Susceptibility to COVID-19 in Patients Treated With Antimalarials: A Population-Based Study in Emilia-Romagna, Northern Italy

Carlo Salvarani, Pamela Mancuso, Federica Gradellini, Nilla Viani, Paolo Pandolfi, Massimo Reta, Giuliano Carrozzi, Gilda Sandri, Gianluigi Bajocchi, Elena Galli, Francesco Muratore, Luigi Boiardi, Nicolò Pipitone, Giulia Cassone, Stefania Croci, Anna Maria Marata, Massimo Costantini, Paolo Giorgi Rossi

Research output: Contribution to journalArticlepeer-review


Objective: To evaluate the susceptibility to coronavirus disease 2019 (COVID-19) in patients with autoimmune conditions treated with antimalarials in a population-based study. Methods: All residents treated with chloroquine (CQ)/hydroxychloroquine (HCQ) from July through December 2019 and living in 3 provinces of Regione Emilia-Romagna were identified by drug prescription registries and matched with the registry containing all residents living in the same areas who have had swabs and tested positive for severe acute respiratory syndrome coronavirus 2 (SARS–CoV-2). Odds ratios (ORs) and 95% confidence intervals (95% CIs) were calculated. Results: A total of 4,408 patients were identified. The prevalence of patients receiving antimalarials was 0.85 per 1,000 men and 3.3 per 1,000 women. The cumulative incidence of testing during the study period was 2.7% in the general population and 3.8% among those receiving CQ or HCQ, while the cumulative incidence of testing positive was 0.55% in the general population and 0.70% among those receiving CQ/HCQ. Multivariate models showed that those receiving CQ/HCQ had a slightly higher probability of being tested compared to the general population (OR 1.09 [95% CI 0.94–1.28]), the same probability of being diagnosed as having COVID-19 (OR 0.94 [95% CI 0.66–1.34]), and a slightly lower probability of being positive once tested (OR 0.83 [95% CI 0.56–1.23]). None of the differences were significant. Conclusion: Our findings do not support the use of antimalarials as a prophylactic treatment of COVID-19.

Original languageEnglish
Pages (from-to)48-52
Number of pages5
JournalArthritis and Rheumatology
Issue number1
Publication statusPublished - Jan 2021

ASJC Scopus subject areas

  • Immunology and Allergy
  • Rheumatology
  • Immunology

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