This study concluded that there is no association between using hydroxychloroquine for the treatment of rheumatoid arthritis or systemic lupus before COVID-19 exposure and COVID-19 mortality risk, meaning that pre-exposure hydroxychloroquine use does not improve or worsen COVID-19 mortality. However, there are still other clinical trials being conducted investigating hydroxychloroquine as a pre-exposure prophylactic treatment for COVID-19.

Johns Hopkins University

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Although clinical studies have not clearly demonstrated that hydroxychloroquine can successfully treat COVID-19, some in vitro studies have demonstrated that hydroxychloroquine can prevent the entry of the virus into epithelial cells.  Thus, this study investigated the effectiveness of using hydroxychloroquine as a pre-exposure prophylactic treatment to help prevent COVID-19 mortality.  



Hydroxychloroquine as Pre-Exposure Prophylactic Treatment for COVID-19 Patients

Rentsch, C. T., Devito, N. J., Mackenna, B., Morton, C. E., Bhaskaran, K., Brown, J. P., . . . Goldacre, B. (2020). Effect of pre-exposure use of hydroxychloroquine on COVID-19 mortality: A population-based cohort study in patients with rheumatoid arthritis or systemic lupus erythematosus using the OpenSAFELY platform. The Lancet Rheumatology. doi:10.1016/s2665-9913(20)30378-7

Effect of pre-exposure use of hydroxychloroquine on COVID-19 mortality: a population-based cohort study in patients with rheumatoid arthritis or systemic lupus erythematosus using the OpenSAFELY platform

No association between regular use of hydroxychloroquine before the pandemic hit and COVID-19 mortality risk was observed.  Specifically, the absolute cumulative risk difference between patients who regularly used hydroxycholoroquine and patients who were not using hydroxychloroquine was 0.008% - a very minimal difference.  The standardized cumulative mortality for regular hydroxychloroquine users was 0.23%, and the standardized cumulative mortality for non-hydroxychloroquine users was 0.22%.  


Results

The study design was an observational, population-based cohort study in England. Electronic health records from primary care practices and death registrations were analyzed using OpenSAFELY, a data platform created for real-time analysis during the COVID-19 pandemic. Patients 18 years or older diagnosed with either rheumatoid arthritis or systemic lupus who regularly used hydroxychloroquine were included. The control group consisted of patients with the same conditions who did not regularly use hydroxychloroquine. A Cox regression was utilized to assess the association between the use or non-use of hydroxychloroquine before the pandemic and COVID-19 mortality risk.

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