AB1122 HAVE TREATMENTS FOR AUTOIMMUNE DISEASES WORSENED THE PROGNOSIS OF COVID-19 INFECTION?

Abstract

BackgroundAccording to the literature patients with autoimmune diseases (AID) have a high risk of develop serious infections due to the use of immunosuppressive treatment. In published clinical trials neither the risk nor the severity of COVID-19 infection in patients with AID seem to be higher than in the general population.ObjectivesThe objective of our study is to analyse the clinical course in patients with AID undergoing immunosuppressive treatments and infected by COVID-19.MethodsPatients were included after reviewing four rheumatology outpatient clinics from Ciudad Real University General Hospital between November 2020 and February 2021. The inclusion criteria were being older than 18 years and being positive for COVID-19 by epidemiological (positive molecular and/or antigen test) or clinical criteria (symptoms compatible between March and May 2020). We collected demographic data, cardiovascular comorbidities, AID, treatment with synthetic or biological DMARDs, immunomodulators or glucocorticoids; and progression of infection COVID-19.ResultsWe found a total of 210 patients that had suffered from SARS-COV2 of which 95 patients were affected by AID. The most prevalent pathology in our sample was spondylarthritis followed by arthritis rheumatoid and systemic lupus erythematosus of which 81.82%, 100% and one 92.86% respectively were receiving treatment to control the disease. Among the 95 patients suffering from COVID and AID a small number of patients did not follow any immunosuppressive treatment regimen (n=25) but most of our patients were undergoing immunosuppressors (n=70); the most used drugs were prednisone and methotrexate. No statistically significant differences were found between the treated versus untreated group in the studied variables, being similar the results relative to mean age, sex, presence of cardiovascular risk factors, absence of symptoms, number of admissions to hospital ward or in Intensive Care Unit, or complications during COVID-19 infection (Table 1).Table 1.Baseline characteristics of patient with AID undergoing or not immunosuppressors.TreatedUntreatedpn=70 (73,68%)n=25 (26,32%)Medium age (SD)51,74 (+/- 2,18)55,74 (+/-3,36)0,467Female sex, n (%)49 (70%)17 (68%)0,852HTA, n (%)22 (31,4%)5 (20%)0,277DM, n (%)8 (11,4%)2 (8%)0,632DL, n (%)13 (18,6%)1 (4%)0,078Tobacco, n (%)7 (10%)3 (12%)0,78Asymptomatic, n (%)13 (18,6%)4 (16%)0,773Admitted, n (%)11 (15,7%)5 (20%)0,623ICU, n (%)2 (2,9%)0 (0%)0,393ARDS, n (%)7 (10%)2 (8%)0,769Overinfection, n (%)4 (5,7%)0 (0%)0,222Thrombosis, n (%)1 (1,4%)0(0%)0,548Death, n (%)6 (8,6%)2 (8%)0,930SD, standard deviation; n, absolute numbers; %, percentages; p, p-value; AID, autoimmune diseases; HTA, arterial hypertension; DM, diabetes mellitus; DL, dyslipidaemia; ICU: intensive care unit; ARDS: Acute respiratory distress syndromeConclusionPatients treated with synthetic or biologicals DMARDs, immunomodulators or glucocorticoids do not seem have a higher rate of death or hospital admission respect to patients diagnosed of AID without such treatments.