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Low COVID-19 infection rate in patients with rheumatism

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Coronavirus 2019 (COVID-19) infection in patients with rheumatoid arthritis was surprisingly low in the results of a new systematic review attempting to observe the pandemic burden on potentially at-risk populations.

A team of Texas investigators American College of Rheumatology (ACR) Convergence 2020 This week shows that patients with rheumatoid arthritis had lower COVID-19 infections, disease severity, and associated mortality until May of this year.

Findings show that the initial fear of immunosuppressed patients in the field at the onset of the pandemic may be mitigated by the minimally observed effect from COVID-19, other data presented at ACR2020. Complements.

Researchers led by Akhil Food, MD, a medical intern at the University of Texas School of Medicine in Galveston, were tracking their very early concerns when they began the trial.

“When the pandemic began, patients with rheumatoid arthritis were at high risk of infection and were concerned about whether to continue immunotherapy or not,” Sood said in a statement. “I was interested in seeing if these patients were at high risk of COVID-19 infection.”

And if such a patient becomes infected, the clinician wants to know the risk of severity of the disease course to ensure that the biotherapy prescribed responsibly during the pandemic is controlled. You would think, Sood said.

Sood et al. Conducted a systematic review of articles published between January and May of this year for COVID-19 results in patients with rheumatoid arthritis. They extracted patient demographics and the use of biological or targeted therapies from the observed data.

The results measured for their assessment included hospitalization, intensive care unit (ICU) admission, and death. Patients were stratified with “severe” or “non-severe” results based on the clinical symptoms of COVID-19 and the need for hospitalization or ICU admission.

From their assessment, the researchers found eight observational cohort trials involving 6095 patients with rheumatic disease. Among them, based on clinical indications, only 123 patients (2%) were found to be very suspected of being COVID-19 positive or COVID-19 infection. The most commonly reported rheumatoid diseases in this subpopulation included rheumatoid arthritis (28%) and psoriatic arthritis (7%).

Approximately two-thirds (68%) of patients with COVID-19 with rheumatic disease were using biologics at the time. Most commonly, it was an anti-TNF agent (31%). Almost three-quarters (73%) of COVID-19 patients were not hospitalized. Of the 27%, 13 required ICU admission and 4 died.

Researchers have emphasized the need for larger cohort analysis to better examine COVID-19 results between biological and non-biological users, disease severity index and therapeutic use. Factors such as duration were not considered in this assessment. However, current findings show that patients with rheumatism have a lower incidence of COVID-19 and a lower risk of hospitalization or death in infected patients.

“We are waiting for additional extensive research, including patients with rheumatoid arthritis related to biological and targeted therapies,” said Sood. “Another area of ​​our interest is to investigate the risk factors for severe COVID-19 infection in patients with rheumatoid arthritis, which is to closely monitor which patients and reduce their risk. I hope it helps to develop preventative measures for. “

the study, “COVID-19 infection in patients with rheumatic disease by biological and targeted therapies: systematic review, ”Was announced at ACR2020.

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