Hydroxychloroquine(HCQ) is a disease-modifying anti-rheumatic drug that is often used in patients with rheumatoid arthritis(RA), systemic lupus erythematosus(SLE), and other autoimmune diseases like Sjogren's Syndrome(SS) or Mixed Connective Tissue Disease(MCTD). It has been observed that in-vitro, SARS-Cov-2 viral replication is reduced by HCQ, but in doses higher than 1000mg. There is controversy about whether it can help in preventing or treating COVID-19, but it is not approved by any international association.
Our study aimed to evaluate and analyze the incidence of COVID-19 in patients with SLE, RA, SS and, MCTD who were taking Hydroxychloroquine for their rheumatic diseases.
This was a prospective study that included 145 patients with SLE, RA, SS, and MCTD who were on HCQ. The study began on 25/02/2020 (14 days before discovering the first cases of SARS-Cov2 in Albania) and was completed on 25 March 2021, coinciding with the start of massive vaccination. All patients were completed with SARS-Cov-2 serology and PCR.
After analyzing the data, it was seen that in 24 patients(16.6%) were found positive IgG anti-Cov-2, 4 patients had experienced pulmonary complications, however, not requiring hospitalization. Twelve of them had RA, 3 had SS, 7 patients had SLE and 2 patients had MCTD. All IgG-positive patients had taken 200mg/day. The other 121 patients(83.4%) were found to have negative IgG anti-Cov-2 antibodies.
Our study resulted in a low incidence of COVID-19 in patients with rheumatic diseases on hydroxychloroquine. This suggests a protective role of this drug in rheumatic patients, even in moderate usual doses.