Low incidence of COVID-19 among patients with rheumatic disease on biologic therapy
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The incidence of COVID-19 infection was low among patients with rheumatic diseases who were using biologic therapies, according to data presented at the ACR Convergence 2020.
“The impact of COVID-19 in patients with rheumatic disease is not well understood,” Akhil Sood, MD, from the University of Texas Medical Branch, in Galveston, said during a press conference. “These patients require lifelong immunosuppression to control their disease activity and being on immunosuppression places them at increased risk for infection. At the same time, many of these medications are undergoing investigation as possible therapy for COVID-19 and this led us to question: What is the risk of COVID-19 with rheumatic disease and what are the outcomes?”
To examine the role of biologic therapies in COVID-19 outcomes, Sood and colleagues reviewed studies from PubMed/Medline and Scopus that reported on COVID-19 outcomes among patients with rheumatic disease (n=6,095). The researchers extracted key data on demographic information and use of specific biologics or targeted therapy, as well as outcomes such as hospitalization, ICU admission and death.
Sood and colleagues grouped patients into severe or non-severe categories based on the clinical symptoms and need for hospitalization and ICU care.
According to study results, only 2% of patients (n=123) were found to be positive or highly suspicious for COVID-19. Among patients who were infected with COVID-19, 73% were never hospitalized. Among those hospitalized, 13 patients required admission to an ICU and four patients died.
“We found that, among those that tested positive [for COVID-19] only a few required hospitalization and, overall, a low proportion of patients required ICU care and death rate was low in this group,” Sood said.
Among the group of patients that were positive or highly suspicious for COVID-19, 68% of patients with COVID-19 were prescribed biologics, with 31% receiving anti-TNF drugs and 6% receiving JAK inhibitors. In this group, the most reported rheumatic diseases were rheumatoid arthritis (28%) and psoriatic arthritis (7%).
“The overall findings of this study are reassuring,” Sood said. “The risk of COVID-19 among patients with rheumatic disease was low and biologics did not appear to increase the risk of COVID-19 infection. [However], there is a word of caution. Patients on steroids are at increased risk for severe outcomes and this needs to be closely looked at in future studies. In addition, we need to look at demographic factors, such as age, race, gender, as well as comorbidities that may be associated with poor outcomes.”
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Sood A. Abstract #0008. Presented at: ACR Convergence 2020; November 5-9, 2020 (virtual meeting).
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