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Risk Factors for Infection and Health Impacts of the Coronavirus Disease 2019 (COVID-19) Pandemic in People With Autoimmune Diseases
BACKGROUND: People with autoimmune or inflammatory conditions taking immunomodulatory/suppressive medications may have higher risk of novel coronavirus disease 2019 (COVID-19). Chronic disease care has also changed for many patients, with uncertain downstream consequences. METHODS: We included parti...
Autores principales: | , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Oxford University Press
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8135997/ https://www.ncbi.nlm.nih.gov/pubmed/33956972 http://dx.doi.org/10.1093/cid/ciab407 |
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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 taking immunomodulatory/suppressive medications may have higher risk of novel coronavirus disease 2019 (COVID-19). Chronic disease care has also changed for many patients, with uncertain downstream consequences. METHODS: We included participants with autoimmune or inflammatory conditions followed by specialists at Johns Hopkins. Participants completed periodic surveys querying comorbidities, disease-modifying medications, exposures, COVID-19 testing and outcomes, social behaviors, and disruptions to healthcare. We assessed whether COVID-19 risk is higher among those on immunomodulating or suppressive agents and characterized pandemic-associated changes to care and mental health. RESULTS: In total, 265 (5.6%) developed COVID-19 over 9 months of follow-up (April–December 2020). Patient characteristics (age, race, comorbidity, medications) were associated with differences in social distancing behaviors during the pandemic. Glucocorticoid exposure was associated with higher odds of COVID-19 in models incorporating behavior and other potential confounders (odds ratio [OR]: 1.43; 95% confidence interval [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 kidney disease (OR: 1.76; 95% CI: 1.04, 2.97) were associated with higher odds of COVID-19. Of the 2156 reporting pre-pandemic utilization of infusion, mental health or rehabilitative services, 975 (45.2%) reported disruptions therein, which disproportionately affected individuals experiencing changes to employment or income. CONCLUSIONS: Glucocorticoid exposure 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-8135997 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-81359972021-05-21 Risk Factors for Infection and Health Impacts of the Coronavirus Disease 2019 (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 Clin Infect Dis Major Articles and Commentaries BACKGROUND: People with autoimmune or inflammatory conditions taking immunomodulatory/suppressive medications may have higher risk of novel coronavirus disease 2019 (COVID-19). Chronic disease care has also changed for many patients, with uncertain downstream consequences. METHODS: We included participants with autoimmune or inflammatory conditions followed by specialists at Johns Hopkins. Participants completed periodic surveys querying comorbidities, disease-modifying medications, exposures, COVID-19 testing and outcomes, social behaviors, and disruptions to healthcare. We assessed whether COVID-19 risk is higher among those on immunomodulating or suppressive agents and characterized pandemic-associated changes to care and mental health. RESULTS: In total, 265 (5.6%) developed COVID-19 over 9 months of follow-up (April–December 2020). Patient characteristics (age, race, comorbidity, medications) were associated with differences in social distancing behaviors during the pandemic. Glucocorticoid exposure was associated with higher odds of COVID-19 in models incorporating behavior and other potential confounders (odds ratio [OR]: 1.43; 95% confidence interval [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 kidney disease (OR: 1.76; 95% CI: 1.04, 2.97) were associated with higher odds of COVID-19. Of the 2156 reporting pre-pandemic utilization of infusion, mental health or rehabilitative services, 975 (45.2%) reported disruptions therein, which disproportionately affected individuals experiencing changes to employment or income. CONCLUSIONS: Glucocorticoid exposure 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. Oxford University Press 2021-05-06 /pmc/articles/PMC8135997/ /pubmed/33956972 http://dx.doi.org/10.1093/cid/ciab407 Text en © The Author(s) 2021. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com. https://academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_modelThis article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (https://academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model) |
spellingShingle | Major Articles and Commentaries 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 Coronavirus Disease 2019 (COVID-19) Pandemic in People With Autoimmune Diseases |
title | Risk Factors for Infection and Health Impacts of the Coronavirus Disease 2019 (COVID-19) Pandemic in People With Autoimmune Diseases |
title_full | Risk Factors for Infection and Health Impacts of the Coronavirus Disease 2019 (COVID-19) Pandemic in People With Autoimmune Diseases |
title_fullStr | Risk Factors for Infection and Health Impacts of the Coronavirus Disease 2019 (COVID-19) Pandemic in People With Autoimmune Diseases |
title_full_unstemmed | Risk Factors for Infection and Health Impacts of the Coronavirus Disease 2019 (COVID-19) Pandemic in People With Autoimmune Diseases |
title_short | Risk Factors for Infection and Health Impacts of the Coronavirus Disease 2019 (COVID-19) Pandemic in People With Autoimmune Diseases |
title_sort | risk factors for infection and health impacts of the coronavirus disease 2019 (covid-19) pandemic in people with autoimmune diseases |
topic | Major Articles and Commentaries |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8135997/ https://www.ncbi.nlm.nih.gov/pubmed/33956972 http://dx.doi.org/10.1093/cid/ciab407 |
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