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Abstract

Background

Several clinical trials have assessed the protective potential of chloroquine and hydroxychloroquine. Chronic exposure to such drugs might lower the risk of infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) or severe coronavirus disease (COVID-19).

Aim

To assess COVID-19 incidence and risk of hospitalisation in a cohort of patients chronically taking chloroquine/hydroxychloroquine.

Methods

We used linked health administration databases to follow a cohort of patients with chronic prescription of hydroxychloroquine/chloroquine and a control cohort matched by age, sex and primary care service area, between 1 January and 30 April 2020. COVID-19 cases were identified using International Classification of Diseases 10 codes.

Results

We analysed a cohort of 6,746 patients (80% female) with active prescriptions for hydroxychloroquine/chloroquine, and 13,492 controls. During follow-up, there were 97 (1.4%) COVID-19 cases in the exposed cohort and 183 (1.4%) among controls. The incidence rate was very similar between the two groups (12.05 vs 11.35 cases/100,000 person-days). The exposed cohort was not at lower risk of infection compared with controls (hazard ratio (HR): 1.08; 95% confidence interval (CI): 0.83–1.44; p = 0.50). Forty cases (0.6%) were admitted to hospital in the exposed cohort and 50 (0.4%) in the control cohort, suggesting a higher hospitalisation rate in the former, though differences were not confirmed after adjustment (HR: 1·46; 95% CI: 0.91–2.34; p = 0.10).

Conclusions

Patients chronically exposed to chloroquine/hydroxychloroquine did not differ in risk of COVID-19 nor hospitalisation, compared with controls. As controls were mainly female, findings might not be generalisable to a male population.

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2021-03-04
2024-11-21
http://instance.metastore.ingenta.com/content/10.2807/1560-7917.ES.2021.26.9.2001202
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Incidence of COVID-19 in patients exposed to chloroquine and hydroxychloroquine: results from a population-based prospective cohort in Catalonia, Spain, 2020
<p class="citation"> <span>Citation style for this article:</span> <span class="meta-value authors"> <a href="/search?value1=Rosa+Maria+Vivanco-Hidalgo&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Vivanco-Hidalgo Rosa Maria</a>, <a href="/search?value1=Israel+Molina&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Molina Israel</a>, <a href="/search?value1=Elisenda+Martinez&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Martinez Elisenda</a>, <a href="/search?value1=Ram%C3%B3n+Roman-Vi%C3%B1as&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Roman-Viñas Ramón</a>, <a href="/search?value1=Adri%C3%A1n+S%C3%A1nchez-Montalv%C3%A1&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Sánchez-Montalvá Adrián</a>, <a href="/search?value1=Joan+Fibla&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Fibla Joan</a>, <a href="/search?value1=Caridad+Pontes&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Pontes Caridad</a>, <a href="/search?value1=C%C3%A9sar++Velasco+Mu%C3%B1oz&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Velasco Muñoz César </a>, <a href="/search?value1=on+behalf+of+the+Real+World+Data+Working+Group&option1=author&noRedirect=true" class="nonDisambigAuthorLink">on behalf of the Real World Data Working Group</a></span>. Incidence of COVID-19 in patients exposed to chloroquine and hydroxychloroquine: results from a population-based prospective cohort in Catalonia, Spain, 2020. <a href="/content/ecdc">Euro Surveill.</a> 2021;26(9):pii=2001202. <a href="https://doi.org/10.2807/1560-7917.ES.2021.26.9.2001202" title="doi link" target="_blank">https://doi.org/10.2807/1560-7917.ES.2021.26.9.2001202</a> <span class="ES_Article_citation"> <span class="generated">Received</span>: 15 Jun 2020;&nbsp;&nbsp; <span class="generated">Accepted</span>: 19 Oct 2020 </span> </p>
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