medwireNews: The authors of a prospective US case series outline the experience of 86 patients with immune-mediated inflammatory diseases and confirmed or highly suspected COVID-19.
As reported in a correspondence to The New England Journal of Medicine, the 14 patients who required hospital treatment were older than the 72 who did not (average 50 vs 46 years), and included a higher proportion of people with rheumatoid arthritis (43 vs 19%), but the distribution of the other diseases, including psoriatic arthritis and inflammatory bowel disease, “was similar.” None of the nine people with ankylosing spondylitis from the cohort were admitted to hospital.
In a multivariate analysis adjusting for factors including age, sex, BMI, and comorbidities, hospitalized patients were significantly more likely to be taking prednisone (29 vs 6%), hydroxychloroquine (21 vs 7%), or methotrexate (43 vs 15%) at baseline than ambulatory patients. A smaller proportion of hospitalized versus ambulatory patients were taking biologics or JAK inhibitors (50 vs 76%) but the between-group difference did not reach statistical significance.
Jose Scher and colleagues from New York University note that these findings were consistent when they restricted the analysis to the 59 people with confirmed SARS-CoV2 infection. While acknowledging that their study “was limited in sample size,” they conclude that “baseline use of biologics is not associated with worse Covid-19 outcomes.”
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N Engl J Med 2020; doi:10.1056/NEJMc2009567