Tanzer KORKMAZ, İlker KIZILOĞLU, Vedat GERDAN, Aslı SENER

ROMATİZMAL HASTALIK NEDENİ İLE HİDROKSİKLOROKİNİN KULLANIMININ COVİD-19'a YAKALANMA VE HASTALIK SEYRİ ÜZERİNE ETKİSİ

Giriş: COVID-19 virüsü dünya çapında yayılmaya ve öldürmeye devam etmektedir. Hidroksiklorokinin etkinliği ve güvenilirliği kanıtlanmadığı için klinik araştırmalar dışında profilaksi için kullanılmaması gerektiği bildirilmiştir. Ancak yerel bir alanda yaptığımız bu çalışmanın sonuçlarının literatür verilerine katkı sağlayacağını düşünüyoruz. Gereç ve Yöntem: Bu çalışmada romatolojik hastalıkları nedeniyle hidroksiklorokin kullanan ve kullanmayan erişkin hastalar retrospektif değerlendirildi. Hidroksiklorokin kullanmayan hastalar kontrol grubu olarak belirlendi. PCR sonuçları ile hastaların hidroksiklorokinin kullanım özellikleri karşılaştırıldı. Bulgular: Hastaların çoğunluğunu (ortanca yaş: 51.8- 17-89 arası) kadınlar (en sık ev hanımı) oluşturmakta idi. Hidroksiklorokin kullanan hasta grubundaki 22 (%5.72) hastanın COVİD-19 şüphesiyle PCR testi yaptırdığı ve sadece ikisinde (%0.52) PCR pozitifliği saptandığı tespit edilmiştir. Kontrol grubunda ise (n=299) PCR testi yapılan 65 hastanın (%21,73) 24'ünde (%8.02) COVİD-19 tespit edildiği görülmektedir. PCR pozitifliği hidroksiklorokinin kullanan grupta istatistiksel olarak daha düşük tespit edildi (n = 2, %0.52, n = 24, %8.02, p = 0.0001). Sonuç: Çalışmamız, hidroksiklorokinin kullanmayanlara göre düzenli olarak hidroksiklorokinin kullananlarda PCR pozitifliğinin daha düşük olduğunu desteklemektedir.

THE EFFECT OF HYDROXYCHLOROQUINE USE DUE TO RHEUMATIC DISEASE ON THE RISK OF COVID-19 INFECTION AND ITS COURSE

Introduction: COVID-19 virus continues to spread and kill worldwide. Some studies examining hydroxychloroquine as a prophylactic agent reported that its efficiency and reliability have not been proven so that it must not be used for prophylaxis other than clinical researches. However we think that the results of this study we conducted in a local area will contribute to the literature data. Material and Method: In this study, adult patients who used and did not use hydroxychloroquine due to rheumatological diseases were evaluated retrospectively. Patients who did not use hydroxychloroquine were determined as the control group. The PCR results and the use of hydroxychloroquine features in the patients were compared. Results: The majority of the patients (median age: 51.8- range 17-89) were women and housewives. In the patient group using hydroxychloroquine, 22 patients were tested for PCR and only 2 positive patients were found. COVİD-19 was detected in 24 (8.02%) of 65 (21.73%) patients who underwent PCR test at control group (n = 299). PCR positivity was statistically lower in the HC group (n = 2, 0.52%, n = 24, 8.02%, respectively, p = 0.0001). Conclusions: Our study supported the fact that there is a lower PCR positivity who are using Hydroxychloroquine regularly, as compared to those who are not using hydroxychloroquine.

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1. Yang Y, Islam MS, Wang J, Li Y, Chen X. Traditional Chinese medicine in the treatment of patients ınfected with 2019-New Coronavirus (SARS-CoV-2): A review and perspective. International Journal of Biological Sciences 2020; 16(10): 1708-17.
2. Dashboard WCDC-: https://covid19.who.int. Data last updated 2021/1/7, 10:18am CET 2021.
3. Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet 2020; 395(10223): 497-506.
4. Gao J TZ, Yang X. Breakthrough: Chloroquine phosphate has shown apparent efficacy in treatment of COVID-19 associated pneumonia in clinical studies. BioScience Trends /Advance Publication 2020; 14(1): 72-3.
5. Savarino A, Boelaert JR, Cassone A, Majori G, Cauda R. Effects of chloroquine on viral infections: an old drug against today's diseases? Lancet Infect Dis 2003; 3(11): 722-7.
6. Wang M, Cao R, Zhang L, Yang X, Liu J, Xu M et al. Remdesivir and chloroquine effectively inhibit the recently emerged novel coronavirus (2019-nCoV) in vitro. Cell Res 2020; 30(3): 269-71.
7. Yao X, Ye F, Zhang M, Cui C, Huang B, Niu P et al. In Vitro Antiviral Activity and Projection of Optimized Dosing Design of Hydroxychloroquine for the Treatment of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). Clin Infect Dis 2020; 71(15): 732-9.
8. Infectious Diseases Society of America Guidelines on the Treatment and Management of Patients with COVID-19. https://www.idsociety.org/practice-guideline/covid-19-guideline-treatment-and-management/ (Accessed on April 13, 2020).
9. Agrawal S GAD, Gupta N. Emerging prophylaxis strategies against COVID-19. Monaldi Archives for Chest Disease 2020 30; 90(1): 1289.
10. Vincent MJ, Bergeron E, Benjannet S, Erickson BR, Rollin PE, Ksiazek TG et al. Chloroquine is a potent inhibitor of SARS coronavirus infection and spread. Virology Journal 2005; 2(1): 69.
11. Gendelman O, Amital H, Bragazzi NL, Watad A, Chodick G. Continuous hydroxychloroquine or colchicine therapy does not prevent infection with SARS-CoV-2: Insights from a large healthcare database analysis. Autoimmun Rev 2020; 19(7): 102566.
12. Gautret P LJ, Parola P, Hoang T, Meddeb L, Mailhe M, Doudier B et al. Hydroxychloroquine and azithromycin as a treatment of COVID-19: results of an open- label non-randomized clinical trial. Int J Antimicrob Agents 2020; 56(1): 105949.
13. Rosendaal FR. Review of: "Hydroxychloroquine and azithromycin as a treatment of COVID-19: results of an open-label nonrandomized clinical trial Gautret et al. Int J Antimicrob Agents 2020; 56(1): 106063.
14. Goldman JD, Diaz G, Urba WJ. Use of hydroxychloroquine in combination with azithromycin for patients with COVID-19 is not supported by recent literature. Int J Antimicrob Agents 2021 57(1): 106174.
15. Monti M, Vertogen B, Masini C, Donati C, Lilli C, Zingaretti C et al. Hydroxychloroquine as Prophylaxis for COVID-19: A Review. Frontiers in pharmacology 2020; 11: 605185
16. Pereira BB. Challenges and cares to promote rational use of chloroquine and hydroxychloroquine in the management of coronavirus disease 2019 (COVID-19) pandemic: a timely review. J Toxicol Environ Health B Crit Rev 2020; 23(4): 177-81.
17. Boulware DR, Pullen MF, Bangdiwala AS, Pastick KA, Lofgren SM, Okafor EC et al. A randomized trial of hydroxychloroquine as postexposure prophylaxis for Covid-19. New England Journal of Medicine 2020; 383(6): 517-25.
18. Rajasingham R, Bangdiwala AS, Nicol MR, Skipper CP, Pastick KA, Axelrod ML et al. Hydroxychloroquine as pre-exposure prophylaxis for Coronavirus Disease 2019 (COVID-19) in healthcare workers: A randomized trial. Clinical Infectious Diseases 2020; 09.18.20197327.
19. Abella BS, Jolkovsky EL, Biney BT, Uspal JE, Hyman MC, Frank I et al. Efficacy and safety of Hydroxychloroquine vs Placebo for Pre-exposure SARS-CoV-2 prophylaxis among health care workers: A randomized clinical trial. JAMA Internal Medicine 2021; 181(2): 195-202.