Failure of chronic hydroxychloroquine in preventing severe complications of COVID-19 in patients with rheumatic diseases

Pham, Khanh; Torres, Heidi; Satlin, Michael J; Goyal, Parag; Gulick, Roy M

OBJECTIVE: To compare baseline characteristics, clinical presentations, and outcomes of patients with rheumatic conditions requiring hospitalization for COVID-19 who received chronic hydroxychloroquine to those who did not receive chronic hydroxychloroquine. METHODS: We identified all patients with a rheumatologic disease who were admitted with COVID-19 to two hospitals in New York City between March 3-April 30 2020. Patients who received chronic hydroxychloroquine prior to admission were matched 1:2 (±10 years of age) to patients who did not receive chronic hydroxychloroquine. We compared demographics, comorbidities, hydroxychloroquine dosages, concurrent medications, presentations, and outcomes between the groups. RESULTS: There were 14 patients receiving hydroxychloroquine and 28 matched control subjects. The median age of cases was 63 years (IQR 43–73) and 60 years (IQR 41–75) for controls. Control subjects had a higher prevalence of pulmonary diseases (42.8%), diabetes (35.7%), and obesity (35.7%) than their case counterparts (28.6%, 14.3%, and 7.1%, respectively). A higher proportion of case than control subjects (50% vs.s 25%) reported usage of prednisone for their rheumatic conditions prior to admission. Despite these differences in baseline characteristics, univariate logistic regression revealed no statistically significant differences in the need for mechanical ventilation (OR 1.5; 95% CI: 0.34–6.38) or in-hospital mortality (OR 0.77; 95% CI: 0.13–4.56). CONCLUSION: Hydroxychloroquine therapy in individuals with rheumatic conditions was not associated with less severe presentations of COVID-19 among hospitalized patients compared with individuals with rheumatic conditions not receiving hydroxychloroquine.