Abstract
Objective
The COVID-19 pandemic has raised questions about the management of systemic immunosuppressive treatments for rheumatic conditions. It is well known that rheumatic patients are at risk of developing infections because of their immunocompromised state. Moreover, drugs such as hydroxychloroquine or tocilizumab that are widely used to treat rheumatic diseases are now being used to treat COVID-19. The aim of this multicentre retrospective study of rheumatic patients in the Italian regions of Lombardy and Marche was to determine whether patients receiving biological or small molecules treatment are more susceptible to the development of COVID-19 than the general population.
Methods
The local registry data of 10,260 rheumatic patients being treated with bDMARDs or small molecules were evaluated from 15 March to 23 April 2020. The final analysis was based on the registry data relating to 7.204, telephone contacts and/or outpatient visits.
Results
Forty-seven of the 7.204 patients were diagnosed with COVID-19, seven of whom died; the patients who had symptoms resembling those of COVID-19 but had negative swabs were considered negative for the disease. The overall infection rate was 0.65, and the crude case fatality risk (CFR) in the patients with COVID-19 was 14.9%. There was no difference in the mortality rate among the patients receiving the different individual biological drugs or small molecules.
Conclusions
Our findings suggest that the susceptibility of rheumatic patients to COVID-19 is the same as that of the general population, but confirm that age, disease duration, and the number of co-morbidities are associated with an increased risk of a severe form of the disease. It seems that immunosuppressants drugs do not effectively represent a risk factor for COVID- 19.
【저자키워드】 biologics, COVID 19, infections, registries, Small molecules, DMARDs, rheumatic disease, 【초록키워드】 COVID-19, Treatment, Hydroxychloroquine, Tocilizumab, susceptibility, COVID-19 pandemic, Infection, risk, Local, Symptom, drug, risk factor, COVID, Retrospective study, management, Patient, Immunocompromised, co-morbidity, age, multicentre, small molecule, General population, mortality rate, infection rate, CFR, disease, Immunosuppressant, fatality, Analysis, lombardy, Immunosuppressive treatment, increased risk, no difference, Final, treat, telephone contact, registry data, objective, susceptible, Seven, Result, the patient, the disease, evaluated, raised, receiving, treated, determine, question, conditions, biological drug, diagnosed with COVID-19, Italian region, Marche, negative swab, with COVID-19, 【제목키워드】 Infection, COVID, Retrospective study, multicentre, treated, biological drug, Marche, patients from Lombardy,