Patients with systemic lupus erythematosus using hydroxychloroquine or chloroquine develop severe COVID-19 at similar frequency as patients not on antimalarials: need to explore antithrombotic benefits for COVID-19 coagulopathy. Response to: 'Clinical course of COVID-19 in patients with systemic lupus erythematosus under long-term treatment with hydroxychloroquine' by Carbillon et al .

We thank Carbillon et al for their correspondence.1 The use of hydroxychloroquine (HCQ) in pregnant women with systemic lupus erythematosus (SLE) is not controversial.2 3 Similar to its primary role in the prophylaxis and treatment of SLE, discontinuation of HCQ in pregnancy has been linked to increased disease activity and glucocorticoid use in women with lupus.4–6 Given its benefit and preferable safety profile, the continuation of baseline HCQ therapy in pregnant women with lupus is recommended to maintain disease remission,2 3 regardless of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) status. In contrast, there is currently no evidence to suggest that baseline use of HCQ in pregnant women with lupus is protective of SARS-CoV-2 infection or severe COVID-19. The authors adequately summarise our findings …