METHODS: Patients with autoimmune rheumatic disease taking DMARDs with or without long-term (> 6 months) HCQ treatment prior to the COVID-19 outbreak were selected consecutively. The diagnosis of COVID-19 was made based on the history of symptoms suggestive of the disease and/or serum IgG positivity. During statistical analysis, the risk of COVID-19 infection was calculated in rheumatic patients taking DMARDs versus controls, as well as in patients taking HCQ versus those who are not. The ORs and 95% CIs were also calculated. The participants in the control group were selected from individuals without RD.
RESULTS: A total of 800 patients with RD and 449 controls were analyzed. COVID-19 infection was detected in 16.8% of rheumatic patients versus 17.6% of controls (OR 0.95; 95% CI 0.7-1.28). The proportions of COVID-19 infection in HCQ users versus non-users were 15.3% and 18.1%, respectively (OR 0.87; 95% CI 0.61-1.26). These results remained unchanged after adjusting for all covariates using logistic regression analysis.
CONCLUSIONS: These findings indicate that rheumatic patients taking DMARDs are not at a higher risk of COVID-19 infection, and that HCQ therapy has no influence on the risk of COVID-19 infection. Key points • The risk of COVID-19 infection is not higher in patients with RD on DMARD therapy. • The prevalence of COVID-19 infection in HCQ users has not significant difference relative to non-users. • Significant percent of RD patients taking DMARDs had asymptomatic infection. • There was a positive association between leflunamide therapy and the risk of COVID-19 infection.
方法:连续选择在COVID-19爆发前接受或未接受长期(>6个月)HCQ治疗的自身免疫性风湿病患者。COVID-19的诊断是根据提示疾病的症状史和/或血清IgG阳性做出的。在统计分析过程中,计算了服用DMARDs的风湿病患者与对照组的COVID-19感染风险,以及服用HCQ的患者与不服用HCQ的患者。还计算了OR和95%CI。对照组的参与者从没有RD的个体中选择。
结果:共分析了800例RD患者和449例对照。在风湿性疾病患者中检测到16.8%的COVID-19感染,对照组为17.6%(OR0.95;95%CI0.7-1.28)。HCQ使用者与非使用者的COVID-19感染比例分别为15.3%和18.1%,分别为(OR0.87;95%CI0.61-1.26)。在使用逻辑回归分析调整所有协变量后,这些结果保持不变。
结论:这些结果表明,服用DMARDs的风湿病患者感染COVID-19的风险并不高,HCQ治疗对COVID-19感染的风险没有影响。要点•接受DMARD治疗的RD患者感染COVID-19的风险并不高。•HCQ使用者中COVID-19感染的患病率与非使用者相比没有显着差异。•服用DMARDs的RD患者中有显著百分比无症状感染。•来氟尼胺治疗与COVID-19感染风险呈正相关。