Role of Hydroxychloroquine in Rheumatoid Arthritis and Systemic Lupus Erythematosus Patients during COVID-19 Pandemic

Abstract

Background: Antimalarial drugs including Hydroxychloroquine (HCQ) and chloroquine have been demonstrated to be associated with anti-inflammatory actions in different connective tissue diseases (CTD) as rheumatoid arthritis (RA) and Systemic Lupus Erythematosus (SLE). One of the points of interest was the emergent antiviral effect of these drugs against Covid-19 infection. However, this antiviral effect is still debatable. Objective: The objective was to study HCQ effects on the severity and outcome of COVID-19 infection in patients with RA and SLE. Patients and Methods: A total of 94 cases diagnosed as RA and SLE with COVID-19 infection were comprised in the study and were categorized into 2 groups: the first group included patients who were receiving HCQ treatment before infection, and the second group included patients who were not receiving HCQ before. Clinical, laboratory, and radiological findings as well as the outcome of patients were assessed to compare the severity of COVID-19 infection in both groups. Results: Demographic data showed higher female predominance. Fever, cough, rhinorrhea, and myalgia were observed in both groups with no significant variation except for rhinorrhea. D-dimer was significantly increased in the first group. Decreased oxygen saturation, need for mechanical ventilation, radiological changes suggestive of COVID-19 infection, and acute kidney injury (AKI) were more observed in the HCQ group with statistical significance. Conclusion: HCQ administration was not associated with less severe infection or better outcomes in RA and SLE patients infected with COVID-19.