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Effect of chronic hydroxychloroquine use on COVID-19 risk in patients with rheumatoid arthritis and systemic lupus erythematosus: a multicenter retrospective cohort

Walbi et al., Journal of International Medical Research, doi:10.1177/03000605221090363
Apr 2022  
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HCQ for COVID-19
1st treatment shown to reduce risk in March 2020, now with p < 0.00000000001 from 419 studies, recognized in 46 countries.
No treatment is 100% effective. Protocols combine treatments.
5,100+ studies for 109 treatments. c19hcq.org
Retrospective RA/SLE patients in Saudi Arabia. Numbers in this paper are contradictory. Figure 1 and the introduction to the results indicate 304 HCQ users, while Table 1 and later in the results shows 207 (arms switched). The subsequent text reporting the ICU results (2 non-HCQ-users, zero HCQ users) suggests that the labels are switched in Figure 2, or possibly just specific results.
This study is excluded in meta analysis: unresolved data inconsistency.
Walbi et al., 6 Apr 2022, retrospective, Saudi Arabia, peer-reviewed, 16 authors, study period March 2020 - February 2021.
This PaperHCQAll
Effect of chronic hydroxychloroquine use on COVID-19 risk in patients with rheumatoid arthritis and systemic lupus erythematosus: a multicenter retrospective cohort
Ismail A Walbi, Hassan A Albarqi, Nayef Saleh Alghanim, Marzooq Abdullah Albadi, Hesham Mohammed Al Maimouni, Saad Ahmed Alkahtani, Ali Mohamed Alshabi, Amer S Alali, Faleh Alqahtani, Amal Hassan Al-Najjar, Mohammad A Hazzazi, Deemah S Alanazi, Abdulrahman Abdulaziz Sabei, Omer S Alsaweed, Rahaf K Alajra, Hussain Alqhtani
Journal of International Medical Research, doi:10.1177/03000605221090363
Objective: Hydroxychloroquine (HCQ) has been used during the coronavirus disease 2019 (COVID-19) pandemic because of its reported anti-viral activity. This study examined the association of chronic HCQ use with the incidence and complications of COVID-19. Methods: This retrospective cohort study included adults with rheumatoid arthritis and/or systemic lupus erythematosus who visited rheumatology clinics in three tertiary hospitals in Riyadh, Saudi Arabia between January 2019 and December 2020. Patients were categorized into two groups based on HCQ use. Data were obtained from the electronic health record and by interviews with patients. The primary study objective was the incidence of COVID-19 and its complications from March 2020 to February 2021. Results: Almost 11% of the study cohort was positive for COVID-19, and the incidence of COVID-19 was similar between HCQ users (11.11%) and nonusers (10.86%). Disease complication rates were similar in the study arms, and they mainly included fever, dry cough, fatigue, and breathing difficulty. Conclusions: This study revealed no significant association between chronic HCQ use and the incidence of COVID-19, and disease complications were similar in the study arms.
Declaration of competing interests The authors declare that they have no competing interests. Author contributions IAW, HA, and HAA participated in the design of the study. IAW, HA, HAA, SAA, AMA, NSA, MAA, HMA, AHA, FA, and MAH prepared the methodology. IAW, ASA, NSA, MAA, HMA, AHA, and MAH supervised the project. IAW, HAA, and HA wrote the original draft. DSA, AAS, OSA, and RKA collected data. SAA, AMA, DSA, AAS, ASA, and FA reviewed and edited the writing. HA and IAW conducted the formal analysis. HA performed the statistical analysis. All authors reviewed and approved the final manuscript.
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