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. 2021 Jul 28;15(7):e0009635.
doi: 10.1371/journal.pntd.0009635. eCollection 2021 Jul.

The influence of leprosy-related clinical and epidemiological variables in the occurrence and severity of COVID-19: A prospective real-world cohort study

Selma Regina Penha Silva Cerqueira  1   2 , Patrícia Duarte Deps  3 , Débora Vilela Cunha  2 , Natanael Victor Furtunato Bezerra  1 , Daniel Holanda Barroso  1   2 , Ana Bárbara Sapienza Pinheiro  4 , Gecilmara Salviato Pillegi  5 , Taynah Alves Rocha Repsold  3 , Patrícia Shu Kurizky  1   2 , Simon M Collin  3 , Ciro Martins Gomes  1   2   4
Affiliations

The influence of leprosy-related clinical and epidemiological variables in the occurrence and severity of COVID-19: A prospective real-world cohort study

Selma Regina Penha Silva Cerqueira et al. PLoS Negl Trop Dis. .

Abstract

Background: Protective effects of Bacillus Calmette-Guérin (BCG) vaccination and clofazimine and dapsone treatment against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection have been reported. Patients at risk for leprosy represent an interesting model for assessing the effects of these therapies on the occurrence and severity of coronavirus disease 2019 (COVID-19). We assessed the influence of leprosy-related variables in the occurrence and severity of COVID-19.

Methodology/principal findings: We performed a 14-month prospective real-world cohort study in which the main risk factor was 2 previous vaccinations with BCG and the main outcome was COVID-19 detection by reverse transcription polymerase chain reaction (RT-PCR). A Cox proportional hazards model was used. Among the 406 included patients, 113 were diagnosed with leprosy. During follow-up, 69 (16.99%) patients contracted COVID-19. Survival analysis showed that leprosy was associated with COVID-19 (p<0.001), but multivariate analysis showed that only COVID-19-positive household contacts (hazard ratio (HR) = 8.04; 95% CI = 4.93-13.11) and diabetes mellitus (HR = 2.06; 95% CI = 1.04-4.06) were significant risk factors for COVID-19.

Conclusions/significance: Leprosy patients are vulnerable to COVID-19 because they have more frequent contact with SARS-CoV-2-infected patients, possibly due to social and economic limitations. Our model showed that the use of corticosteroids, thalidomide, pentoxifylline, clofazimine, or dapsone or BCG vaccination did not affect the occurrence or severity of COVID-19.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Study flow chart.
HHC = household contact.
Fig 2
Fig 2. Survival curves adjusted for active leprosy and COVID-19 positive household contact representing possible risk factors for the occurrence of COVID-19.
N = no, Y = yes, HHC = household contacts.
Fig 3
Fig 3. Hazard ratios and 95% confidence intervals calculated by the Cox proportional hazards model.
See this image and copyright information in PMC

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