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

• Published in: The American journal of case reports Vol. 21; p. e927304
• Main Authors: Zurita, María Fernanda, Iglesias Arreaga, Adriana, Luzuriaga Chavez, Adriana A, Zurita, Luis
• Format: Journal Article
• Language: English
• Published: United States International Scientific Literature, Inc 26-09-2020
• Subjects: Adult; Clinical Laboratory Techniques; Coronavirus Infections - diagnosis; Coronavirus Infections - epidemiology; Coronavirus Infections - prevention & control; COVID-19; COVID-19 Testing; Dyspnea - diagnosis; Dyspnea - etiology; Ecuador; Emergency Service, Hospital; Female; Fever - diagnosis; Fever - etiology; Humans; Hydroxychloroquine - administration & dosage; Lupus Erythematosus, Systemic - drug therapy; Middle Aged; Pandemics - prevention & control; Pandemics - statistics & numerical data; Pneumonia, Viral - diagnosis; Pneumonia, Viral - epidemiology; Pneumonia, Viral - prevention & control; Real-Time Polymerase Chain Reaction - methods; Risk Assessment; RNA, Viral - analysis; Sampling Studies; Treatment Failure; Young Adult; Ecuador
• ISSN: 1941-5923; 1941-5923
• DOI: 10.12659/AJCR.927304

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.