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Multicenter Study
. 2023 Mar 1;29(2):68-77.
doi: 10.1097/RHU.0000000000001903. Epub 2022 Nov 30.

Does the Use of Immunosuppressive Drugs Impact on SARS-CoV-2 Infection Outcome? Data From A National Cohort of Patients With Immune-Mediated Inflammatory Diseases (SAR-COVID Registry)

Carolina Ayelen Isnardi, Enrique R Soriano  1 , Cesar Graf  2 , María Celina de la Vega  2 , Bernardo A Pons-Estel  3 , Karen Roberts  4 , Rosana Quintana  4 , Gimena Gomez  4 , Jinoos Yazdany  5 , Verónica Saurit  6 , Roberto Miguel Báez  7 , Vanessa Viviana Castro Coello  8 , Cecilia Nora Pisoni  9 , Guillermo Berbotto, Florencia Vivero  10 , Marcos David Zelaya  11 , María J Haye Salinas  12 , Álvaro A Reyes Torres  1 , Sofía Ornella  13 , Romina Estefanía Nieto, Federico Nicolás Maldonado  8 , María Julieta Gamba  14 , María de Los Ángeles Severina  15 , Yohana Tissera  16 , Paula Alba, Adriana Karina Cogo, Gelsomina Alle  1 , Carla Gobbi  17 , Andrea Baños, Edson Velozo  18 , Mariana Pera  19 , Romina Tanten  1 , Juan Alejandro Albiero, Hernán Maldonado Ficco, María Victoria Martire  20 , María Soledad Gálvez Elkin  21 , Micaela Cosatti  9 , María Alejandra Cusa  22 , Dora Pereira  23 , Verónica G Savio, Guillermo J Pons-Estel  4
Affiliations
Multicenter Study

Does the Use of Immunosuppressive Drugs Impact on SARS-CoV-2 Infection Outcome? Data From A National Cohort of Patients With Immune-Mediated Inflammatory Diseases (SAR-COVID Registry)

Carolina Ayelen Isnardi et al. J Clin Rheumatol. .

Abstract

Background/objective: This study describes the impact of immunomodulatory and/or immunosuppressive (IM/IS) drugs in the outcomes of COVID-19 infection in a cohort of patients with immune-mediated inflammatory diseases (IMIDs).

Methods: Adult patients with IMIDs with a confirmed SARS-CoV-2 infection were included. Data were reported by the treating physician between August 13, 2020 and July 31, 2021. Sociodemographic data, comorbidities, and DMARDs, as well as clinical characteristics, complications, and treatment of the SARS-CoV-2 infection, were recorded. Descriptive analysis and multivariable logistic regression models were carried out.

Results: A total of 1672 patients with IMIDs were included, of whom 1402 were treated with IM/IS drugs. The most frequent diseases were rheumatoid arthritis (47.7%) and systemic lupus erythematosus (18.4%). COVID-19 symptoms were present in 95.2% of the patients. A total of 461 (27.6%) patients were hospitalized, 8.2% were admitted to the intensive care unit, and 4.4% died due to COVID-19.Patients without IM/IS treatment used glucocorticoids less frequently but at higher doses, had higher levels of disease activity, were significantly older, were more frequently hospitalized, admitted to the intensive care unit, and died due to COVID-19. After adjusting for these factors, treatment with IM/IS drugs was not associated with a worse COVID-19 outcome (World Health Organization-Ordinal Scale ≥5) (odds ratio, 1.24; 95% confidence interval, 0.73-2.06).

Conclusions: SAR-COVID is the first multicenter Argentine registry collecting data from patients with rheumatic diseases and SARS-CoV-2 infection. After adjusting for relevant covariates, treatment with IM/IS drugs was not associated with severe COVID-19 in patients with IMIDs.

Study registration: This study has been registered in ClinicalTrials.gov under the number NCT04568421.

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Conflict of interest statement

Conflicts of interest: The authors declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: SAR-COVID is a multisponsor registry, where Pfizer, Abbvie, and Elea Phoenix had provided unrestricted grants. None of them has participated or influenced the development of the project, data collection, analysis, and interpretation, or the drafting of this report. They do not have access to the information collected in the database.

Figures

FIGURE 1
FIGURE 1
SAR-COVID study design. A, Patients with IMIDs; B, Patients with no IMIDs.
FIGURE 2
FIGURE 2
Oxygen requirements during hospitalization in patients with SARS-CoV-2 infection and IMIDs. Difference between groups, p = 0.143. NIMV, noninvasive mechanical ventilation; IMV, invasive mechanical ventilation.
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