Chronic Hydroxychloroquine Therapy and COVID-19 Outcomes: A Retrospective Case-Control Analysis

Abstract: J AM ACAD DERMATOL VOLUME 84, NUMBER 6 Medicine, Boston University School of Medicine, Massachusetts.e Drs Hartman and La are cofirst authors. Funding sources: Supported by an American Skin Association research grant (120795 to Dr Hartman). IRB approval status: Not applicable. Reprints not available from the authors. Correspondence to: Rebecca I. Hartman, MD, MPH, Harvard Medical School, BWH Department of Dermatology, 221 Longwood Ave, Boston, MA 02215 E-mail: rhartman@bwh.harvard.edu Conflicts of interest None disclosed. REFERENCES 1. Faries MB, Thompson JF, Cochran AJ, et al. Completion dissection or observation for sentinel-node metastasis in melanoma. N Engl J Med. 2017;376(23):2211-2222. 2. Wei EX, Chen L, Ma F, Keri J, Hu S. Recent dermatology visit is associated with thinner Breslow depth nodular melanomas. J Am Acad Dermatol. 2019;80(4):1143-1144. 3. Roetzheim RG, Lee JH, Ferrante JM, et al. The influence of dermatologist and primary care physician visits on melanoma outcomes among Medicare beneficiaries. J Am Board Fam Med. 2013;26(6):637-647. 4. Jackson GL, Melton LD, Abbott DH, et al. Quality of nonmetastatic colorectal cancer care in the Department of Veterans Affairs. J Clin Oncol. 2010;28(19):3176-3181. 5. Orkaby AR, Nussbaum L, Ho YL, et al. The burden of frailty among U.S. veterans and its association with mortality, 2002-2012. J Gerontol A Biol Sci Med Sci. 2019;74(8): 1257-1264. https://doi.org/10.1016/j.jaad.2020.12.069 Chronic hydroxychloroquine therapy and COVID-19 outcomes: A retrospective case-control analysis To the Editor: Hydroxychloroquine (HCQ) has failed to show significant therapeutic benefit for patients with coronavirus disease-2019 (COVID-19) in recent studies, although interest in this medication’s potential pre- and postprophylactic efficacy remains, with 1 retrospective study showing reduced COVID-19 infection among patients taking chronic HCQ.1,2 In this study, we sought to evaluate COVID-19 clinical outcomes in patients taking chronic HCQ for an underlying condition as well as in a matched cohort not taking HCQ at time of COVID-19 diagnosis. Research Letters 1769 Table I. Hydroxychloroquine indication, dosage, and duration at time of COVID-19 diagnosis HCQ indication, dosage, and duration (N = 50) HCQ indication Systemic lupus erythematosus Rheumatoid arthritis Connective tissue disease overlap syndromes €gren syndrome Sjo Mixed connective tissue disease Undifferentiated connective tissue disease Erythema nodosum during pregnancy Carcinoid Myalgic encephalomyelitis/ chronic fatigue syndrome Acquired hypogammaglobulinemia HCQ dosage 200 mg HCQ daily 200 mg HCQ 2 times daily (400 mg total) 200 mg HCQ 3 times daily (600 mg total) Mean duration of HCQ therapy before COVID-19 diagnosis (IQR) n (%) 17 (34.0) 11 (22.0) 9 (18.0) 6 (12.0) 2 (4.0) 1 (2.0) 1 (2.0) 1 (2.0) 1 (2.0) 1 (2.0) 13 (36.0) 36 (72.0) 1 (2.0) 28 (14.25-44.25) months COVID-19, Coronavirus disease-2019; HCQ, hydroxychloroquine; IQR, interquartile range. We identified all patients with severe acute respiratory syndrome coronavirus 2 seen at New York University from March to April 2020 using International Classification of Diseases, 10th revision codes and included patients taking HCQ for $6 weeks before their COVID-19 diagnosis. Control subjects were randomly selected from the remaining severe acute respiratory syndrome coronavirus 2epositive patients with automated matching for age, gender, and immunosuppressive medication using..