According to a new study, COVID-19 infection rates are low in people with rheumatic diseases and those infected have experienced a mild case. This data was presented at ACR Convergence, the American College of Rheumatology’s annual meeting.
“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,” Akhil Sood, MD, University of Texas Medical Branch in Galveston, said. “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.”
This systematic review focused on studies reporting the outcome of COVID-19 infection among patients with rheumatic diseases receiving biologic and targeted therapies. Articles were sourced from PubMed/Medline and Scopus for the dates of January 1, 2020 to June 1, 2020. Demographic information and use of biologic or targeted therapy were extracted. Patients were grouped into severe, such as increased risk of respiratory failure or life-threatening complications, or non-severe based on clinical symptoms, need for hospitalization, and ICU care.
A total of 8 observational cohort studies were included, with 6,095 patients. Approximately 123 patients (2%) were positive or highly suspicious for COVID-19 infection based on clinical features. A majority of patients were not were not hospitalized (91 patients). Thirteen patients required ICU admission and 4 patients died (3.2% of total).
Rheumatoid arthritis and psoriatic arthritis were the most common rheumatic diseases (28% and 7%, respectively). Across all studies, 68% of COVID-19 patients were receiving biologics. Anti-TNF agents were the most common. Only 6% were using JAK inhibitors.
Sood and his colleagues are waiting for more extensive studies. Additionally, they are interested in “... examining risk factors for severe COVID-19 infection in patients with rheumatic disease. We hope this can help us identify which patients to closely monitor and possibly develop precautions to mitigate their risk.”
