Exploring the long-term hydroxychloroquine’s effects on COVID-19 outcomes in patients with autoimmune diseases: a systematic review and meta-analysis

DOI record: { "DOI": "10.1007/s00228-026-04066-y", "ISSN": [ "0031-6970", "1432-1041" ], "URL": "http://dx.doi.org/10.1007/s00228-026-04066-y", "alternative-id": [ "4066" ], "article-number": "140", "assertion": [ { "group": { "label": "Article History", "name": "ArticleHistory" }, "label": "Received", "name": "received", "order": 1, "value": "22 January 2026" }, { "group": { "label": "Article History", "name": "ArticleHistory" }, "label": "Accepted", "name": "accepted", "order": 2, "value": "18 April 2026" }, { "group": { "label": "Article History", "name": "ArticleHistory" }, "label": "First Online", "name": "first_online", "order": 3, "value": "7 May 2026" }, { "group": { "label": "Declarations", "name": "EthicsHeading" }, "name": "Ethics", "order": 1 }, { "group": { "label": "Competing interests", "name": "EthicsHeading" }, "name": "Ethics", "order": 2, "value": "The authors declare no competing interests." } ], "author": [ { "affiliation": [], "family": "Amal", "given": "Heba M.", "role": [ { "role": "author", "vocabulary": "crossref" } ], "sequence": "first" }, { "affiliation": [], "family": "Mohamed", "given": "Amr Maher Galal", "role": [ { "role": "author", "vocabulary": "crossref" } ], "sequence": "additional" }, { "affiliation": [], "family": "Abdel-Halim", "given": "Mona Osman", "role": [ { "role": "author", "vocabulary": "crossref" } ], "sequence": "additional" }, { "affiliation": [], "family": "Hassan", "given": "Mohamed Said", "role": [ { "role": "author", "vocabulary": "crossref" } ], "sequence": "additional" }, { "affiliation": [], "family": "Khorshid", "given": "Omayma Anwar", "role": [ { "role": "author", "vocabulary": "crossref" } ], "sequence": "additional" }, { "affiliation": [], "family": "Osman", "given": "Walla’a A.", "role": [ { "role": "author", "vocabulary": "crossref" } ], "sequence": "additional" } ], "container-title": "European Journal of Clinical Pharmacology", "container-title-short": "Eur J Clin Pharmacol", "content-domain": { "crossmark-restriction": false, "domain": [ "link.springer.com" ] }, "created": { "date-parts": [ [ 2026, 5, 7 ] ], "date-time": "2026-05-07T02:13:42Z", "timestamp": 1778120022000 }, "deposited": { "date-parts": [ [ 2026, 5, 7 ] ], "date-time": "2026-05-07T02:13:49Z", "timestamp": 1778120029000 }, "indexed": { "date-parts": [ [ 2026, 5, 7 ] ], "date-time": "2026-05-07T03:10:26Z", "timestamp": 1778123426834, "version": "3.51.4" }, "is-referenced-by-count": 0, "issue": "6", "issued": { "date-parts": [ [ 2026, 5, 7 ] ] }, "journal-issue": { "issue": "6", "published-print": { "date-parts": [ [ 2026, 6 ] ] } }, "language": "en", "license": [ { "URL": "https://www.springernature.com/gp/researchers/text-and-data-mining", "content-version": "tdm", "delay-in-days": 0, "start": { "date-parts": [ [ 2026, 5, 7 ] ], "date-time": "2026-05-07T00:00:00Z", "timestamp": 1778112000000 } }, { "URL": "https://www.springernature.com/gp/researchers/text-and-data-mining", "content-version": "vor", "delay-in-days": 0, "start": { "date-parts": [ [ 2026, 5, 7 ] ], "date-time": "2026-05-07T00:00:00Z", "timestamp": 1778112000000 } } ], "link": [ { "URL": "https://link.springer.com/content/pdf/10.1007/s00228-026-04066-y.pdf", "content-type": "application/pdf", "content-version": "vor", "intended-application": "text-mining" }, { "URL": "https://link.springer.com/article/10.1007/s00228-026-04066-y", "content-type": "text/html", "content-version": "vor", "intended-application": "text-mining" }, { "URL": "https://link.springer.com/content/pdf/10.1007/s00228-026-04066-y.pdf", "content-type": "application/pdf", "content-version": "vor", "intended-application": "similarity-checking" } ], "member": "297", "original-title": [], "prefix": "10.1007", "published": { "date-parts": [ [ 2026, 5, 7 ] ] }, "published-online": { "date-parts": [ [ 2026, 5, 7 ] ] }, "published-print": { "date-parts": [ [ 2026, 6 ] ] }, "publisher": "Springer Science and Business Media LLC", "reference": [ { "DOI": "10.1016/j.clim.2020.108427", "author": "K Yuki", "doi-asserted-by": "publisher", "journal-title": "Clinical Immunology", "key": "4066_CR1", "unstructured": "Yuki K, Fujiogi M, Koutsogiannaki S (2020) COVID-19 pathophysiology: a review. Clinical Immunology 215:108427", "volume": "215", "year": "2020" }, { "DOI": "10.1007/s11481-020-09923-w", "author": "P Pahan", "doi-asserted-by": "publisher", "first-page": "174", "issue": "2", "journal-title": "J Neuroimmune Pharmacol", "key": "4066_CR2", "unstructured": "Pahan P, Pahan K (2020) Smooth or risky revisit of an old malaria drug for COVID-19? J Neuroimmune Pharmacol 15(2):174–180", "volume": "15", "year": "2020" }, { "DOI": "10.1038/s41421-019-0132-8", "author": "J Liu", "doi-asserted-by": "publisher", "first-page": "1", "issue": "1", "journal-title": "Cell discovery", "key": "4066_CR3", "unstructured": "Liu J, Cao R, Xu M, Wang X, Zhang H, Hu H et al (2020) Hydroxychloroquine, a less toxic derivative of chloroquine, is effective in inhibiting SARS-CoV-2 infection in vitro. Cell discovery 6(1):1–4", "volume": "6", "year": "2020" }, { "DOI": "10.1016/j.dsx.2020.05.017", "doi-asserted-by": "crossref", "key": "4066_CR4", "unstructured": "Singh AK, Singh A, Singh R, Misra A (2020) Hydroxychloroquine in patients with COVID-19: A Systematic Review and meta-analysis. Diabetes & metabolic syndrome: Clinical research & reviews. ;14(4):589 – 96" }, { "DOI": "10.4103/jopcs.jopcs_12_20", "author": "M Sahu", "doi-asserted-by": "publisher", "first-page": "27", "issue": "2", "journal-title": "J Prim Care Specialties", "key": "4066_CR5", "unstructured": "Sahu M, Kumar A, Shankar SH, Patidar D, Vishwakarma VK, Sahoo P et al (2021) Insights into the Mechanisms of Action of Chloroquine and Hydroxychloroquine and its Use in COVID-19 for Chemoprophylaxis. J Prim Care Specialties 2(2):27–32", "volume": "2", "year": "2021" }, { "DOI": "10.1038/s41419-020-2721-8", "author": "X Li", "doi-asserted-by": "publisher", "first-page": "512", "issue": "7", "journal-title": "Cell Death Dis", "key": "4066_CR6", "unstructured": "Li X, Wang Y, Agostinis P, Rabson A, Melino G, Carafoli E et al (2020) Is hydroxychloroquine beneficial for COVID-19 patients? Cell Death Dis 11(7):512", "volume": "11", "year": "2020" }, { "DOI": "10.1136/bmj.d549", "doi-asserted-by": "crossref", "key": "4066_CR7", "unstructured": "Riley RD, Higgins JP, Deeks JJ (2011) Interpretation of random effects meta-analyses. BMJ. ;342" }, { "DOI": "10.1007/978-3-030-71921-0_7", "doi-asserted-by": "crossref", "key": "4066_CR8", "unstructured": "Srinivasjois R (2021) Fixed and random-effects models for meta-analysis. Principles and practice of systematic reviews and meta-analysis. Springer, pp 73–78" }, { "key": "4066_CR9", "unstructured": "Jpt H (2008) Cochrane handbook for systematic reviews of interventions. http://www.cochrane-handbookorg" }, { "DOI": "10.1007/s00296-021-04857-9", "author": "ZA Alzahrani", "doi-asserted-by": "publisher", "first-page": "1097", "issue": "6", "journal-title": "Rheumatol Int", "key": "4066_CR10", "unstructured": "Alzahrani ZA, Alghamdi KA, Almaqati AS (2021) Clinical characteristics and outcome of COVID-19 in patients with rheumatic diseases. Rheumatol Int 41(6):1097–1103", "volume": "41", "year": "2021" }, { "DOI": "10.4103/injr.injr_327_20", "author": "SV Annamalai", "doi-asserted-by": "publisher", "first-page": "441", "issue": "4", "journal-title": "Indian J Rheumatol", "key": "4066_CR11", "unstructured": "Annamalai SV, Santhanam S, Mohanasundaram K, Nambi T, Sankaran S, Natarajan R et al (2021) COVID-19 and Rheumatic Diseases in Tamil Nadu-A Multicenter Retrospective Observational Study. Indian J Rheumatol 16(4):441–446", "volume": "16", "year": "2021" }, { "DOI": "10.1111/ijcp.14442", "author": "S Batıbay", "doi-asserted-by": "publisher", "issue": "9", "journal-title": "International Journal of Clinical Practice", "key": "4066_CR12", "unstructured": "Batıbay S, Koçak Ulucaköy R, Özdemir B, Günendi Z, Göğüş FN (2021) Clinical outcomes of Covid-19 in patients with rheumatic diseases and the effects of the pandemic on rheumatology outpatient care: a single‐centre experience from Turkey. International Journal of Clinical Practice 75(9):e14442", "volume": "75", "year": "2021" }, { "DOI": "10.1007/s10067-021-05675-x", "author": "G Espinosa", "doi-asserted-by": "publisher", "first-page": "2057", "issue": "5", "journal-title": "Clin Rheumatol", "key": "4066_CR13", "unstructured": "Espinosa G, Prieto-González S, Llevadot M, Marco-Hernández J, Martínez-Artuña A, Pérez-Isidro A et al (2021) The impact of SARS-CoV-2 coronavirus infection in patients with systemic lupus erythematosus from a single center in Catalonia. Clin Rheumatol 40(5):2057–2063", "volume": "40", "year": "2021" }, { "DOI": "10.1016/S2665-9913(20)30305-2", "author": "CA Gentry", "doi-asserted-by": "publisher", "first-page": "e689", "issue": "11", "journal-title": "Lancet Rheumatol", "key": "4066_CR14", "unstructured": "Gentry CA, Humphrey MB, Thind SK, Hendrickson SC, Kurdgelashvili G, Williams RJ (2020) Long-term hydroxychloroquine use in patients with rheumatic conditions and development of SARS-CoV-2 infection: a retrospective cohort study. Lancet Rheumatol 2(11):e689–e97", "volume": "2", "year": "2020" }, { "DOI": "10.1007/s40744-021-00373-1", "author": "D Guillaume", "doi-asserted-by": "publisher", "first-page": "1887", "issue": "4", "journal-title": "Rheumatol Therapy", "key": "4066_CR15", "unstructured": "Guillaume D, Magalie B, Sina E, Imene S-M, Frederic V, Mathieu D et al (2021) Antirheumatic drug intake influence on occurrence of COVID-19 infection in ambulatory patients with immune-mediated inflammatory diseases: a cohort study. Rheumatol Therapy 8(4):1887–1895", "volume": "8", "year": "2021" }, { "DOI": "10.1016/j.cmi.2020.12.003", "author": "S-Y Jung", "doi-asserted-by": "publisher", "first-page": "611", "issue": "4", "journal-title": "Clin Microbiol Infect", "key": "4066_CR16", "unstructured": "Jung S-Y, Kim M-S, Kim M-C, Choi S-H, Chung J-W, Choi ST (2021) Effect of hydroxychloroquine pre-exposure on infection with SARS-CoV-2 in rheumatic disease patients: a population-based cohort study. Clin Microbiol Infect 27(4):611–617", "volume": "27", "year": "2021" }, { "DOI": "10.1371/journal.pone.0249036", "author": "J Macías", "doi-asserted-by": "publisher", "first-page": "e0249036", "issue": "4", "journal-title": "PLoS ONE", "key": "4066_CR17", "unstructured": "Macías J, González-Moreno P, Sánchez-García E, Morillo-Verdugo R, Pérez-Venegas JJ, Pinilla A et al (2021) Similar incidence of coronavirus disease 2019 (COVID-19) in patients with rheumatic diseases with and without hydroxychloroquine therapy. PLoS ONE 16(4):e0249036", "volume": "16", "year": "2021" }, { "DOI": "10.2174/1874312902115010069", "doi-asserted-by": "crossref", "key": "4066_CR18", "unstructured": "Mollaeian A, Kim DS, Haas CJ (2021) COVID-19 Prevalence and Outcomes among Individuals with Rheumatoid Arthritis and Systemic Lupus Erythematosus Taking Hydroxychloroquine; A Retrospective Analysis. Open Rheumatol J. ;15(1)" }, { "DOI": "10.1093/rap/rkab014", "author": "K Pham", "doi-asserted-by": "publisher", "first-page": "rkab014", "issue": "1", "journal-title": "Rheumatol Adv Pract", "key": "4066_CR19", "unstructured": "Pham K, Torres H, Satlin MJ, Goyal P, Gulick RM (2021) Failure of chronic hydroxychloroquine in preventing severe complications of COVID-19 in patients with rheumatic diseases. Rheumatol Adv Pract 5(1):rkab014", "volume": "5", "year": "2021" }, { "DOI": "10.1016/j.jaad.2020.10.098", "author": "LK Rangel", "doi-asserted-by": "publisher", "first-page": "1769", "issue": "6", "journal-title": "J Am Acad Dermatol", "key": "4066_CR20", "unstructured": "Rangel LK, Shah P, Sicco KL, Caplan AS, Femia A (2021) Chronic hydroxychloroquine therapy and COVID-19 outcomes: A retrospective case-control analysis. J Am Acad Dermatol 84(6):1769–1772", "volume": "84", "year": "2021" }, { "DOI": "10.1016/S2665-9913(20)30378-7", "author": "CT Rentsch", "doi-asserted-by": "publisher", "first-page": "e19", "issue": "1", "journal-title": "Lancet Rheumatol", "key": "4066_CR21", "unstructured": "Rentsch CT, DeVito NJ, MacKenna B, Morton CE, Bhaskaran K, Brown JP et al (2021) Effect of pre-exposure use of hydroxychloroquine on COVID-19 mortality: a population-based cohort study in patients with rheumatoid arthritis or systemic lupus erythematosus using the OpenSAFELY platform. Lancet Rheumatol 3(1):e19–e27", "volume": "3", "year": "2021" }, { "DOI": "10.21608/ejhm.2022.270499", "author": "A Sobh", "doi-asserted-by": "publisher", "first-page": "6589", "issue": "2", "journal-title": "Egypt J Hosp Med", "key": "4066_CR22", "unstructured": "Sobh A, Elegezy M, Mofreh M, El-nagdy AH, Tohlob M, Elnagdy MH et al (2022) Role of hydroxychloroquine in rheumatoid arthritis and systemic lupus erythematosus patients during COVID-19 pandemic. Egypt J Hosp Med 89(2):6589–6595", "volume": "89", "year": "2022" }, { "DOI": "10.1136/annrheumdis-2021-221636", "author": "MF Ugarte-Gil", "doi-asserted-by": "publisher", "first-page": "970", "issue": "7", "journal-title": "Ann Rheum Dis", "key": "4066_CR23", "unstructured": "Ugarte-Gil MF, Alarcón GS, Izadi Z, Duarte-García A, Reátegui-Sokolova C, Clarke AE et al (2022) Characteristics associated with poor COVID-19 outcomes in individuals with systemic lupus erythematosus: data from the COVID-19 Global Rheumatology Alliance. Ann Rheum Dis 81(7):970–978", "volume": "81", "year": "2022" }, { "DOI": "10.1177/03000605221090363", "author": "IA Walbi", "doi-asserted-by": "publisher", "first-page": "030006052210903", "issue": "4", "journal-title": "J Int Med Res", "key": "4066_CR24", "unstructured": "Walbi IA, Albarqi HA, Alghanim NS, Albadi MA, Al Maimouni HM, Alkahtani SA et al (2022) Effect of chronic hydroxychloroquine use on COVID-19 risk in patients with rheumatoid arthritis and systemic lupus erythematosus: a multicenter retrospective cohort. J Int Med Res 50(4):03000605221090363", "volume": "50", "year": "2022" }, { "DOI": "10.1002/mco2.56", "author": "C Ye", "doi-asserted-by": "publisher", "first-page": "82", "issue": "1", "journal-title": "China MedComm", "key": "4066_CR25", "unstructured": "Ye C, Zhong J, Cai S, Dong L, Li C, Hou X et al (2021) COVID-19 infection in patients with connective tissue disease: A multicity study in Hubei province. China MedComm 2(1):82–90", "volume": "2", "year": "2021" }, { "DOI": "10.1002/art.41450", "author": "R Fernandez-Ruiz", "doi-asserted-by": "publisher", "first-page": "1971", "issue": "12", "journal-title": "Arthritis Rheumatol", "key": "4066_CR26", "unstructured": "Fernandez-Ruiz R, Masson M, Kim MY, Myers B, Haberman RH, Castillo R et al (2020) Leveraging the United States epicenter to provide insights on COVID‐19 in patients with systemic lupus erythematosus. Arthritis Rheumatol 72(12):1971–1980", "volume": "72", "year": "2020" }, { "DOI": "10.1056/NEJMoa2022926", "author": "RC Group", "doi-asserted-by": "publisher", "first-page": "2030", "issue": "21", "journal-title": "N Engl J Med", "key": "4066_CR27", "unstructured": "Group RC (2020) Effect of hydroxychloroquine in hospitalized patients with Covid-19. N Engl J Med 383(21):2030–2040", "volume": "383", "year": "2020" }, { "DOI": "10.1001/jama.2020.8630", "author": "ES Rosenberg", "doi-asserted-by": "publisher", "first-page": "2493", "issue": "24", "journal-title": "JAMA", "key": "4066_CR28", "unstructured": "Rosenberg ES, Dufort EM, Udo T, Wilberschied LA, Kumar J, Tesoriero J et al (2020) Association of treatment with hydroxychloroquine or azithromycin with in-hospital mortality in patients with COVID-19 in New York State. JAMA 323(24):2493–2502", "volume": "323", "year": "2020" }, { "DOI": "10.1007/s11739-020-02505-x", "author": "L Ayerbe", "doi-asserted-by": "publisher", "first-page": "1501", "issue": "8", "journal-title": "Intern Emerg Med", "key": "4066_CR29", "unstructured": "Ayerbe L, Risco-Risco C, Ayis S (2020) The association of treatment with hydroxychloroquine and hospital mortality in COVID-19 patients. Intern Emerg Med 15(8):1501–1506", "volume": "15", "year": "2020" }, { "DOI": "10.9734/jpri/2020/v32i830468", "author": "AS Ali", "doi-asserted-by": "publisher", "first-page": "29", "journal-title": "J Pharmaceut Res Int", "key": "4066_CR30", "unstructured": "Ali AS, Abdel-Rahman MS, Almalikil RS, Mohamed AS, Alfaifi KA, Fadil AE et al (2020) Optimizing the use of hydroxychloroquine in the management of COVID-19 given its pharmacological profile. J Pharmaceut Res Int 32:29–43", "volume": "32", "year": "2020" }, { "DOI": "10.1016/j.ijantimicag.2020.106007", "author": "H Derendorf", "doi-asserted-by": "publisher", "first-page": "106007", "issue": "6", "journal-title": "Int J Antimicrob Agents", "key": "4066_CR31", "unstructured": "Derendorf H (2020) Excessive lysosomal ion-trapping of hydroxychloroquine and azithromycin. Int J Antimicrob Agents 55(6):106007", "volume": "55", "year": "2020" }, { "DOI": "10.1136/bmj.m1849", "doi-asserted-by": "crossref", "key": "4066_CR32", "unstructured": "Tang W, Cao Z, Han M, Wang Z, Chen J, Sun W et al (2020) Hydroxychloroquine in patients with mainly mild to moderate coronavirus disease 2019: open label, randomised controlled trial. BMJ. ;369" }, { "DOI": "10.1038/s41467-021-22446-z", "author": "C Axfors", "doi-asserted-by": "publisher", "first-page": "2349", "issue": "1", "journal-title": "Nat Commun", "key": "4066_CR33", "unstructured": "Axfors C, Schmitt AM, Janiaud P, Van’t Hooft J, Abd-Elsalam S, Abdo EF et al (2021) Mortality outcomes with hydroxychloroquine and chloroquine in COVID-19 from an international collaborative meta-analysis of randomized trials. Nat Commun 12(1):2349", "volume": "12", "year": "2021" }, { "DOI": "10.1016/j.ijid.2020.06.099", "author": "S Arshad", "doi-asserted-by": "publisher", "first-page": "396", "journal-title": "Int J Infect Dis", "key": "4066_CR34", "unstructured": "Arshad S, Kilgore P, Chaudhry ZS, Jacobsen G, Wang DD, Huitsing K et al (2020) Treatment with hydroxychloroquine, azithromycin, and combination in patients hospitalized with COVID-19. Int J Infect Dis 97:396–403", "volume": "97", "year": "2020" }, { "DOI": "10.1016/j.ijantimicag.2020.105960", "author": "J Fantini", "doi-asserted-by": "publisher", "first-page": "105960", "issue": "5", "journal-title": "Int J Antimicrob Agents", "key": "4066_CR35", "unstructured": "Fantini J, Di Scala C, Chahinian H, Yahi N (2020) Structural and molecular modelling studies reveal a new mechanism of action of chloroquine and hydroxychloroquine against SARS-CoV-2 infection. Int J Antimicrob Agents 55(5):105960", "volume": "55", "year": "2020" }, { "DOI": "10.3390/jcm11226865", "author": "I Landsteiner de Sampaio Amêndola", "doi-asserted-by": "publisher", "first-page": "6865", "issue": "22", "journal-title": "J Clin Med", "key": "4066_CR36", "unstructured": "Landsteiner de Sampaio Amêndola I, Aires Pinheiro J, Povoa P, Cés de Souza Dantas V, Serafim RB (2022) COVID-19 Infection in Rheumatic Patients on Chronic Antimalarial Drugs: A Systematic Review and Meta-Analysis. J Clin Med 11(22):6865", "volume": "11", "year": "2022" }, { "DOI": "10.1111/imj.15202", "author": "T Eviatar", "doi-asserted-by": "publisher", "first-page": "682", "issue": "5", "journal-title": "Intern Med J", "key": "4066_CR37", "unstructured": "Eviatar T, Elalouf O, Furer V, Goldstein-Lahat Y, Paran Y, Pel S et al (2021) Prevalence of COVID‐19 and seroprevalence to SARS‐CoV‐2 in a rheumatologic patient population from a tertiary referral clinic in Israel. Intern Med J 51(5):682–690", "volume": "51", "year": "2021" }, { "DOI": "10.1007/s00296-020-04676-4", "author": "F Montero", "doi-asserted-by": "publisher", "first-page": "1593", "issue": "10", "journal-title": "Rheumatol Int", "key": "4066_CR38", "unstructured": "Montero F, Martínez-Barrio J, Serrano-Benavente B, González T, Rivera J, Molina Collada J et al (2020) Coronavirus disease 2019 (COVID-19) in autoimmune and inflammatory conditions: clinical characteristics of poor outcomes. Rheumatol Int 40(10):1593–1598", "volume": "40", "year": "2020" }, { "DOI": "10.1093/ajhp/zxab056", "author": "N Awad", "doi-asserted-by": "publisher", "first-page": "689", "issue": "8", "journal-title": "Am J Health-System Pharm", "key": "4066_CR39", "unstructured": "Awad N, Schiller DS, Fulman M, Chak A (2021) Impact of hydroxychloroquine on disease progression and ICU admissions in patients with SARS-CoV-2 infection. Am J Health-System Pharm 78(8):689–696", "volume": "78", "year": "2021" }, { "DOI": "10.1056/NEJMoa2019014", "author": "AB Cavalcanti", "doi-asserted-by": "publisher", "first-page": "2041", "issue": "21", "journal-title": "N Engl J Med", "key": "4066_CR40", "unstructured": "Cavalcanti AB, Zampieri FG, Rosa RG, Azevedo LC, Veiga VC, Avezum A et al (2020) Hydroxychloroquine with or without azithromycin in mild-to-moderate Covid-19. N Engl J Med 383(21):2041–2052", "volume": "383", "year": "2020" }, { "DOI": "10.1056/NEJMoa2012410", "author": "J Geleris", "doi-asserted-by": "publisher", "first-page": "2411", "issue": "25", "journal-title": "N Engl J Med", "key": "4066_CR41", "unstructured": "Geleris J, Sun Y, Platt J, Zucker J, Baldwin M, Hripcsak G et al (2020) Observational study of hydroxychloroquine in hospitalized patients with Covid-19. N Engl J Med 382(25):2411–2418", "volume": "382", "year": "2020" }, { "DOI": "10.1089/aid.2015.0336", "author": "JM Jacobson", "doi-asserted-by": "publisher", "first-page": "636", "issue": "7", "journal-title": "AIDS Res Hum Retroviruses", "key": "4066_CR42", "unstructured": "Jacobson JM, Bosinger SE, Kang M, Belaunzaran-Zamudio P, Matining RM, Wilson CC et al (2016) The effect of chloroquine on immune activation and interferon signatures associated with HIV-1. AIDS Res Hum Retroviruses 32(7):636–647", "volume": "32", "year": "2016" }, { "DOI": "10.1016/j.clim.2018.07.003", "author": "M Torigoe", "doi-asserted-by": "publisher", "first-page": "1", "journal-title": "Clin Immunol", "key": "4066_CR43", "unstructured": "Torigoe M, Sakata K, Ishii A, Iwata S, Nakayamada S, Tanaka Y (2018) Hydroxychloroquine efficiently suppresses inflammatory responses of human class-switched memory B cells via Toll-like receptor 9 inhibition. Clin Immunol 195:1–7", "volume": "195", "year": "2018" }, { "DOI": "10.1056/NEJMc2035374", "doi-asserted-by": "crossref", "key": "4066_CR44", "unstructured": "Horby P, White NJ, Landray MJ (2021) Hydroxychloroquine in hospitalized patients with Covid-19. Reply. N Engl J Med 384(9)" } ], "reference-count": 44, "references-count": 44, "relation": {}, "resource": { "primary": { "URL": "https://link.springer.com/10.1007/s00228-026-04066-y" } }, "score": 1, "short-title": [], "source": "Crossref", "subject": [], "subtitle": [], "title": "Exploring the long-term hydroxychloroquine’s effects on COVID-19 outcomes in patients with autoimmune diseases: a systematic review and meta-analysis", "type": "journal-article", "update-policy": "https://doi.org/10.1007/springer_crossmark_policy", "volume": "82" }