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

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Authors: 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

Citation: EUROPEAN REVIEW FOR MEDICAL AND PHARMACOLOGICAL SCIENCES, Vol.26(10) : 3,760-3,770, 2022-05

MeSH: Antirheumatic Agents* / therapeutic use ; Autoimmune Diseases* ; COVID-19* / drug therapy ; Humans ; Incidence ; Rheumatic Diseases* / drug therapy ; Rheumatic Diseases* / epidemiology

Abstract: 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.