PDF(Pubmed)
Abstract：
OBJECTIVE: Patients with rheumatic disease taking long-term disease-modifying anti-rheumatic drugs (DMARDs) are expected to have a higher risk of infection due to the alterations in cellular immunity associated with these medications. However, the potential risks associated with these drugs remain unclear. This study aimed to estimate the risk of COVID-19 infection in patients with rheumatic disease taking disease-modifying anti-rheumatic drugs.
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.
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.
摘要：
目的：由于与这些药物相关的细胞免疫改变，长期服用改善病情的抗风湿药（DMARDs）的风湿性疾病患者预计有更高的感染风险。然而,与这些药物相关的潜在风险尚不清楚.这项研究旨在评估服用改善疾病的抗风湿药物的风湿病患者感染COVID-19的风险。
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。
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。
