674; 95% CI 0.46–0.98).</jats:p>\n' ' </jats:sec><jats:sec>\n' ' <jats:title>Conclusion</jats:title>\n' ' <jats:p>Patients with rheumatic disease on hydroxychloroquine presented a ' 'similar occurrence of COVID-19 to household cohabitants, suggesting a lack of any protective ' 'role against SARS-CoV-2 infection.</jats:p>\n' ' <jats:p><jats:italic>Trial registration</jats:italic> Brazilian Registry of ' 'Clinical Trials (ReBEC; RBR – 9KTWX6).</jats:p>\n' ' </jats:sec>', 'DOI': '10.1186/s42358-021-00217-0', 'type': 'journal-article', 'created': {'date-parts': [[2021, 10, 7]], 'date-time': '2021-10-07T14:07:57Z', 'timestamp': 1633615677000}, 'update-policy': 'http://dx.doi.org/10.1007/springer_crossmark_policy', 'source': 'Crossref', 'is-referenced-by-count': 7, 'title': 'Chronic use of hydroxychloroquine did not protect against COVID-19 in a large cohort of patients ' 'with rheumatic diseases in Brazil', 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JMIR Res ' 'Protoc. 2020;9:e23532.', 'journal-title': 'JMIR Res Protoc'}], 'container-title': 'Advances in Rheumatology', 'original-title': [], 'language': 'en', 'link': [ { 'URL': 'https://link.springer.com/content/pdf/10.1186/s42358-021-00217-0.pdf', 'content-type': 'application/pdf', 'content-version': 'vor', 'intended-application': 'text-mining'}, { 'URL': 'https://link.springer.com/article/10.1186/s42358-021-00217-0/fulltext.html', 'content-type': 'text/html', 'content-version': 'vor', 'intended-application': 'text-mining'}, { 'URL': 'https://link.springer.com/content/pdf/10.1186/s42358-021-00217-0.pdf', 'content-type': 'application/pdf', 'content-version': 'vor', 'intended-application': 'similarity-checking'}], 'deposited': { 'date-parts': [[2021, 10, 7]], 'date-time': '2021-10-07T15:14:48Z', 'timestamp': 1633619688000}, 'score': 1, 'resource': { 'primary': { 'URL': 'https://advancesinrheumatology.biomedcentral.com/articles/10.1186/s42358-021-00217-0'}}, 'subtitle': [], 'short-title': [], 'issued': {'date-parts': [[2021, 10, 7]]}, 'references-count': 82, 'journal-issue': {'issue': '1', 'published-print': {'date-parts': [[2021, 12]]}}, 'alternative-id': ['217'], 'URL': 'http://dx.doi.org/10.1186/s42358-021-00217-0', 'relation': {}, 'ISSN': ['2523-3106'], 'subject': [], 'container-title-short': 'Adv Rheumatol', 'published': {'date-parts': [[2021, 10, 7]]}, 'assertion': [ { 'value': '2 April 2021', 'order': 1, 'name': 'received', 'label': 'Received', 'group': {'name': 'ArticleHistory', 'label': 'Article History'}}, { 'value': '14 September 2021', 'order': 2, 'name': 'accepted', 'label': 'Accepted', 'group': {'name': 'ArticleHistory', 'label': 'Article History'}}, { 'value': '7 October 2021', 'order': 3, 'name': 'first_online', 'label': 'First Online', 'group': {'name': 'ArticleHistory', 'label': 'Article History'}}, {'order': 1, 'name': 'Ethics', 'group': {'name': 'EthicsHeading', 'label': 'Declarations'}}, { 'value': 'This protocol was approved by the Brazilian Committee of Ethics in Human ' 'Research – CONEP on March 27^th, 2020 (CAAE 30246120.3.1001.5505). ' 'The informed consent process was conducted by phone, as CONEP waived the ' 'requirement for the written informed consent form due to the COVID-19 social ' 'distancing constraints. This study was registered at the Brazilian Registry of ' 'Clinical Trials (ReBEC; RBR – 9KTWX6). All sections are in accordance with ' 'STROBE guidelines.', 'order': 2, 'name': 'Ethics', 'group': {'name': 'EthicsHeading', 'label': 'Ethics approval and consent to participate'}}, { 'value': 'The consent of publication was given together with the consent of participation ' 'fol all participants and Investigators.', 'order': 3, 'name': 'Ethics', 'group': {'name': 'EthicsHeading', 'label': 'Consent for publication'}}, { 'value': 'The authors declare that they have no competing interests.', 'order': 4, 'name': 'Ethics', 'group': {'name': 'EthicsHeading', 'label': 'Competing interests'}}], 'article-number': '60'}