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No evidence so far on the protective effect of hydroxychloroquine to prevent COVID-19: response to the comment by Joob and Wiwanitkit
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  1. Vasco C. Romão1,2,
  2. Ana Rita Cruz-Machado1,2,
  3. João Eurico Fonseca1,2
  1. 1 Rheumatology Department, Hospital de Santa Maria, CHULN, Lisbon Academic Medical Centre, Lisbon, Portugal
  2. 2 Rheumatology Research Unit, Instituto de Medicina Molecular João Lobo Antunes, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
  1. Correspondence to Prof. João Eurico Fonseca, Rheumatology Research Unit, Instituto de Medicina Molecular João Lobo Antunes. Av Prof Egas Moniz, 1649-028, Lisbon, Portugal; jecfonseca{at}gmail.com

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We read with interest the comment by Joob and Wiwanitkit1 on the letter published by Monti et al in the Annals of the Rheumatic Diseases (ARD).2 In it, the authors state that there are no reported cases of patients with systemic lupus erythematosus (SLE) with COVID-19 and suggest that this may be due to a protective effect of hydroxychloroquine, a mainstay treatment taken by most patients with SLE. A similar suggestion had already been made earlier this month in the ARD by colleagues from Italy,3 the first hardly-hit western country, and was reinforced by yet another recently published letter.4

As is now widely known, this old antimalarial drug, which has been part of the daily therapeutic armamentarium of rheumatologists for decades, has reached the global spotlight after demonstration of antiviral efficacy in vitro5 and some suggestions of clinical efficacy in studies with methodological limitations and fast peer-review …

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