efficacy of pre-exposure treatment with hydroxy-chloroquine on the risk and severity of covid-19 infection

Conditions: COVID-19

Summary: there is a pandemic in the world by covid-19. currently, the pharmacological curative or prophylactic treatments for this infection are not known. recent studies have suggested that hydroxy-chloroquine could be effective in vitro and in vivo against covid-19. the main objective of this study is to assess in patients with autoimmune disease treated with long course hydroxy-chloroquine initiated before the pandemic covid-19 had an independent protective effect on the risk or the severity of infection with covid-19.

a pre- or post-exposure treatment strategy has been validated in some infectious diseases. in particular, in hiv infection, this type of prophylactic treatment reduces the rate of infection in at-risk populations. the first studies from chinese show that in case of immunosuppression or immunosuppressive treatment, whatever the causal pathology, covid-19 infection is more severe. the present study presents a population of patients with lupus (sle) or gougerot's disease (sgd) who are treated for a long time, with hydroxy-chloroquine. the protective effect against covid-19 infection of hydroxy-chloroquine compared to populations not exposed to this drug requires to be assessed in patients and their control groups under or without immunosuppressive treatments. it is hypothesized that long-term treatment with hydroxy-chloroquine in sle or sgd taken in its usual indication before the onset of the pandemic could decrease the number of covid19 infections and/or the intensity of the disease.

Eligibility criteria:
inclusion criteria: group with hydroxychloroquine treatment (hc +): * led/sg diagnosed * treatment with hydroxy-chloroquine in the 3 months before and during the outbreak at covid 19, at least in december 2019. patients may have treatment with immunosuppressants in combination with hydroxy-chloroquine. * covid19 diagnostic questionnaire and available serology result. group without hydroxychloroquine treatment (hc-) : * no hydroxy-chloroquine intake for more than 12 months --\> hc- without an immunosuppressant * viral hepatitis c cured for more than 12 months or primitive bile cholangitis (cbp) whose diagnosis is based on international criteria. * non-significant liver fibrosis assessed either by historical histology or by fibroscan with non-significant liver fibrosis metavir - f3 (at last available examination) * no hydroxy-chloroquine, or immunosuppressants have been taken for more than 12 months. * covid19 diagnostic questionnaire and covid19 serology result available. --\>hc- with an immunosuppressant * diagnosis of led/sg according to the cab criteria revised in 1997 or autoimmune hepatitis according to the international criteria validated in 2008. * patients treated with immunosuppressants for at least three months before the start of the pandemic at covid 19, at least since december 2019. * covid19 diagnostic questionnaire and available serology result. exclusion criteria: * anti-cd20 or cyclophosphamide taken during the six months prior to the completion of the covid 19 serology. * refusal of a blood test for antibodies to covid-19. * protected adults * pregnant or breastfeeding women. * lack of health insurance coverage

Keywords: lupus erythematous disease prophylaxis pre-emptive therapy hydroxy-chloroquine