Coronavirus disease 2019, immune-mediated inflammatory diseases and immunosuppressive therapies – A Danish population-based cohort study
Limited data exist regarding the disease course of coronavirus disease 2019 (COVID-19) and its relationship with immunosuppressants among patients with immune-mediated inflammatory diseases (IMIDs). Therefore, this study aims to investigate the association between COVID-19, frequent rheumatological,...
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| Veröffentlicht in: | Journal of autoimmunity 2021-03, Vol.118, p.102613-102613, Article 102613 |
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| container_title | Journal of autoimmunity |
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| creator | Attauabi, Mohamed Seidelin, Jakob Benedict Felding, Oluf Krautwald Wewer, Mads Damsgaard Vinther Arp, Laura Kirstine Sarikaya, Melek Zahra Egeberg, Alexander Vladimirova, Nora Bendtsen, Flemming Burisch, Johan |
| description | Limited data exist regarding the disease course of coronavirus disease 2019 (COVID-19) and its relationship with immunosuppressants among patients with immune-mediated inflammatory diseases (IMIDs). Therefore, this study aims to investigate the association between COVID-19, frequent rheumatological, dermatological, gastrointestinal, and neurological IMIDs and immunosuppressants.
We conducted a Danish population-based cohort study including all residents living within Capital Region of Denmark and Region Zealand from January 28th, 2020 until September 15th, 2020 with the only eligibility criterion being a test for SARS-CoV-2 via reverse transcription–polymerase chain-reaction. Main outcomes included development of COVID-19, COVID-19-related hospitalization and mortality.
COVID-19 was less common among patients with IMIDs than the background population (n = 328/20,513 (1.60%) and n = 10,792/583,788(1.85%), p |
| doi_str_mv | 10.1016/j.jaut.2021.102613 |
| format | Article |
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We conducted a Danish population-based cohort study including all residents living within Capital Region of Denmark and Region Zealand from January 28th, 2020 until September 15th, 2020 with the only eligibility criterion being a test for SARS-CoV-2 via reverse transcription–polymerase chain-reaction. Main outcomes included development of COVID-19, COVID-19-related hospitalization and mortality.
COVID-19 was less common among patients with IMIDs than the background population (n = 328/20,513 (1.60%) and n = 10,792/583,788(1.85%), p < 0.01, respectively). However, those with IMIDs had a significantly higher risk of COVID-19-related hospitalization (31.1% and 18.6%, p < 0.01, respectively) and mortality (9.8% and 4.3%, p < 0.01, respectively), which were associated with patients older than 65 years, and presence of comorbidities. Furthermore, systemic steroids were independently associated with a severe course of COVID-19 (Odds ratio (OR) = 3.56 (95%CI 1.83–7.10), p < 0.01), while biologic therapies were associated with a reduced risk hereof (OR = 0.47 (95%CI 0.22–0.95), p = 0.04). Patients suspending immunosuppressants due to COVID-19 had an increased risk of subsequent hospitalization (OR = 3.59 (95%CI 1.31–10.78), p = 0.02).
This study found a lower occurrence, but a more severe disease course, of COVID-19 among patients with IMIDs, which was associated with the use of systemic steroids for IMIDs and suspension of other immunosuppressants. This study emphasizes the importance of weighing risks before suspending immunosuppressants during COVID-19.
•We found a lower occurrence of COVID-19 among patients with IMIDs compared to the background population.•Patients with IMIDs experienced a more severe COVID-19 in terms of COVID-19 related hospitalization and mortality.•Severity of COVID-19 was associated with systemic steroids in treatment of IMIDs and suspension of other immunosuppressants.•Use of biologic therapies were associated with a milder disease course of COVID-19.</description><identifier>ISSN: 0896-8411</identifier><identifier>EISSN: 1095-9157</identifier><identifier>DOI: 10.1016/j.jaut.2021.102613</identifier><identifier>PMID: 33592545</identifier><language>eng</language><publisher>England: Elsevier Ltd</publisher><subject>Adult ; Age Factors ; Aged ; Autoimmune diseases ; COVID-19 ; COVID-19 - diagnosis ; COVID-19 - epidemiology ; COVID-19 Drug Treatment ; COVID-19 Nucleic Acid Testing ; Denmark - epidemiology ; Epidemiology ; Female ; Humans ; Immune-mediated inflammatory diseases ; Immunosuppression Therapy ; Immunosuppressive agents ; Immunosuppressive Agents - administration & dosage ; Inflammation - diagnosis ; Inflammation - epidemiology ; Inflammation - therapy ; Male ; Middle Aged ; Population-based ; Risk Factors ; SARS-CoV-2</subject><ispartof>Journal of autoimmunity, 2021-03, Vol.118, p.102613-102613, Article 102613</ispartof><rights>2021 Elsevier Ltd</rights><rights>Copyright © 2021 Elsevier Ltd. All rights reserved.</rights><rights>2021 Elsevier Ltd. All rights reserved. 2021 Elsevier Ltd</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c521t-bd9a57e6bea6d9465a1e6207608c3897d45f3005e49df77885ef787aca2fd3423</citedby><cites>FETCH-LOGICAL-c521t-bd9a57e6bea6d9465a1e6207608c3897d45f3005e49df77885ef787aca2fd3423</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0896841121000214$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>230,314,776,780,881,3536,27903,27904,65309</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33592545$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Attauabi, Mohamed</creatorcontrib><creatorcontrib>Seidelin, Jakob Benedict</creatorcontrib><creatorcontrib>Felding, Oluf Krautwald</creatorcontrib><creatorcontrib>Wewer, Mads Damsgaard</creatorcontrib><creatorcontrib>Vinther Arp, Laura Kirstine</creatorcontrib><creatorcontrib>Sarikaya, Melek Zahra</creatorcontrib><creatorcontrib>Egeberg, Alexander</creatorcontrib><creatorcontrib>Vladimirova, Nora</creatorcontrib><creatorcontrib>Bendtsen, Flemming</creatorcontrib><creatorcontrib>Burisch, Johan</creatorcontrib><title>Coronavirus disease 2019, immune-mediated inflammatory diseases and immunosuppressive therapies – A Danish population-based cohort study</title><title>Journal of autoimmunity</title><addtitle>J Autoimmun</addtitle><description>Limited data exist regarding the disease course of coronavirus disease 2019 (COVID-19) and its relationship with immunosuppressants among patients with immune-mediated inflammatory diseases (IMIDs). Therefore, this study aims to investigate the association between COVID-19, frequent rheumatological, dermatological, gastrointestinal, and neurological IMIDs and immunosuppressants.
We conducted a Danish population-based cohort study including all residents living within Capital Region of Denmark and Region Zealand from January 28th, 2020 until September 15th, 2020 with the only eligibility criterion being a test for SARS-CoV-2 via reverse transcription–polymerase chain-reaction. Main outcomes included development of COVID-19, COVID-19-related hospitalization and mortality.
COVID-19 was less common among patients with IMIDs than the background population (n = 328/20,513 (1.60%) and n = 10,792/583,788(1.85%), p < 0.01, respectively). However, those with IMIDs had a significantly higher risk of COVID-19-related hospitalization (31.1% and 18.6%, p < 0.01, respectively) and mortality (9.8% and 4.3%, p < 0.01, respectively), which were associated with patients older than 65 years, and presence of comorbidities. Furthermore, systemic steroids were independently associated with a severe course of COVID-19 (Odds ratio (OR) = 3.56 (95%CI 1.83–7.10), p < 0.01), while biologic therapies were associated with a reduced risk hereof (OR = 0.47 (95%CI 0.22–0.95), p = 0.04). Patients suspending immunosuppressants due to COVID-19 had an increased risk of subsequent hospitalization (OR = 3.59 (95%CI 1.31–10.78), p = 0.02).
This study found a lower occurrence, but a more severe disease course, of COVID-19 among patients with IMIDs, which was associated with the use of systemic steroids for IMIDs and suspension of other immunosuppressants. This study emphasizes the importance of weighing risks before suspending immunosuppressants during COVID-19.
•We found a lower occurrence of COVID-19 among patients with IMIDs compared to the background population.•Patients with IMIDs experienced a more severe COVID-19 in terms of COVID-19 related hospitalization and mortality.•Severity of COVID-19 was associated with systemic steroids in treatment of IMIDs and suspension of other immunosuppressants.•Use of biologic therapies were associated with a milder disease course of COVID-19.</description><subject>Adult</subject><subject>Age Factors</subject><subject>Aged</subject><subject>Autoimmune diseases</subject><subject>COVID-19</subject><subject>COVID-19 - diagnosis</subject><subject>COVID-19 - epidemiology</subject><subject>COVID-19 Drug Treatment</subject><subject>COVID-19 Nucleic Acid Testing</subject><subject>Denmark - epidemiology</subject><subject>Epidemiology</subject><subject>Female</subject><subject>Humans</subject><subject>Immune-mediated inflammatory diseases</subject><subject>Immunosuppression Therapy</subject><subject>Immunosuppressive agents</subject><subject>Immunosuppressive Agents - administration & dosage</subject><subject>Inflammation - diagnosis</subject><subject>Inflammation - epidemiology</subject><subject>Inflammation - therapy</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Population-based</subject><subject>Risk Factors</subject><subject>SARS-CoV-2</subject><issn>0896-8411</issn><issn>1095-9157</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kc-KFDEQh4Mo7rj6Ah4kRw_2mKQ76W4QYRn_woIXPYeapNrJ0J20SXpgbnv26hv6JGaY3UUvngKpr36p1EfIc87WnHH1er_ew5LXggleLoTi9QOy4qyXVc9l-5CsWNerqms4vyBPUtozxrmU8jG5qGvZC9nIFfm5CTF4OLi4JGpdQkhIBeP9K-qmafFYTWgdZLTU-WGEaYIc4vEOTRS8PZMhLfMcMSV3QJp3GGF2pf775he9ou_Au7Sjc5iXEbILvtqWbktN2IWYacqLPT4ljwYYEz67PS_Jtw_vv24-VddfPn7eXF1XRgqeq63tQbaotgjK9o2SwFEJ1irWmbrrW9vIoWZMYtPboW27TuLQdi0YEIOtG1Ffkrfn3HnZls8Z9DnCqOfoJohHHcDpfyve7fT3cNAlpSxWloCXtwEx_FgwZT25ZHAcwWNYkhZNzxRTkrOCijNqYkgp4nD_DGf6JFHv9UmiPknUZ4ml6cXfA9633FkrwJszgGVNB4dRJ-PQm2IqosnaBve__D-UtrKl</recordid><startdate>20210301</startdate><enddate>20210301</enddate><creator>Attauabi, Mohamed</creator><creator>Seidelin, Jakob Benedict</creator><creator>Felding, Oluf Krautwald</creator><creator>Wewer, Mads Damsgaard</creator><creator>Vinther Arp, Laura Kirstine</creator><creator>Sarikaya, Melek Zahra</creator><creator>Egeberg, Alexander</creator><creator>Vladimirova, Nora</creator><creator>Bendtsen, Flemming</creator><creator>Burisch, Johan</creator><general>Elsevier Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20210301</creationdate><title>Coronavirus disease 2019, immune-mediated inflammatory diseases and immunosuppressive therapies – A Danish population-based cohort study</title><author>Attauabi, Mohamed ; Seidelin, Jakob Benedict ; Felding, Oluf Krautwald ; Wewer, Mads Damsgaard ; Vinther Arp, Laura Kirstine ; Sarikaya, Melek Zahra ; Egeberg, Alexander ; Vladimirova, Nora ; Bendtsen, Flemming ; Burisch, Johan</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c521t-bd9a57e6bea6d9465a1e6207608c3897d45f3005e49df77885ef787aca2fd3423</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Adult</topic><topic>Age Factors</topic><topic>Aged</topic><topic>Autoimmune diseases</topic><topic>COVID-19</topic><topic>COVID-19 - diagnosis</topic><topic>COVID-19 - epidemiology</topic><topic>COVID-19 Drug Treatment</topic><topic>COVID-19 Nucleic Acid Testing</topic><topic>Denmark - epidemiology</topic><topic>Epidemiology</topic><topic>Female</topic><topic>Humans</topic><topic>Immune-mediated inflammatory diseases</topic><topic>Immunosuppression Therapy</topic><topic>Immunosuppressive agents</topic><topic>Immunosuppressive Agents - administration & dosage</topic><topic>Inflammation - diagnosis</topic><topic>Inflammation - epidemiology</topic><topic>Inflammation - therapy</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Population-based</topic><topic>Risk Factors</topic><topic>SARS-CoV-2</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Attauabi, Mohamed</creatorcontrib><creatorcontrib>Seidelin, Jakob Benedict</creatorcontrib><creatorcontrib>Felding, Oluf Krautwald</creatorcontrib><creatorcontrib>Wewer, Mads Damsgaard</creatorcontrib><creatorcontrib>Vinther Arp, Laura Kirstine</creatorcontrib><creatorcontrib>Sarikaya, Melek Zahra</creatorcontrib><creatorcontrib>Egeberg, Alexander</creatorcontrib><creatorcontrib>Vladimirova, Nora</creatorcontrib><creatorcontrib>Bendtsen, Flemming</creatorcontrib><creatorcontrib>Burisch, Johan</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Journal of autoimmunity</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Attauabi, Mohamed</au><au>Seidelin, Jakob Benedict</au><au>Felding, Oluf Krautwald</au><au>Wewer, Mads Damsgaard</au><au>Vinther Arp, Laura Kirstine</au><au>Sarikaya, Melek Zahra</au><au>Egeberg, Alexander</au><au>Vladimirova, Nora</au><au>Bendtsen, Flemming</au><au>Burisch, Johan</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Coronavirus disease 2019, immune-mediated inflammatory diseases and immunosuppressive therapies – A Danish population-based cohort study</atitle><jtitle>Journal of autoimmunity</jtitle><addtitle>J Autoimmun</addtitle><date>2021-03-01</date><risdate>2021</risdate><volume>118</volume><spage>102613</spage><epage>102613</epage><pages>102613-102613</pages><artnum>102613</artnum><issn>0896-8411</issn><eissn>1095-9157</eissn><abstract>Limited data exist regarding the disease course of coronavirus disease 2019 (COVID-19) and its relationship with immunosuppressants among patients with immune-mediated inflammatory diseases (IMIDs). Therefore, this study aims to investigate the association between COVID-19, frequent rheumatological, dermatological, gastrointestinal, and neurological IMIDs and immunosuppressants.
We conducted a Danish population-based cohort study including all residents living within Capital Region of Denmark and Region Zealand from January 28th, 2020 until September 15th, 2020 with the only eligibility criterion being a test for SARS-CoV-2 via reverse transcription–polymerase chain-reaction. Main outcomes included development of COVID-19, COVID-19-related hospitalization and mortality.
COVID-19 was less common among patients with IMIDs than the background population (n = 328/20,513 (1.60%) and n = 10,792/583,788(1.85%), p < 0.01, respectively). However, those with IMIDs had a significantly higher risk of COVID-19-related hospitalization (31.1% and 18.6%, p < 0.01, respectively) and mortality (9.8% and 4.3%, p < 0.01, respectively), which were associated with patients older than 65 years, and presence of comorbidities. Furthermore, systemic steroids were independently associated with a severe course of COVID-19 (Odds ratio (OR) = 3.56 (95%CI 1.83–7.10), p < 0.01), while biologic therapies were associated with a reduced risk hereof (OR = 0.47 (95%CI 0.22–0.95), p = 0.04). Patients suspending immunosuppressants due to COVID-19 had an increased risk of subsequent hospitalization (OR = 3.59 (95%CI 1.31–10.78), p = 0.02).
This study found a lower occurrence, but a more severe disease course, of COVID-19 among patients with IMIDs, which was associated with the use of systemic steroids for IMIDs and suspension of other immunosuppressants. This study emphasizes the importance of weighing risks before suspending immunosuppressants during COVID-19.
•We found a lower occurrence of COVID-19 among patients with IMIDs compared to the background population.•Patients with IMIDs experienced a more severe COVID-19 in terms of COVID-19 related hospitalization and mortality.•Severity of COVID-19 was associated with systemic steroids in treatment of IMIDs and suspension of other immunosuppressants.•Use of biologic therapies were associated with a milder disease course of COVID-19.</abstract><cop>England</cop><pub>Elsevier Ltd</pub><pmid>33592545</pmid><doi>10.1016/j.jaut.2021.102613</doi><tpages>1</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Journal of autoimmunity, 2021-03, Vol.118, p.102613-102613, Article 102613 |
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| subjects | Adult Age Factors Aged Autoimmune diseases COVID-19 COVID-19 - diagnosis COVID-19 - epidemiology COVID-19 Drug Treatment COVID-19 Nucleic Acid Testing Denmark - epidemiology Epidemiology Female Humans Immune-mediated inflammatory diseases Immunosuppression Therapy Immunosuppressive agents Immunosuppressive Agents - administration & dosage Inflammation - diagnosis Inflammation - epidemiology Inflammation - therapy Male Middle Aged Population-based Risk Factors SARS-CoV-2 |
| title | Coronavirus disease 2019, immune-mediated inflammatory diseases and immunosuppressive therapies – A Danish population-based cohort study |
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