Nutritional Advice El Mondo
Objectives:
The prevalence and clinical outcomes of COVID-19 in patients with autoimmune diseases who are frequently treated with disease modifying therapies remains poorly understood. Therefore, this review article has been conducted.
Do patients with autoimmune diseases have an increased risk of COVID-19?
Study design:
This review article included 62 observational studies with a total of 319 ,025 patients with autoimmune diseases.
There was no publication bias.
Results and conclusions:
The investigators found the prevalence of COVID-19 among patients with autoimmune diseases was 0.011 [95% CI = 0.005 to 0.025].
The investigators found meta-analysis of 7 case-controlled studies demonstrated that the risk of COVID-19 in autoimmune diseases was significantly higher than in control patients [OR = 2.19, 95% CI = 1.05 to 4.58, p = 0.038, I2 = 78.0%].
The investigators found meta-analysis of 65 observational studies including 2,766 patients with autoimmune diseases diagnosed with COVID-19 showed that the hospitalisation rate due to COVID-19 was 0.35 [95% CI = 0.23 to 0.50]. Hospitalisation rates of AHD, IBD, IMID, psoriasis/AISD, RD and SLE/SjS/SSc were 0.52 [95% CI = 0.23 to 0.80], 0.29 [95% CI = 0.21 to 0.38], 0.24 [95% CI = 0.12 to 0.43], 0.26 [95% CI = 0.15 to 0.41], 0.54 [95% CI = 0.46 to 0.63] and 0.33 [95% CI = 0.20 to 0.49], respectively, with RD having the highest hospitalisation rate.
The investigators found the mortality due to COVID-19 in patients with ADs was 0.066 [95% CI = 0.036 to 0.12]. Mortality of AHD, IBD, IMID, psoriasis/AISD, RD and SLE/SjS/SSc were 0.094 [95% CI = 0.019 to 0.36], 0.045 [95% CI = 0.032 to 0.063], 0.017 [95% CI = 0.004 to 0.065], 0.097 [95% CI = 0.042 to 0.21], 0.113 [95% CI= 0.098 to 0.13] and 0.069 [95% CI = 0.032 to 0.14], respectively.
Patients with RD had the highest mortality rate, which was consistent with the analysis of the hospitalisation rate.
The investigators found meta-analysis of 6 case-controlled studies showed no differences in hospitalisations [OR = 1.05, 95% CI = 0.78 to 1.42, p = 0.73], death [OR = 0.55, 95% CI = 0.081 to 3.68, p = 0.53], intensive care unit (ICU) admission [OR = 1.22, 95% CI = 0.42 to 3.60, p = 0.72] or mechanical/non-invasive ventilation [OR = 1.03, 95% CI = 0.22 to 4.81, p = 0.97] when compared with the control population.
The investigators found meta-regression analysis showed that older age [regression coefficient: 0.070, 95% CI = 0.046 to 0.095, p 0.001], a higher proportion of patients with hypertension [regression coefficient = 0.017, 95% CI = 0.002 to 0.032, p = 0.024] or at least one comorbidity [regression coefficient = 0.024, 95% CI = 0.007 to 0.040, p = 0.004] in patients with autoimmune diseases had a higher risk of hospitalisation due to COVID-19.
The investigators found meta-regression analysis showed older age [regression coefficient: 0.068, 95% CI = 0.048 to 0.089, p 0.001], a higher proportion of hypertension [regression coefficient = 0.034, 95% CI = 0.022 to 0.045, p 0.001] and diabetes [regression coefficient: 0.038, 95% CI = 0.012 to 0.064, p = 0.004] were associated with a higher mortality rate due to COVID-19.
The investigators found glucocorticoids, csDMARDs and b/tsDMARDs-csDMARDs combination therapy increased the risk of hospitalisation and death due to COVID-19, whereas b/tsDMARDs monotherapy, particularly antitumour necrosis factor agents, were associated with a lower risk of hospitalisation and death due to COVID-19.
The investigators concluded that patients with autoimmune diseases have an increased risk of COVID-19, primarily attributed to glucocorticoid use. b/tsDMARDs monotherapy is associated with a lower risk of severe COVID-19 suggesting its safety in the COVID-19 pandemic.
Original title:
Prevalence and clinical outcomes of COVID-19 in patients with autoimmune diseases: a systematic review and meta-analysis by Akiyama S, Hamdeh S, […], Sakuraba A.
Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7554412/
Additional information of El Mondo:
Find more information/studies on coronavirus right here.