COVID-19 susceptibility and clinical outcomes in autoimmune inflammatory rheumatic diseases (AIRDs): a systematic review and meta-analysis

J.I. Shin, S.E. Kim, M.H. Lee, M.S. Kim, S.W. Lee, S. Park, Y.H. Shin, J.W. Yang, J.M. Song, S.Y. Moon, S.Y. Kim, Y. Park, D.I. Suh, J.M. Yang, S.H. Cho, H.Y. Jin, S.H. Hong, H.-H. Won, A. Kronbichler, A. Koyanagi, L. Jacob, J. Hwang, K. Tizaoui, K.H. Lee, J.H. Kim, D.K. Yon, L. Smith

Department of Pediatrics, Yonsei University College of Medicine, Seoul, Republic of Korea. yonkkang@gmail.com

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• Immunology
• Infectious Diseases
• Rheumatology

OBJECTIVE: This meta-analysis aims to assess the susceptibility to and clinical outcomes of COVID-19 in autoimmune inflammatory rheumatic disease (AIRD) and following AIRD drug use.

MATERIALS AND METHODS: We included observational and case-controlled studies assessing susceptibility and clinical outcomes of COVID-19 in patients with AIRD as well as the clinical outcomes of COVID-19 with or without use of steroids and conventional synthetic disease-modifying antirheumatic drugs (csDMARDs).

RESULTS: Meta-analysis including three studies showed that patients with AIRD are not more susceptible to COVID-19 compared to patients without AIRD or the general population (OR: 1.11, 95% CI: 0.58 to 2.14). Incidence of severe outcomes of COVID-19 (OR: 1.34, 95% CI: 0.76 to 2.35) and COVID-19 related death (OR: 1.21, 95% CI: 0.68 to 2.16) also did not show significant difference. The clinical outcomes of COVID-19 among AIRD patients with and without csDMARD or steroid showed that both use of steroid (OR: 1.69, 95% CI: 0.96 to 2.98) or csDMARD (OR: 1.35, 95% CI: 0.63 to 3.08) had no effect on clinical outcomes of COVID-19.

CONCLUSIONS: AIRD does not increase susceptibility to COVID-19, not affecting the clinical outcome of COVID-19. Similarly, the use of steroids or csDMARDs for AIRD does not worsen the clinical outcome.

 

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