Risk of COVID-19 hospitalization and mortality in rheumatic patients treated with hydroxychloroquine or other conventional DMARDs in Italy.
Identifieur interne : 000107 ( Main/Corpus ); précédent : 000106; suivant : 000108Risk of COVID-19 hospitalization and mortality in rheumatic patients treated with hydroxychloroquine or other conventional DMARDs in Italy.
Auteurs : Stefania Spila Alegiani ; Salvatore Crisafulli ; Paolo Giorgi Rossi ; Pamela Mancuso ; Carlo Salvarani ; Fabiola Atzeni ; Rosa Gini ; Ursula Kirchmayer ; Valeria Belleudi ; Peter Konstantin Kurotschka ; Olivia Leoni ; Monica Ludergnani ; Eliana Ferroni ; Susanna Baracco ; Marco Massari ; Gianluca TrifirSource :
- Rheumatology (Oxford, England) [ 1462-0332 ] ; 2021.
Abstract
OBJECTIVES
To ascertain if hydroxychloroquine (HCQ)/chloroquine (CLQ) and other conventional disease-modifying anti-rheumatic drugs (cDMARDs) use, and rheumatic diseases per se, may be associated with COVID-19-related risk of hospitalization and mortality.
METHODS
This case-control study nested within a cohort of cDMARD users was conducted in the Lombardy, Veneto, Tuscany and Lazio regions and Reggio Emilia province. Claims databases were linked to COVID-19 surveillance registries. Risk of COVID-19-related outcomes was estimated using a multivariate conditional logistic regression analysis, comparing HCQ/CLQ vs methotrexate, vs other cDMARDs and vs non-use of these drugs. Presence of rheumatic diseases vs their absence in a non-nested population was investigated.
RESULTS
1275 cases hospitalized due to COVID-19 were matched to 12 734 controls. Compared with recent use of methotrexate, no association between HCQ/CLQ monotherapy and COVID-19 hospitalization (OR 0.83 [95%CI, 0.69-1.00]) or mortality (OR 1.19 [95%CI, 0.85-1.67]) was observed. A lower risk was found when comparing HCQ/CLQ use to the concomitant use of other cDMARDs and glucocorticoids. HCQ/CLQ was not associated with COVID-19 hospitalization as compared with non-use. An increased risk for recent use of either methotrexate monotherapy (OR 1.19 [95% CI, 1.05-1.34]) or other cDMARDs (OR 1.21 [95% CI, 1.08-1.36]) vs non-use was found. Rheumatic diseases were not associated with COVID-19-related outcomes.
CONCLUSION
HCQ/CLQ use in rheumatic patients was not associated with a protective effect against COVID-19-related outcomes. Use of other cDMARDs was associated with an increased risk when compared with non-use, and, if concomitantly used with glucocorticoids, also vs HCQ/CLQ, probably to be ascribed to immunosuppressive action.
DOI: 10.1093/rheumatology/keab348
PubMed: 33856453
PubMed Central: PMC8083276
Links to Exploration step
pubmed:33856453Le document en format XML
<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Risk of COVID-19 hospitalization and mortality in rheumatic patients treated with hydroxychloroquine or other conventional DMARDs in Italy.</title><author><name sortKey="Alegiani, Stefania Spila" sort="Alegiani, Stefania Spila" uniqKey="Alegiani S" first="Stefania Spila" last="Alegiani">Stefania Spila Alegiani</name><affiliation><nlm:affiliation>Pharmacoepidemiology Unit, National Centre for Drug Research and Evaluation, Istituto Superiore di Sanità, Rome, Italy.</nlm:affiliation></affiliation></author><author><name sortKey="Crisafulli, Salvatore" sort="Crisafulli, Salvatore" uniqKey="Crisafulli S" first="Salvatore" last="Crisafulli">Salvatore Crisafulli</name><affiliation><nlm:affiliation>Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Italian Society of Pharmacology, Milan, Italy.</nlm:affiliation></affiliation></author><author><name sortKey="Rossi, Paolo Giorgi" sort="Rossi, Paolo Giorgi" uniqKey="Rossi P" first="Paolo Giorgi" last="Rossi">Paolo Giorgi Rossi</name><affiliation><nlm:affiliation>Epidemiology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy.</nlm:affiliation></affiliation></author><author><name sortKey="Mancuso, Pamela" sort="Mancuso, Pamela" uniqKey="Mancuso P" first="Pamela" last="Mancuso">Pamela Mancuso</name><affiliation><nlm:affiliation>Epidemiology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy.</nlm:affiliation></affiliation></author><author><name sortKey="Salvarani, Carlo" sort="Salvarani, Carlo" uniqKey="Salvarani C" first="Carlo" last="Salvarani">Carlo Salvarani</name><affiliation><nlm:affiliation>Unit of Rheumatology, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Emilia-Romagna, Italy.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Department of Surgery, Medicine, Dentistry and Morphological Sciences with Interest in Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Modena, Emilia-Romagna, Italy.</nlm:affiliation></affiliation></author><author><name sortKey="Atzeni, Fabiola" sort="Atzeni, Fabiola" uniqKey="Atzeni F" first="Fabiola" last="Atzeni">Fabiola Atzeni</name><affiliation><nlm:affiliation>Rheumatology Unit, Department of Experimental and Internal Medicine, University of Messina, Messina, Italy.</nlm:affiliation></affiliation></author><author><name sortKey="Gini, Rosa" sort="Gini, Rosa" uniqKey="Gini R" first="Rosa" last="Gini">Rosa Gini</name><affiliation><nlm:affiliation>Agenzia Regionale di Sanità della Toscana, Florence, Italy.</nlm:affiliation></affiliation></author><author><name sortKey="Kirchmayer, Ursula" sort="Kirchmayer, Ursula" uniqKey="Kirchmayer U" first="Ursula" last="Kirchmayer">Ursula Kirchmayer</name><affiliation><nlm:affiliation>Department of Epidemiology ASL Roma 1, Lazio Regional Health Service, Rome, Italy.</nlm:affiliation></affiliation></author><author><name sortKey="Belleudi, Valeria" sort="Belleudi, Valeria" uniqKey="Belleudi V" first="Valeria" last="Belleudi">Valeria Belleudi</name><affiliation><nlm:affiliation>Department of Epidemiology ASL Roma 1, Lazio Regional Health Service, Rome, Italy.</nlm:affiliation></affiliation></author><author><name sortKey="Kurotschka, Peter Konstantin" sort="Kurotschka, Peter Konstantin" uniqKey="Kurotschka P" first="Peter Konstantin" last="Kurotschka">Peter Konstantin Kurotschka</name><affiliation><nlm:affiliation>Department of Medical Sciences and Public Health, Faculty of Medicine and Surgery, University of Cagliari, Cagliari, Italy.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Regional Health Trust of Sardinia Region, Cagliari, Italy.</nlm:affiliation></affiliation></author><author><name sortKey="Leoni, Olivia" sort="Leoni, Olivia" uniqKey="Leoni O" first="Olivia" last="Leoni">Olivia Leoni</name><affiliation><nlm:affiliation>Epidemiology Observatory-Department of Health of Lombardy Region, Milan, Italy.</nlm:affiliation></affiliation></author><author><name sortKey="Ludergnani, Monica" sort="Ludergnani, Monica" uniqKey="Ludergnani M" first="Monica" last="Ludergnani">Monica Ludergnani</name><affiliation><nlm:affiliation>Epidemiology Observatory-Department of Health of Lombardy Region, Milan, Italy.</nlm:affiliation></affiliation></author><author><name sortKey="Ferroni, Eliana" sort="Ferroni, Eliana" uniqKey="Ferroni E" first="Eliana" last="Ferroni">Eliana Ferroni</name><affiliation><nlm:affiliation>Azienda Zero of the Veneto Region, Padua, Italy.</nlm:affiliation></affiliation></author><author><name sortKey="Baracco, Susanna" sort="Baracco, Susanna" uniqKey="Baracco S" first="Susanna" last="Baracco">Susanna Baracco</name><affiliation><nlm:affiliation>Azienda Zero of the Veneto Region, Padua, Italy.</nlm:affiliation></affiliation></author><author><name sortKey="Massari, Marco" sort="Massari, Marco" uniqKey="Massari M" first="Marco" last="Massari">Marco Massari</name><affiliation><nlm:affiliation>Pharmacoepidemiology Unit, National Centre for Drug Research and Evaluation, Istituto Superiore di Sanità, Rome, Italy.</nlm:affiliation></affiliation></author><author><name sortKey="Trifir, Gianluca" sort="Trifir, Gianluca" uniqKey="Trifir G" first="Gianluca" last="Trifir">Gianluca Trifir</name><affiliation><nlm:affiliation>Italian Society of Pharmacology, Milan, Italy.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Department of Diagnostics and Public Health, University of Verona, Verona, Italy.</nlm:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2021">2021</date><idno type="RBID">pubmed:33856453</idno><idno type="pmid">33856453</idno><idno type="doi">10.1093/rheumatology/keab348</idno><idno type="pmc">PMC8083276</idno><idno type="wicri:Area/Main/Corpus">000107</idno><idno type="wicri:explorRef" wicri:stream="Main" wicri:step="Corpus" wicri:corpus="PubMed">000107</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Risk of COVID-19 hospitalization and mortality in rheumatic patients treated with hydroxychloroquine or other conventional DMARDs in Italy.</title><author><name sortKey="Alegiani, Stefania Spila" sort="Alegiani, Stefania Spila" uniqKey="Alegiani S" first="Stefania Spila" last="Alegiani">Stefania Spila Alegiani</name><affiliation><nlm:affiliation>Pharmacoepidemiology Unit, National Centre for Drug Research and Evaluation, Istituto Superiore di Sanità, Rome, Italy.</nlm:affiliation></affiliation></author><author><name sortKey="Crisafulli, Salvatore" sort="Crisafulli, Salvatore" uniqKey="Crisafulli S" first="Salvatore" last="Crisafulli">Salvatore Crisafulli</name><affiliation><nlm:affiliation>Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Italian Society of Pharmacology, Milan, Italy.</nlm:affiliation></affiliation></author><author><name sortKey="Rossi, Paolo Giorgi" sort="Rossi, Paolo Giorgi" uniqKey="Rossi P" first="Paolo Giorgi" last="Rossi">Paolo Giorgi Rossi</name><affiliation><nlm:affiliation>Epidemiology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy.</nlm:affiliation></affiliation></author><author><name sortKey="Mancuso, Pamela" sort="Mancuso, Pamela" uniqKey="Mancuso P" first="Pamela" last="Mancuso">Pamela Mancuso</name><affiliation><nlm:affiliation>Epidemiology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy.</nlm:affiliation></affiliation></author><author><name sortKey="Salvarani, Carlo" sort="Salvarani, Carlo" uniqKey="Salvarani C" first="Carlo" last="Salvarani">Carlo Salvarani</name><affiliation><nlm:affiliation>Unit of Rheumatology, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Emilia-Romagna, Italy.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Department of Surgery, Medicine, Dentistry and Morphological Sciences with Interest in Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Modena, Emilia-Romagna, Italy.</nlm:affiliation></affiliation></author><author><name sortKey="Atzeni, Fabiola" sort="Atzeni, Fabiola" uniqKey="Atzeni F" first="Fabiola" last="Atzeni">Fabiola Atzeni</name><affiliation><nlm:affiliation>Rheumatology Unit, Department of Experimental and Internal Medicine, University of Messina, Messina, Italy.</nlm:affiliation></affiliation></author><author><name sortKey="Gini, Rosa" sort="Gini, Rosa" uniqKey="Gini R" first="Rosa" last="Gini">Rosa Gini</name><affiliation><nlm:affiliation>Agenzia Regionale di Sanità della Toscana, Florence, Italy.</nlm:affiliation></affiliation></author><author><name sortKey="Kirchmayer, Ursula" sort="Kirchmayer, Ursula" uniqKey="Kirchmayer U" first="Ursula" last="Kirchmayer">Ursula Kirchmayer</name><affiliation><nlm:affiliation>Department of Epidemiology ASL Roma 1, Lazio Regional Health Service, Rome, Italy.</nlm:affiliation></affiliation></author><author><name sortKey="Belleudi, Valeria" sort="Belleudi, Valeria" uniqKey="Belleudi V" first="Valeria" last="Belleudi">Valeria Belleudi</name><affiliation><nlm:affiliation>Department of Epidemiology ASL Roma 1, Lazio Regional Health Service, Rome, Italy.</nlm:affiliation></affiliation></author><author><name sortKey="Kurotschka, Peter Konstantin" sort="Kurotschka, Peter Konstantin" uniqKey="Kurotschka P" first="Peter Konstantin" last="Kurotschka">Peter Konstantin Kurotschka</name><affiliation><nlm:affiliation>Department of Medical Sciences and Public Health, Faculty of Medicine and Surgery, University of Cagliari, Cagliari, Italy.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Regional Health Trust of Sardinia Region, Cagliari, Italy.</nlm:affiliation></affiliation></author><author><name sortKey="Leoni, Olivia" sort="Leoni, Olivia" uniqKey="Leoni O" first="Olivia" last="Leoni">Olivia Leoni</name><affiliation><nlm:affiliation>Epidemiology Observatory-Department of Health of Lombardy Region, Milan, Italy.</nlm:affiliation></affiliation></author><author><name sortKey="Ludergnani, Monica" sort="Ludergnani, Monica" uniqKey="Ludergnani M" first="Monica" last="Ludergnani">Monica Ludergnani</name><affiliation><nlm:affiliation>Epidemiology Observatory-Department of Health of Lombardy Region, Milan, Italy.</nlm:affiliation></affiliation></author><author><name sortKey="Ferroni, Eliana" sort="Ferroni, Eliana" uniqKey="Ferroni E" first="Eliana" last="Ferroni">Eliana Ferroni</name><affiliation><nlm:affiliation>Azienda Zero of the Veneto Region, Padua, Italy.</nlm:affiliation></affiliation></author><author><name sortKey="Baracco, Susanna" sort="Baracco, Susanna" uniqKey="Baracco S" first="Susanna" last="Baracco">Susanna Baracco</name><affiliation><nlm:affiliation>Azienda Zero of the Veneto Region, Padua, Italy.</nlm:affiliation></affiliation></author><author><name sortKey="Massari, Marco" sort="Massari, Marco" uniqKey="Massari M" first="Marco" last="Massari">Marco Massari</name><affiliation><nlm:affiliation>Pharmacoepidemiology Unit, National Centre for Drug Research and Evaluation, Istituto Superiore di Sanità, Rome, Italy.</nlm:affiliation></affiliation></author><author><name sortKey="Trifir, Gianluca" sort="Trifir, Gianluca" uniqKey="Trifir G" first="Gianluca" last="Trifir">Gianluca Trifir</name><affiliation><nlm:affiliation>Italian Society of Pharmacology, Milan, Italy.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Department of Diagnostics and Public Health, University of Verona, Verona, Italy.</nlm:affiliation></affiliation></author></analytic><series><title level="j">Rheumatology (Oxford, England)</title><idno type="eISSN">1462-0332</idno><imprint><date when="2021" type="published">2021</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><b>OBJECTIVES</b></p><p>To ascertain if hydroxychloroquine (HCQ)/chloroquine (CLQ) and other conventional disease-modifying anti-rheumatic drugs (cDMARDs) use, and rheumatic diseases per se, may be associated with COVID-19-related risk of hospitalization and mortality.</p></div><div type="abstract" xml:lang="en"><p><b>METHODS</b></p><p>This case-control study nested within a cohort of cDMARD users was conducted in the Lombardy, Veneto, Tuscany and Lazio regions and Reggio Emilia province. Claims databases were linked to COVID-19 surveillance registries. Risk of COVID-19-related outcomes was estimated using a multivariate conditional logistic regression analysis, comparing HCQ/CLQ vs methotrexate, vs other cDMARDs and vs non-use of these drugs. Presence of rheumatic diseases vs their absence in a non-nested population was investigated.</p></div><div type="abstract" xml:lang="en"><p><b>RESULTS</b></p><p>1275 cases hospitalized due to COVID-19 were matched to 12 734 controls. Compared with recent use of methotrexate, no association between HCQ/CLQ monotherapy and COVID-19 hospitalization (OR 0.83 [95%CI, 0.69-1.00]) or mortality (OR 1.19 [95%CI, 0.85-1.67]) was observed. A lower risk was found when comparing HCQ/CLQ use to the concomitant use of other cDMARDs and glucocorticoids. HCQ/CLQ was not associated with COVID-19 hospitalization as compared with non-use. An increased risk for recent use of either methotrexate monotherapy (OR 1.19 [95% CI, 1.05-1.34]) or other cDMARDs (OR 1.21 [95% CI, 1.08-1.36]) vs non-use was found. Rheumatic diseases were not associated with COVID-19-related outcomes.</p></div><div type="abstract" xml:lang="en"><p><b>CONCLUSION</b></p><p>HCQ/CLQ use in rheumatic patients was not associated with a protective effect against COVID-19-related outcomes. Use of other cDMARDs was associated with an increased risk when compared with non-use, and, if concomitantly used with glucocorticoids, also vs HCQ/CLQ, probably to be ascribed to immunosuppressive action.</p></div></front></TEI><pubmed><MedlineCitation Status="Publisher" Owner="NLM"><PMID Version="1">33856453</PMID><DateRevised><Year>2021</Year><Month>05</Month><Day>04</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1462-0332</ISSN><JournalIssue CitedMedium="Internet"><PubDate><Year>2021</Year><Month>Apr</Month><Day>15</Day></PubDate></JournalIssue><Title>Rheumatology (Oxford, England)</Title><ISOAbbreviation>Rheumatology (Oxford)</ISOAbbreviation></Journal><ArticleTitle>Risk of COVID-19 hospitalization and mortality in rheumatic patients treated with hydroxychloroquine or other conventional DMARDs in Italy.</ArticleTitle><ELocationID EIdType="pii" ValidYN="Y">keab348</ELocationID><ELocationID EIdType="doi" ValidYN="Y">10.1093/rheumatology/keab348</ELocationID><Abstract><AbstractText Label="OBJECTIVES" NlmCategory="OBJECTIVE">To ascertain if hydroxychloroquine (HCQ)/chloroquine (CLQ) and other conventional disease-modifying anti-rheumatic drugs (cDMARDs) use, and rheumatic diseases per se, may be associated with COVID-19-related risk of hospitalization and mortality.</AbstractText><AbstractText Label="METHODS" NlmCategory="METHODS">This case-control study nested within a cohort of cDMARD users was conducted in the Lombardy, Veneto, Tuscany and Lazio regions and Reggio Emilia province. Claims databases were linked to COVID-19 surveillance registries. Risk of COVID-19-related outcomes was estimated using a multivariate conditional logistic regression analysis, comparing HCQ/CLQ vs methotrexate, vs other cDMARDs and vs non-use of these drugs. Presence of rheumatic diseases vs their absence in a non-nested population was investigated.</AbstractText><AbstractText Label="RESULTS" NlmCategory="RESULTS">1275 cases hospitalized due to COVID-19 were matched to 12 734 controls. Compared with recent use of methotrexate, no association between HCQ/CLQ monotherapy and COVID-19 hospitalization (OR 0.83 [95%CI, 0.69-1.00]) or mortality (OR 1.19 [95%CI, 0.85-1.67]) was observed. A lower risk was found when comparing HCQ/CLQ use to the concomitant use of other cDMARDs and glucocorticoids. HCQ/CLQ was not associated with COVID-19 hospitalization as compared with non-use. An increased risk for recent use of either methotrexate monotherapy (OR 1.19 [95% CI, 1.05-1.34]) or other cDMARDs (OR 1.21 [95% CI, 1.08-1.36]) vs non-use was found. Rheumatic diseases were not associated with COVID-19-related outcomes.</AbstractText><AbstractText Label="CONCLUSION" NlmCategory="CONCLUSIONS">HCQ/CLQ use in rheumatic patients was not associated with a protective effect against COVID-19-related outcomes. Use of other cDMARDs was associated with an increased risk when compared with non-use, and, if concomitantly used with glucocorticoids, also vs HCQ/CLQ, probably to be ascribed to immunosuppressive action.</AbstractText><CopyrightInformation>© The Author(s) 2021. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For permissions, please email: journals.permissions@oup.com.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Alegiani</LastName><ForeName>Stefania Spila</ForeName><Initials>SS</Initials><AffiliationInfo><Affiliation>Pharmacoepidemiology Unit, National Centre for Drug Research and Evaluation, Istituto Superiore di Sanità, Rome, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Crisafulli</LastName><ForeName>Salvatore</ForeName><Initials>S</Initials><AffiliationInfo><Affiliation>Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Italian Society of Pharmacology, Milan, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Rossi</LastName><ForeName>Paolo Giorgi</ForeName><Initials>PG</Initials><AffiliationInfo><Affiliation>Epidemiology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Mancuso</LastName><ForeName>Pamela</ForeName><Initials>P</Initials><AffiliationInfo><Affiliation>Epidemiology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Salvarani</LastName><ForeName>Carlo</ForeName><Initials>C</Initials><AffiliationInfo><Affiliation>Unit of Rheumatology, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Emilia-Romagna, Italy.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Department of Surgery, Medicine, Dentistry and Morphological Sciences with Interest in Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Modena, Emilia-Romagna, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Atzeni</LastName><ForeName>Fabiola</ForeName><Initials>F</Initials><AffiliationInfo><Affiliation>Rheumatology Unit, Department of Experimental and Internal Medicine, University of Messina, Messina, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Gini</LastName><ForeName>Rosa</ForeName><Initials>R</Initials><AffiliationInfo><Affiliation>Agenzia Regionale di Sanità della Toscana, Florence, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Kirchmayer</LastName><ForeName>Ursula</ForeName><Initials>U</Initials><AffiliationInfo><Affiliation>Department of Epidemiology ASL Roma 1, Lazio Regional Health Service, Rome, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Belleudi</LastName><ForeName>Valeria</ForeName><Initials>V</Initials><AffiliationInfo><Affiliation>Department of Epidemiology ASL Roma 1, Lazio Regional Health Service, Rome, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Kurotschka</LastName><ForeName>Peter Konstantin</ForeName><Initials>PK</Initials><AffiliationInfo><Affiliation>Department of Medical Sciences and Public Health, Faculty of Medicine and Surgery, University of Cagliari, Cagliari, Italy.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Regional Health Trust of Sardinia Region, Cagliari, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Leoni</LastName><ForeName>Olivia</ForeName><Initials>O</Initials><AffiliationInfo><Affiliation>Epidemiology Observatory-Department of Health of Lombardy Region, Milan, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Ludergnani</LastName><ForeName>Monica</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Epidemiology Observatory-Department of Health of Lombardy Region, Milan, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Ferroni</LastName><ForeName>Eliana</ForeName><Initials>E</Initials><AffiliationInfo><Affiliation>Azienda Zero of the Veneto Region, Padua, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Baracco</LastName><ForeName>Susanna</ForeName><Initials>S</Initials><AffiliationInfo><Affiliation>Azienda Zero of the Veneto Region, Padua, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Massari</LastName><ForeName>Marco</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Pharmacoepidemiology Unit, National Centre for Drug Research and Evaluation, Istituto Superiore di Sanità, Rome, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Trifirò</LastName><ForeName>Gianluca</ForeName><Initials>G</Initials><AffiliationInfo><Affiliation>Italian Society of Pharmacology, Milan, Italy.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Department of Diagnostics and Public Health, University of Verona, Verona, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><CollectiveName>ITA-COVID-19 Network</CollectiveName></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2021</Year><Month>04</Month><Day>15</Day></ArticleDate></Article><MedlineJournalInfo><Country>England</Country><MedlineTA>Rheumatology (Oxford)</MedlineTA><NlmUniqueID>100883501</NlmUniqueID><ISSNLinking>1462-0324</ISSNLinking></MedlineJournalInfo><CitationSubset>AIM</CitationSubset><CitationSubset>IM</CitationSubset><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">Antirheumatic agents
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HfdIndexSelect -h $EXPLOR_AREA/Data/Main/Corpus/RBID.i -Sk "pubmed:33856453" \
| HfdSelect -Kh $EXPLOR_AREA/Data/Main/Corpus/biblio.hfd \
| NlmPubMed2Wicri -a CovidChloroV1
| This area was generated with Dilib version V0.6.38. |  |