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RISK FACTORS FOR INFECTION AND HEALTH IMPACTS OF THE COVID-19 PANDEMIC IN PEOPLE WITH AUTOIMMUNE DISEASES
BACKGROUND: People with autoimmune or inflammatory conditions who take immunomodulatory/suppressive medications may have a higher risk of novel coronavirus disease 2019 (COVID-19). Chronic disease care has also changed for many patients, with uncertain downstream consequences. OBJECTIVE: Assess whet...
Autores principales: | , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Cold Spring Harbor Laboratory
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7872366/ https://www.ncbi.nlm.nih.gov/pubmed/33564774 http://dx.doi.org/10.1101/2021.02.03.21251069 |
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author | Fitzgerald, Kathryn C. Mecoli, Christopher A. Douglas, Morgan Harris, Samantha Aravidis, Berna Albayda, Jemima Sotirchos, Elias S. Hoke, Ahmet Orbai, Ana-Maria Petri, Michelle Christopher-Stine, Lisa Baer, Alan N. Paik, Julie J. Adler, Brittany L. Tiniakou, Eleni Timlin, Homa Bhargava, Pavan Newsome, Scott D. Venkatesan, Arun Chaudhry, Vinay Lloyd, Thomas E. Pardo, Carlos A. Stern, Barney J. Lazarev, Mark Truta, Brindusa Saidha, Shiv Chen, Edward S. Sharp, Michelle Gilotra, Nisha Kasper, Edward K. Gelber, Allan C. Bingham, Clifton O. Shah, Ami A. Mowry, Ellen M. |
author_facet | Fitzgerald, Kathryn C. Mecoli, Christopher A. Douglas, Morgan Harris, Samantha Aravidis, Berna Albayda, Jemima Sotirchos, Elias S. Hoke, Ahmet Orbai, Ana-Maria Petri, Michelle Christopher-Stine, Lisa Baer, Alan N. Paik, Julie J. Adler, Brittany L. Tiniakou, Eleni Timlin, Homa Bhargava, Pavan Newsome, Scott D. Venkatesan, Arun Chaudhry, Vinay Lloyd, Thomas E. Pardo, Carlos A. Stern, Barney J. Lazarev, Mark Truta, Brindusa Saidha, Shiv Chen, Edward S. Sharp, Michelle Gilotra, Nisha Kasper, Edward K. Gelber, Allan C. Bingham, Clifton O. Shah, Ami A. Mowry, Ellen M. |
author_sort | Fitzgerald, Kathryn C. |
collection | PubMed |
description | BACKGROUND: People with autoimmune or inflammatory conditions who take immunomodulatory/suppressive medications may have a higher risk of novel coronavirus disease 2019 (COVID-19). Chronic disease care has also changed for many patients, with uncertain downstream consequences. OBJECTIVE: Assess whether COVID-19 risk is higher among those on immunomodulating or suppressive agents and characterize pandemic-associated changes to care. DESIGN: Longitudinal registry study PARTICIPANTS: 4666 individuals with autoimmune or inflammatory conditions followed by specialists in neurology, rheumatology, cardiology, pulmonology or gastroenterology at Johns Hopkins MEASUREMENTS: Periodic surveys querying comorbidities, disease-modifying medications, exposures, COVID-19 testing and outcomes, social behaviors, and disruptions to healthcare RESULTS: A total of 265 (5.6%) developed COVID-19 over 9 months of follow-up (April-December 2020). Patient characteristics (age, race, comorbidity, medication exposure) were associated with differences in social distancing behaviors during the pandemic. Glucocorticoid exposure was associated with higher odds of COVID-19 in multivariable models incorporating behavior and other potential confounders (OR: 1.43; 95%CI: 1.08, 1.89). Other medication classes were not associated with COVID-19 risk. Diabetes (OR: 1.72; 95%CI: 1.08, 2.73), cardiovascular disease (OR: 1.68; 95%CI: 1.24, 2.28), and chronic kidney disease (OR: 1.76; 95%CI: 1.04, 2.97) were each associated with higher odds of COVID-19. Pandemic-related disruption to care was common. Of the 2156 reporting pre-pandemic utilization of infusion, mental health or rehabilitative services, 975 (45.2%) reported disruptions. Individuals experiencing changes to employment or income were at highest odds of care disruption. LIMITATIONS: Results may not be generalizable to all patients with autoimmune or inflammatory conditions. Information was self-reported. CONCLUSIONS: Exposure to glucocorticoids may increase risk of COVID-19 in people with autoimmune or inflammatory conditions. Disruption to healthcare and related services was common. Those with pandemic-related reduced income may be most vulnerable to care disruptions. |
format | Online Article Text |
id | pubmed-7872366 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Cold Spring Harbor Laboratory |
record_format | MEDLINE/PubMed |
spelling | pubmed-78723662021-02-10 RISK FACTORS FOR INFECTION AND HEALTH IMPACTS OF THE COVID-19 PANDEMIC IN PEOPLE WITH AUTOIMMUNE DISEASES Fitzgerald, Kathryn C. Mecoli, Christopher A. Douglas, Morgan Harris, Samantha Aravidis, Berna Albayda, Jemima Sotirchos, Elias S. Hoke, Ahmet Orbai, Ana-Maria Petri, Michelle Christopher-Stine, Lisa Baer, Alan N. Paik, Julie J. Adler, Brittany L. Tiniakou, Eleni Timlin, Homa Bhargava, Pavan Newsome, Scott D. Venkatesan, Arun Chaudhry, Vinay Lloyd, Thomas E. Pardo, Carlos A. Stern, Barney J. Lazarev, Mark Truta, Brindusa Saidha, Shiv Chen, Edward S. Sharp, Michelle Gilotra, Nisha Kasper, Edward K. Gelber, Allan C. Bingham, Clifton O. Shah, Ami A. Mowry, Ellen M. medRxiv Article BACKGROUND: People with autoimmune or inflammatory conditions who take immunomodulatory/suppressive medications may have a higher risk of novel coronavirus disease 2019 (COVID-19). Chronic disease care has also changed for many patients, with uncertain downstream consequences. OBJECTIVE: Assess whether COVID-19 risk is higher among those on immunomodulating or suppressive agents and characterize pandemic-associated changes to care. DESIGN: Longitudinal registry study PARTICIPANTS: 4666 individuals with autoimmune or inflammatory conditions followed by specialists in neurology, rheumatology, cardiology, pulmonology or gastroenterology at Johns Hopkins MEASUREMENTS: Periodic surveys querying comorbidities, disease-modifying medications, exposures, COVID-19 testing and outcomes, social behaviors, and disruptions to healthcare RESULTS: A total of 265 (5.6%) developed COVID-19 over 9 months of follow-up (April-December 2020). Patient characteristics (age, race, comorbidity, medication exposure) were associated with differences in social distancing behaviors during the pandemic. Glucocorticoid exposure was associated with higher odds of COVID-19 in multivariable models incorporating behavior and other potential confounders (OR: 1.43; 95%CI: 1.08, 1.89). Other medication classes were not associated with COVID-19 risk. Diabetes (OR: 1.72; 95%CI: 1.08, 2.73), cardiovascular disease (OR: 1.68; 95%CI: 1.24, 2.28), and chronic kidney disease (OR: 1.76; 95%CI: 1.04, 2.97) were each associated with higher odds of COVID-19. Pandemic-related disruption to care was common. Of the 2156 reporting pre-pandemic utilization of infusion, mental health or rehabilitative services, 975 (45.2%) reported disruptions. Individuals experiencing changes to employment or income were at highest odds of care disruption. LIMITATIONS: Results may not be generalizable to all patients with autoimmune or inflammatory conditions. Information was self-reported. CONCLUSIONS: Exposure to glucocorticoids may increase risk of COVID-19 in people with autoimmune or inflammatory conditions. Disruption to healthcare and related services was common. Those with pandemic-related reduced income may be most vulnerable to care disruptions. Cold Spring Harbor Laboratory 2021-02-05 /pmc/articles/PMC7872366/ /pubmed/33564774 http://dx.doi.org/10.1101/2021.02.03.21251069 Text en https://creativecommons.org/licenses/by-nc-nd/4.0/This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (https://creativecommons.org/licenses/by-nc-nd/4.0/) , which allows reusers to copy and distribute the material in any medium or format in unadapted form only, for noncommercial purposes only, and only so long as attribution is given to the creator. |
spellingShingle | Article Fitzgerald, Kathryn C. Mecoli, Christopher A. Douglas, Morgan Harris, Samantha Aravidis, Berna Albayda, Jemima Sotirchos, Elias S. Hoke, Ahmet Orbai, Ana-Maria Petri, Michelle Christopher-Stine, Lisa Baer, Alan N. Paik, Julie J. Adler, Brittany L. Tiniakou, Eleni Timlin, Homa Bhargava, Pavan Newsome, Scott D. Venkatesan, Arun Chaudhry, Vinay Lloyd, Thomas E. Pardo, Carlos A. Stern, Barney J. Lazarev, Mark Truta, Brindusa Saidha, Shiv Chen, Edward S. Sharp, Michelle Gilotra, Nisha Kasper, Edward K. Gelber, Allan C. Bingham, Clifton O. Shah, Ami A. Mowry, Ellen M. RISK FACTORS FOR INFECTION AND HEALTH IMPACTS OF THE COVID-19 PANDEMIC IN PEOPLE WITH AUTOIMMUNE DISEASES |
title | RISK FACTORS FOR INFECTION AND HEALTH IMPACTS OF THE COVID-19 PANDEMIC IN PEOPLE WITH AUTOIMMUNE DISEASES |
title_full | RISK FACTORS FOR INFECTION AND HEALTH IMPACTS OF THE COVID-19 PANDEMIC IN PEOPLE WITH AUTOIMMUNE DISEASES |
title_fullStr | RISK FACTORS FOR INFECTION AND HEALTH IMPACTS OF THE COVID-19 PANDEMIC IN PEOPLE WITH AUTOIMMUNE DISEASES |
title_full_unstemmed | RISK FACTORS FOR INFECTION AND HEALTH IMPACTS OF THE COVID-19 PANDEMIC IN PEOPLE WITH AUTOIMMUNE DISEASES |
title_short | RISK FACTORS FOR INFECTION AND HEALTH IMPACTS OF THE COVID-19 PANDEMIC IN PEOPLE WITH AUTOIMMUNE DISEASES |
title_sort | risk factors for infection and health impacts of the covid-19 pandemic in people with autoimmune diseases |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7872366/ https://www.ncbi.nlm.nih.gov/pubmed/33564774 http://dx.doi.org/10.1101/2021.02.03.21251069 |
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