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Highlights Hydroxychloroquine pharmacokinetic behavior in COVID-19 patients cannot be predicted using the systemic lupus erythematosus population or by rheumatoid arthritis patients. Bronchoalveolar lavage fluid could be considered a much more instructive “quality control” matrix than plasma on the degree of hydroxychloroquine exposure in the lung. Low plasma concentrations should not induce an increase of the drug dosage because the lung exposure should be high.