Symptomatic Severe Acute Respiratory Syndrome Coronavirus 2 Reinfection in a Lupus Patient Treated With Hydroxychloroquine

A Case Report

Astrid Muyldermans; Piet Maes; Tony Wawina-Bokalanga; Tine Anthierens; Olivier Goldberg; Magali Bartiaux; Oriane Soetens; Ingrid Wybo; Sigi Van den Wijngaert; Denis Pierard


J Med Case Reports. 2021;15(572) 

In This Article

Abstract and Introduction


Background: Hydroxychloroquine and chloroquine have been used for hospitalized coronavirus disease 2019 patients because of their antiviral and anti-inflammatory function. However, little research has been published on the impact of the immunomodulatory effect of (hydroxy)chloroquine on humoral immunity.

Case Presentation: We report a case of symptomatic severe acute respiratory syndrome coronavirus 2 reinfection, diagnosed 141 days after the first episode, in a 56-year-old man of Black African origin treated with hydroxychloroquine for lupus erythematosus. No anti-severe acute respiratory syndrome coronavirus 2 IgG antibodies could be detected 127 days after the initial episode of coronavirus disease 2019.

Conclusions: The treatment with hydroxychloroquine probably explains the decreased immune response with negative serology and subsequent reinfection in our patient. As humoral immunity is crucial to fight a severe acute respiratory syndrome coronavirus 2 infection, the use of (hydroxy)chloroquine is likely to have a detrimental effect on the spread of the virus. This case emphasizes that more needs to be learned about the role of antibodies in protecting against severe acute respiratory syndrome coronavirus 2 (re)infection and the role of (hydroxy)chloroquine on humoral immunity.