背景:自身免疫性起泡障碍(AIBDs)很少见,可能危及生命的疾病通常需要免疫抑制。在SARS-CoV-2大流行期间,AIBDs患者的感染风险和死亡率未知.
目的:我们报告了AIBDs患者SARS-CoV-2感染的结果,并确定使用利妥昔单抗的患者是否增加了SARS-CoV-2感染的风险。
方法:我们检查了在美国医院发生SARS-CoV-2感染的10例AIBDs患者的临床结果。我们对参加临床试验的132例AIBDs患者进行了回顾性分析。
结果:患有严重SARS-CoV-2(n=4)或死亡(n=2)的患者有年龄增长的趋势。这些患者的死亡率高于全国平均水平(20%vs1.6%)。我们的队列包括52例有利妥昔单抗治疗史的患者,其中35人在大流行期间被利妥昔单抗免疫抑制,45名患者从未接受过利妥昔单抗治疗。我们发现,在使用利妥昔单抗免疫抑制的AIBDs患者和未使用利妥昔单抗的患者中,SARS-CoV-2阳性率没有差异(9.1%vs12.1%)。
结论:SARS-CoV-2的检测是按需进行的,而不是监测。整体传输随时间变化,结果取决于接受的治疗。我们队列的样本量小限制了我们结果的普遍性。
结论:本研究提示利妥昔单抗不会增加AIBDs患者SARS-CoV-2检测阳性的风险。然而,由于我们的样本量相对较小,因此应谨慎解释这些结果.
BACKGROUND: Autoimmune blistering disorders (AIBDs) are rare, potentially life-threatening conditions often requiring immunosuppression. Throughout the SARS-CoV-2 pandemic, infection risk and mortality in patients with AIBDs are unknown.
OBJECTIVE: We report the outcomes of SARS-CoV-2 infections in patients with AIBDs and determined if patients on rituximab have an increased risk of SARS-CoV-2 infection.
METHODS: We examined clinical outcomes in 10 patients with AIBDs who developed SARS-CoV-2 infections at an American hospital. We performed a retrospective analysis of 132 patients with AIBDs enrolled in a clinical trial.
RESULTS: Patients with severe SARS-CoV-2 (n = 4) or death (n = 2) trended to be older. These patients had higher mortality than the national average (20% vs 1.6%). Our cohort included 52 patients with a history of rituximab treatment, 35 of whom were immunosuppressed by rituximab during the pandemic, and 45 patients never treated with rituximab. We found no difference between the rates of SARS-CoV-2 positivity in patients with AIBDs immunosuppressed by rituximab and those not on rituximab (9.1% vs 12.1%).
CONCLUSIONS: Testing for SARS-CoV-2 was performed on demand rather than surveillance. Overall transmission varied over time, and outcomes depended on accepted treatments. The small sample size of our cohort limits the generalizability of our results.
CONCLUSIONS: This study suggests that rituximab does not increase the risk of SARS-CoV-2 test positivity in patients with AIBDs. However, these results should be interpreted with caution due to our relatively small sample size.