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Medical Science Monitor Basic Research


SARS-CoV-2 Infection and COVID-19 in 5 Patients in Ecuador After Prior Treatment with Hydroxychloroquine for Systemic Lupus Erythematosus

Unusual clinical course, Diagnostic / therapeutic accidents, Unusual setting of medical care, Adverse events of drug therapy , Educational Purpose (only if useful for a systematic review or synthesis)

María Fernanda Zurita, Adriana Iglesias Arreaga, Adriana A Luzuriaga Chavez, Luis Zurita

Ecuador Universidad Espíritu Santo (Holy Spirit University), School of Medicine, Samborondón, Ecuador

Am J Case Rep 2020; 21:e927304

DOI: 10.12659/AJCR.927304

Available online: 2020-09-14

Published: 2020-09-26

BACKGROUND: This case series describes 5 patients with SARS-CoV-2 infection and COVID-19 in Ecuador who had been treated with hydroxychloroquine for systemic lupus erythematosus (SLE) prior to their COVID-19 illness.
CASE REPORT: Case #1 reports a 29-year-old woman who had been treated with 200 mg of hydroxychloroquine per day for 1 year and presented with flu-like symptoms, chest pain, fever, odynophagia, asthenia, dry cough, and chills.
Case #2 was a 34-year-old woman whose treatment for SLE included 200 mg of hydroxychloroquine per day since 2017. She arrived at the clinic with a dry cough, asthenia, and myalgias.
Case #3 was a 24-year-old woman who had been using 200 mg of hydroxychloroquine per day since 2010. She presented with asthenia, myalgias, headaches, hypogeusia, and anosmia.
Case #4 was a 39-year-old woman taking 200 mg of hydroxychloroquine every day for SLE who presented with dyspnea, chest pain, odynophagia, hypogeusia, anosmia, diarrhea, and fever.
Case #5 was a 46-year-old woman who had been taking 200 mg of hydroxychloroquine since 2019. She came to our hospital complaining of chest pain, fever, and dyspnea.
In all 5 patients, SARS-CoV-2 infection was confirmed with a nasopharyngeal SARS-CoV-2 reverse transcription-polymerase chain reaction (RT-PCR) test using the Cepheid/GeneXpert system.

CONCLUSIONS: All 5 of our patients with SLE who were taking hydroxychloroquine presented with SARS-CoV-2 infection and symptoms of COVID-19. This case series provides support for a lack of prevention of COVID-19 by hydroxychloroquine.

Keywords: COVID-19, hydroxychloroquine, Lupus Erythematosus, Systemic, SARS Virus