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COVID-19 Incidence in Patients With Immunomediated Inflammatory Diseases: Influence of Immunosuppressant Treatments

The effect of immunosuppressant treatments on the incidence of coronavirus disease (COVID-19) remains largely unknown. We studied the association between the pre-exposure to disease-modifying antirheumatic drugs (DMARDs) that decrease immunological responses and the incidence of COVID-19 to explore...

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Autores principales: Soldevila-Domenech, Natalia, Tío, Laura, Llorente-Onaindia, Jone, Martín-García, Elena, Nebot, Pau, de la Torre, Rafael, Gurt, Alba, Maldonado, Rafael, Monfort, Jordi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7845571/
https://www.ncbi.nlm.nih.gov/pubmed/33519443
http://dx.doi.org/10.3389/fphar.2020.583260
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author Soldevila-Domenech, Natalia
Tío, Laura
Llorente-Onaindia, Jone
Martín-García, Elena
Nebot, Pau
de la Torre, Rafael
Gurt, Alba
Maldonado, Rafael
Monfort, Jordi
author_facet Soldevila-Domenech, Natalia
Tío, Laura
Llorente-Onaindia, Jone
Martín-García, Elena
Nebot, Pau
de la Torre, Rafael
Gurt, Alba
Maldonado, Rafael
Monfort, Jordi
author_sort Soldevila-Domenech, Natalia
collection PubMed
description The effect of immunosuppressant treatments on the incidence of coronavirus disease (COVID-19) remains largely unknown. We studied the association between the pre-exposure to disease-modifying antirheumatic drugs (DMARDs) that decrease immunological responses and the incidence of COVID-19 to explore the possible effects of these treatments in early manifestations of the disease. For this purpose, we performed a cross-sectional study including 2,494 patients with immunomediated inflammatory diseases (IMIDs) recruited at the outpatient Rheumatology, Dermatology and Gastroenterology services of Hospital del Mar. The primary outcome was the clinical diagnosis of COVID-19 performed by a physician at the hospital or at the primary care center, from the March 1–29, 2020. Multivariable Poisson regression models were fitted to estimate COVID-19 relative risk (RR) adjusted by comorbidities. We revealed that biological (RR = 0.46, CI 95% = 0.31–0.67) and synthetic (RR = 0.62, CI 95% = 0.43–0.91) DMARDs used in IMIDs diminished the incidence of COVID-19. Striking sex differences were revealed with anti-TNFα compounds (RR = 0.50, CI 95% = 0.33–0.75) with higher effects in women (RR = 0.33, CI 95% = 0.17–0.647). Treatment with low glucocorticoid doses also revealed sex differences decreasing the incidence of COVID-19 predominantly in women (RR = 0.72, CI 95% = 0.42–1.22). Our results report a decreased incidence of COVID-19 in patients receiving specific DMARDs with different immunodepressor mechanisms with striking sex differences. These results underline the interest of repurposing specific DMARDs for the possibility of minimizing the severity of disease progression in the early stages of COVID-19.
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spelling pubmed-78455712021-01-30 COVID-19 Incidence in Patients With Immunomediated Inflammatory Diseases: Influence of Immunosuppressant Treatments Soldevila-Domenech, Natalia Tío, Laura Llorente-Onaindia, Jone Martín-García, Elena Nebot, Pau de la Torre, Rafael Gurt, Alba Maldonado, Rafael Monfort, Jordi Front Pharmacol Pharmacology The effect of immunosuppressant treatments on the incidence of coronavirus disease (COVID-19) remains largely unknown. We studied the association between the pre-exposure to disease-modifying antirheumatic drugs (DMARDs) that decrease immunological responses and the incidence of COVID-19 to explore the possible effects of these treatments in early manifestations of the disease. For this purpose, we performed a cross-sectional study including 2,494 patients with immunomediated inflammatory diseases (IMIDs) recruited at the outpatient Rheumatology, Dermatology and Gastroenterology services of Hospital del Mar. The primary outcome was the clinical diagnosis of COVID-19 performed by a physician at the hospital or at the primary care center, from the March 1–29, 2020. Multivariable Poisson regression models were fitted to estimate COVID-19 relative risk (RR) adjusted by comorbidities. We revealed that biological (RR = 0.46, CI 95% = 0.31–0.67) and synthetic (RR = 0.62, CI 95% = 0.43–0.91) DMARDs used in IMIDs diminished the incidence of COVID-19. Striking sex differences were revealed with anti-TNFα compounds (RR = 0.50, CI 95% = 0.33–0.75) with higher effects in women (RR = 0.33, CI 95% = 0.17–0.647). Treatment with low glucocorticoid doses also revealed sex differences decreasing the incidence of COVID-19 predominantly in women (RR = 0.72, CI 95% = 0.42–1.22). Our results report a decreased incidence of COVID-19 in patients receiving specific DMARDs with different immunodepressor mechanisms with striking sex differences. These results underline the interest of repurposing specific DMARDs for the possibility of minimizing the severity of disease progression in the early stages of COVID-19. Frontiers Media S.A. 2020-12-21 /pmc/articles/PMC7845571/ /pubmed/33519443 http://dx.doi.org/10.3389/fphar.2020.583260 Text en Copyright © 2020 Soldevila-Domenech, Tío, Llorente‐Onaindia, Martín‐García, Nebot, de la Torre, Gurt, Maldonado and Monfort. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Pharmacology
Soldevila-Domenech, Natalia
Tío, Laura
Llorente-Onaindia, Jone
Martín-García, Elena
Nebot, Pau
de la Torre, Rafael
Gurt, Alba
Maldonado, Rafael
Monfort, Jordi
COVID-19 Incidence in Patients With Immunomediated Inflammatory Diseases: Influence of Immunosuppressant Treatments
title COVID-19 Incidence in Patients With Immunomediated Inflammatory Diseases: Influence of Immunosuppressant Treatments
title_full COVID-19 Incidence in Patients With Immunomediated Inflammatory Diseases: Influence of Immunosuppressant Treatments
title_fullStr COVID-19 Incidence in Patients With Immunomediated Inflammatory Diseases: Influence of Immunosuppressant Treatments
title_full_unstemmed COVID-19 Incidence in Patients With Immunomediated Inflammatory Diseases: Influence of Immunosuppressant Treatments
title_short COVID-19 Incidence in Patients With Immunomediated Inflammatory Diseases: Influence of Immunosuppressant Treatments
title_sort covid-19 incidence in patients with immunomediated inflammatory diseases: influence of immunosuppressant treatments
topic Pharmacology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7845571/
https://www.ncbi.nlm.nih.gov/pubmed/33519443
http://dx.doi.org/10.3389/fphar.2020.583260
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