TY - JOUR
T1 - COVID-19 Incidence in Patients With Immunomediated Inflammatory Diseases
T2 - Influence of Immunosuppressant Treatments
AU - Soldevila-Domenech, Natalia
AU - Tío, Laura
AU - Llorente-Onaindia, Jone
AU - Martín-García, Elena
AU - Nebot, Pau
AU - Torre, Rafael de la
AU - Gurt, Alba
AU - Maldonado, Rafael
AU - Monfort, Jordi
N1 - Funding Information:
“Ministerio de Ciencia, Innovación y Universidades” (#AEI-SAF2017-84060-R FEDER to RM, #DPI2016-80283-C2-2-R), “Ministerio de Sanidad, Servicios Sociales e Igualdad” (#RD16/0017/0020 and #PNSD-2017I068 to RM, #PI18/ 00059 to TCS-M) and “Generalitat de Catalunya” (#2017-SGR-669 and #ICREA-Acadèmia 2015 to RM, #2017-SGR-138 to RdlT). NSD is recipient of predoctoral fellowship #2019-DI-47 from the DIUE-AGAUR of the “Generalitat de Catalunya.” The submitted work was supported by the Hospital del Mar.
PY - 2020/12/21
Y1 - 2020/12/21
N2 - The effect of immunosuppressant treatments on the incidence of coronavirus disease (COVID-19) remains largely unknown. We studied the association between the pre-exposure to disease-modifying antirheumatic drugs (DMARDs) that decrease immunological responses and the incidence of COVID-19 to explore the possible effects of these treatments in early manifestations of the disease. For this purpose, we performed a cross-sectional study including 2,494 patients with immunomediated inflammatory diseases (IMIDs) recruited at the outpatient Rheumatology, Dermatology and Gastroenterology services of Hospital del Mar. The primary outcome was the clinical diagnosis of COVID-19 performed by a physician at the hospital or at the primary care center, from the March 1–29, 2020. Multivariable Poisson regression models were fitted to estimate COVID-19 relative risk (RR) adjusted by comorbidities. We revealed that biological (RR = 0.46, CI 95% = 0.31–0.67) and synthetic (RR = 0.62, CI 95% = 0.43–0.91) DMARDs used in IMIDs diminished the incidence of COVID-19. Striking sex differences were revealed with anti-TNFα compounds (RR = 0.50, CI 95% = 0.33–0.75) with higher effects in women (RR = 0.33, CI 95% = 0.17–0.647). Treatment with low glucocorticoid doses also revealed sex differences decreasing the incidence of COVID-19 predominantly in women (RR = 0.72, CI 95% = 0.42–1.22). Our results report a decreased incidence of COVID-19 in patients receiving specific DMARDs with different immunodepressor mechanisms with striking sex differences. These results underline the interest of repurposing specific DMARDs for the possibility of minimizing the severity of disease progression in the early stages of COVID-19.
AB - The effect of immunosuppressant treatments on the incidence of coronavirus disease (COVID-19) remains largely unknown. We studied the association between the pre-exposure to disease-modifying antirheumatic drugs (DMARDs) that decrease immunological responses and the incidence of COVID-19 to explore the possible effects of these treatments in early manifestations of the disease. For this purpose, we performed a cross-sectional study including 2,494 patients with immunomediated inflammatory diseases (IMIDs) recruited at the outpatient Rheumatology, Dermatology and Gastroenterology services of Hospital del Mar. The primary outcome was the clinical diagnosis of COVID-19 performed by a physician at the hospital or at the primary care center, from the March 1–29, 2020. Multivariable Poisson regression models were fitted to estimate COVID-19 relative risk (RR) adjusted by comorbidities. We revealed that biological (RR = 0.46, CI 95% = 0.31–0.67) and synthetic (RR = 0.62, CI 95% = 0.43–0.91) DMARDs used in IMIDs diminished the incidence of COVID-19. Striking sex differences were revealed with anti-TNFα compounds (RR = 0.50, CI 95% = 0.33–0.75) with higher effects in women (RR = 0.33, CI 95% = 0.17–0.647). Treatment with low glucocorticoid doses also revealed sex differences decreasing the incidence of COVID-19 predominantly in women (RR = 0.72, CI 95% = 0.42–1.22). Our results report a decreased incidence of COVID-19 in patients receiving specific DMARDs with different immunodepressor mechanisms with striking sex differences. These results underline the interest of repurposing specific DMARDs for the possibility of minimizing the severity of disease progression in the early stages of COVID-19.
KW - biological therapy
KW - cross-sectional study
KW - disease modifying antirheumatic drugs (DMARDs)
KW - gender
KW - glucocorticoids
KW - relative risk
KW - tumor necrosis factor inhibitor
U2 - 10.3389/fphar.2020.583260
DO - 10.3389/fphar.2020.583260
M3 - Article
AN - SCOPUS:85098981045
SN - 1663-9812
VL - 11
JO - Frontiers in Pharmacology
JF - Frontiers in Pharmacology
M1 - 583260
ER -