Immunosuppressive therapy for IMID does not worsen disease in COVID-19 patients

A recent study has shown that immunosuppressive (IS) therapies for immune-mediated inflammatory diseases (IMIDs) do not increase the risk of SARS-CoV-2 or severe sequelae when controlling for other factors. In addition, tumour necrosis factor α inhibitors may lower the risk of severe infection.

“Finite clinical data and understanding of COVID-19 immunopathology has led to limited, opinion-based recommendations for the management of IMID [patients] receiving IS therapeutics,” the authors said.

A retrospective cohort analysis was performed to determine if IS therapeutic type influences COVID-19 risk among IMID patients. Participants included Henry Ford Health System patients who tested positive for COVID-19 between 1 February and 18 April 2020 and were treated with IS medication for IMID.

Then, the authors combined the therapeutic class of IS medication, comorbidities, and demographic factors into multivariate models to determine the predictors of COVID-19 infection, admission, ventilation, and mortality.

A total of 213 patients with IMID were included, of whom 36.2 percent tested positive for COVID-19. Of note, these patients were not more likely to be hospitalized or need ventilation relative to the general population.

IS therapeutic did not exacerbate the course of disease after multivariate correction, but multidrug regimens and biologics were predictive of an increased and decreased rate of hospitalization, respectively, with the latter driven by tumour necrosis factor α inhibitors.

“A single-centre study somewhat limits the generalization to community-based settings. Only patients tested for COVID-19 were analysed,” the authors noted.