Background
Finite clinical data and understanding of COVID-19 immunopathology has led to limited, opinion-based recommendations for management of immune-mediated inflammatory disease (IMID) patients on immunosuppressive (IS) therapeutics.
Objective
Determine if IS therapeutic type impacts COVID-19 risk among IMID patients.
Methods
We conducted a retrospective cohort analysis of Henry Ford Health System (HFHS) patients tested for COVID-19 between February 1
st
and April 18
th
, 2020 treated with IS medication for IMID. Therapeutic class of IS medication, comorbidities, and demographic factors were combined into multivariate models to determine predictors of COVID-19 infection, admission, ventilation, and mortality.
Results
Of 213 IMID patients, 36.2% tested positive for COVID-19, who had no greater odds of being hospitalized or requiring ventilation relative to the general population. No IS therapeutic worsened the course of disease after multivariate correction, though multi-drug regimens and biologics predicted an increased and decreased rate of hospitalization, respectively, with the latter driven by TNFα inhibitors.
Limitations
A single-center study somewhat limits generalization to community-based settings. Only patients tested for COVID-19 were analyzed.
Conclusion
IS therapies for IMIDs are not associated with a significantly greater risk of SARS-CoV-2 or severe sequelae when controlling for other factors, and TNFα inhibitors may decrease odds of severe infection.
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