Effect of immunosuppressive drugs in immune-mediated inflammatory disease during the coronavirus pandemic

Dermatol Ther. 2020 Nov;33(6):e14204. doi: 10.1111/dth.14204. Epub 2020 Sep 14.

Abstract

The safety of immunosuppressive treatment in patients with Immune-Mediated Inflammatory Diseases (IMIDs) during the Coronavirus pandemic is questioned and it is utmost important for public health. We searched studies trough MEDLINE/EMBASE database, including patient with IMID, undergoing immunosuppressive treatment with a positive diagnosis for SARS-CoV 2. We included 11 studies for the descriptive analysis and 10 studies for the pooled analysis, with a total population of 57 and 53 IMID-affected SARS-CoV-positive patients respectively. Overall no death was reported; 16 patients were hospitalized (30.2%) and only two cases were admitted to Intensive Care Unit (ICU) (3.8%). We found a significant association between the risk of hospitalization and older age (P .03), obesity (P .02), and presence of multi-comorbidity (P .03). No significant association was found between the risk of hospitalization and the use of biological or conventional DMARDs (respectively P .32 and .26), neither when they are used combined (P .85). We found consistent results in the sub-analysis of Psoriasis: 10 patients were hospitalized (31.3%) and only one case was admitted to Intensive Care Unit (ICU) (3.1%) Particular attention should be placed for patients with older age, obesity and multi-comorbidity that are at higher risk of hospitalization.

Keywords: biologic; coronavirus; immune-mediate inflammatory disease; immunosuppressive drugs; psoriasis.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Antirheumatic Agents / adverse effects
  • Antirheumatic Agents / therapeutic use*
  • Biological Products / adverse effects
  • Biological Products / therapeutic use*
  • COVID-19 / epidemiology
  • COVID-19 / immunology*
  • COVID-19 / therapy
  • COVID-19 / virology
  • Female
  • Hospitalization
  • Host-Pathogen Interactions
  • Humans
  • Immunocompromised Host
  • Immunosuppressive Agents / adverse effects
  • Immunosuppressive Agents / therapeutic use*
  • Inflammation / drug therapy*
  • Inflammation / epidemiology
  • Inflammation / immunology
  • Male
  • Middle Aged
  • Multimorbidity
  • Obesity / epidemiology
  • Risk Assessment
  • Risk Factors
  • SARS-CoV-2 / immunology*
  • SARS-CoV-2 / pathogenicity
  • Treatment Outcome

Substances

  • Antirheumatic Agents
  • Biological Products
  • Immunosuppressive Agents