Initial data from the COVID-19 Global Rheumatology Alliance provider registries.

Milena Gianfrancesco and colleagues underlined the potential use of disease-modifying drugs, such as hydroxychloroquine, for coronavirus disease 2019 (COVID-19) treatment, but I was struck by the absence of information about long-term hydroxychloroquine treatment among the reported patients.

Antimalarial drugs have raised hopes and fierce debate among scientific and public communities worldwide, rapidly creating a political dimension. Use of such drugs is a concern for both clinicians and the general population on different levels.

It is unknown whether patients with inflammatory rheumatic disease under treatment are more at risk for infection or serious disease due to severe acute respiratory syndrome coronavirus 2 than the general population. The aim of the COVID-19 Global Rheumatology Alliance provider registries is to determine such features. Beyond this primary objective, description and understanding of the determinants of COVID-19 in patients taking immunomodulatory or immunosuppressive drugs (such as hydroxychloroquine and IL-6 receptor antagonists) might help with understanding the disease pathophysiology to prevent the appearance or decrease the severity of COVID-19 pneumonia or neurological events.

It is critical to indicate in further reports the occurrence of clinically significant disease in patients treated with hydroxychloroquine, as this drug could be useful in preventing severe disease or minimising the viral excretion period. On April 6, a letter in the Annals of the Rheumatic Diseases stated that “hydroxychloroquine use might be an explanation for no report on systemic lupus erythematosus patients with COVID-19”, showing the confidence clinicians might place in incomplete data.