ABSTRACT
Objectives: We aimed at examining whether patients with rheumatological conditions receiving chronic hydroxychloroquine therapy are at a lower risk of developing SARS-CoV-2 infection than those not receiving hydroxychloroquine. Method(s): This historical cohort study included information of all patients aged 18 years or older with rheumatoid arthritis, systemic lupus erythematosus, or associated rheumatological conditions (based on International Classification of Diseases, 10th edition, diagnostic codes). A propensity score was calculated for each patient, and each patientwho was receiving hydroxychloroquine was matched to two patients who were not receiving hydroxychloroquine (controls). The primary endpoint was the proportion of patients with PCR-confirmed SARS-CoV-2 infection among those receiving chronic hydroxychloroquine versus the propensity-matched patients not receiving chronic hydroxychloroquine in 2021. Result(s): 322 patients receiving hydroxychloroquine and 645 patients not receiving hydroxychloroquine were included in the primary analysis. The incidence of active SARS-CoV-2 infections during the study period did not differ between patients receiving hydroxychloroquine and patients not receiving hydroxychloroquine ( [0 3%] vs 78 [0 4%] of 21406;odds ratio 0 79, 95% CI 0 52-1 20, p = 0 27). There were no significant differences in secondary outcomes between the two groups of patients who developed active SARS-CoV-2 infection. For all patients in the study, overall mortality was lower in the hydroxychloroquine group than in the group of patients who did not receive hydroxychloroquine (odds ratio hydroxychloroquine was not associated with the development of active SARS-CoV-2 infection (odds ratio 0 79, 95% CI 0 51-1 42) Conclusion(s): Hydroxychloroquine was not associated with a protective effect against SARS-CoV-2 infection in a large group of patients with rheumatological conditions.
ABSTRACT
Introduction: The role ofcoinfections in patients with COVID-19 has been dismissed, and their role in their prognosis and outcomes is unknown. Materials and Methods: Retrospective study of 306 adults infected by SARS-CoV-2 by antigenic or molecular test. The main objective was to evaluate the role of nosocomial coinfections in patients with COVID-19, follow-up from July 2020 to January 2021. Results: There was a higher frequency of the male gender 78 % in relation to the female 22 %, the accumulated mortalities in the presence of infection nosocomial for those under 60 were 5 (14.7 %), between 60 and 70 (28.57 %) and those over 70 years old 73 (59.8 %), showing that in those over 70 years old it doubles those between 60 and 70 and triples those under 60 years of age, all analyzes showing statistical significance, p<0.005. Discussion: The present study showed an adequate correlation between the presence of nosocomial infection and higher mortality in those who presented it, especially those older than 70 years. Conclusions: Coinfection at the time of diagnosis of COVID-19 is relatively frequent. The implicit mortality that nosocomial infections have in the COVID-19 patient makes it necessary to review care protocols and carry out epidemiological and hospital surveillance activities in these patients. Such findings could be essential to define the role of empirical antimicrobial therapy or prevention strategies. Administration at the time of suspicion of a co-infection, always in an individualized manner and based on the profiles of each health institution. © 2022 Academia Nacional de Medicina. All rights reserved.