Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Comment
. 2020 Nov-Dec;138(6):515-520.
doi: 10.1590/1516-3180.2020.0421.R2.10092020.

COVID-19 and patients with immune-mediated inflammatory diseases undergoing pharmacological treatments: a rapid living systematic review

Aline Pereira da Rocha  1 , Álvaro Nagib Atallah  2 , Ana Carolina Pereira Nunes Pinto  3 , César Ramos Rocha-Filho  4 , Keilla Martins Milby  5 , Vinicius Tassoni Civile  6 , Nelson Carvas Junior  7 , Felipe Sebastião de Assis Reis  8 , Laura Jantsch Ferla  9 , Gabriel Sodré Ramalho  9 , Giulia Fernandes Moça Trevisani  10 , Maria Eduarda Dos Santos Puga  11 , Virgínia Fernandes Moça Trevisani  12
Affiliations
Comment

COVID-19 and patients with immune-mediated inflammatory diseases undergoing pharmacological treatments: a rapid living systematic review

Aline Pereira da Rocha et al. Sao Paulo Med J. 2020 Nov-Dec.

Abstract

Background: Patients with immune-mediated inflammatory diseases (IMID) are at increased risk of infection.

Objective: To assess whether patients undergoing pharmacological treatment for IMID present higher risk of worse outcomes when diagnosed with COVID-19.

Design and setting: Rapid systematic review conducted in the medical school of the Federal University of São Paulo (SP), Brazil.

Methods: We searched CENTRAL, MEDLINE, EMBASE, LILACS, SCOPUS, Web of Science, L·OVE, ClinicalTrials.gov and WHO-ICTRP for studies evaluating patients diagnosed with COVID-19 who were undergoing pharmacological treatment for IMID. Two authors selected studies, extracted data and assessed risk of bias and certainty of evidence, following the Cochrane recommendations.

Results: We identified 1,498 references, from which one cohort study was included. This compared patients with and without rheumatic diseases (RD) who all had been diagnosed with COVID-19. Those with RD seemed to have higher chances of hospitalization and mortality, but no statistical difference was detected between the groups: hospitalization: odds ratio (OR) 1.17; 95% confidence interval (CI) 0.6 to 2.29; mortality rate: OR 1.53; 95% CI 0.33 to 7.11 (very low certainty of evidence). Patients with RD were three times more likely to require admission to intensive care units (ICUs), with invasive mechanical ventilation (IMV), than those without RD: OR 3.72; 95% CI 1.35 to 10.26 (for both outcomes; very low certainty of evidence).

Conclusion: Patients undergoing pharmacological treatment for IMID seem to present higher chances of requiring admission to ICUs, with IMV. Additional high-quality studies are needed to analyze the effects of different treatments for IMID.

PubMed Disclaimer

Conflict of interest statement

Conflict of interest: None

Figures

Figure 1
Figure 1. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) flow diagram.
Figure 2
Figure 2. Risk of bias in the study included.
See this image and copyright information in PMC

Comment on

References

    1. Venerito V, Lopalco G, Iannone F. COVID-19, rheumatic diseases and immunosuppressive drugs: an appeal for medication adherence. Rheumatol Int. 2020;40(5):827–828. doi: 10.1007/s00296-020-04566-9. - DOI - PMC - PubMed
    1. D'Antiga L. Coronaviruses and Immunosuppressed Patients: The Facts During the Third Epidemic. Liver Transpl. 2020;26(6):832–834. doi: 10.1002/lt.25756. - DOI - PubMed
    1. Favalli EG, Ingegnoli F, De Lucia O, et al. COVID-19 infection and rheumatoid arthritis: Faraway, so close! Autoimmun Rev. 2020;19(5):102523–102523. doi: 10.1016/j.autrev.2020.102523. - DOI - PMC - PubMed
    1. Askanase AD, Khalili L, Buyon JP. Thoughts on COVID-19 and autoimmune diseases. Lupus Sci Med. 2020;7(1):e000396. doi: 10.1136/lupus-2020-000396. - DOI - PMC - PubMed
    1. Falagas ME, Manta KG, Betsi GI, Pappas G. Infection-related morbidity and mortality in patients with connective tissue diseases: a systematic review. Clin Rheumatol. 2007;26(5):663–670. doi: 10.1007/s10067-006-0441-9. - DOI - PubMed