People with rheumatic diseases less vulnerable to COVID-19: Study

By Rahul Vaimal, Associate Editor
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A recent study reveals that the COVID-19 infection occurrence is low among people with rheumatic diseases, those infected mostly had a mild course of illness and the mortality rate was also low.

The COVID-19 which spread across the world in early 2020, is an infectious disease. The risk of serious infection or fatality was a severe concern for people with the rheumatic disease as many of them were treated with immunosuppressant medications (drugs that reduce the strength of the immune system) that leave them more susceptible to infection.

When the pandemic surged across the globe, researchers were doubtful regarding how people with rheumatic diseases who are undergoing immunosuppressant therapy will be  affected by the COVID-19 infection.

However, some early studies found that immunosuppressant drugs could build a protective effect, but the vulnerability of these patients towards the infection was a serious concern.

Details of this research were presented at the ACR Convergence program, the American College of Rheumatology’s annual meeting.

Researchers conducted a systematic review of studies that reported the aftereffect of COVID-19 infection among patients with rheumatic diseases who were undergoing biologic and targeted therapies.

“When the pandemic started, there was concern on whether to continue or hold immune therapies among patients with rheumatic diseases because they are at increased risk for infection,” says the study’s co-author, Dr. Akhil Sood, an internal medicine resident in rheumatology at the University of Texas Medical Branch in Galveston.

“We were interested to see if these patients are at an increased risk for COVID-19 infection. If they were to become infected, we wanted to know the severity of their clinical course. This can help us to determine whether it is safe to continue or hold immune therapies in the setting of COVID-19 infection,” Dr. Sood added.

The researchers systematically searched various databases to select relevant studies from January to June 2020 that reported the outcomes of COVID-19 among patients with rheumatic disease and then took out demographic information and patients’ use of biologics or targeted therapy with Janus kinase (JAK) inhibitors.

The study measured COVID-19 outcomes including hospitalization, admission to an ICU and death and divided patients into two groups based on their clinical symptoms severe which mean having increased risk of respiratory failure or life-threatening complications and non-severe.

The final review of the research was based on 6,095 patients with rheumatic diseases from eight cohort studies, with 28 percent having rheumatoid arthritis (RA) and 7 percent having psoriatic arthritis (PsA).

Across all the studies used for the review, 68 percent of COVID-19 patients were taking biologics, with 31 percent consuming anti-TNF drugs and 6 percent taking JAK inhibitors.

The review found that among the 6,095 patients, only 123 or 2 percent were positive or highly vulnerable for COVID-19 and 91 or 73 percent of patients were never hospitalized. Only 13 patients were hospitalized and required admission to an ICU and four died.

“In our analysis, there were a small number of patients on biologics and targeted therapies to make definite conclusions on whether to continue or hold therapies. We are waiting for additional extensive studies that include more patients with rheumatic disease on biologic and targeted therapies,” Dr. Sood said.