Higher COVID-19 death rates linked to certain immune conditions

Since then, many of the people treated with the drugs analyzed in this study have been specifically targeted for a third primary dose of the vaccine, followed by a booster, and are on the list of those offered. antiviral treatments.

The study was carried out by a team from the London School of Hygiene & Tropical Medicine (LSHTM) using the OpenSAFELY platform along with colleagues from the St John’s Institute of Dermatology at Guy’s and St Thomas’ NHS Foundation Trust, University University of Oxford, King’s College London, the University of Exeter and the University of Edinburgh.


After accounting for age, sex, deprivation and smoking status, the study found that people with immune-mediated inflammatory diseases (IMIDs) that affect the intestines, joints and skin were at an increased risk of death. COVID-19-related deaths increased by 23% and 23% respectively. increased risk of COVID-related hospitalization compared with those without an IMID before vaccines and antiviral treatments were available.

People with arthritis appear to be at greatest risk compared with people with intestinal or skin diseases. Compared with the general population, the risk of death was estimated by the researchers to be about 8 additional deaths per 1,000 people with joint disease in a year.

Study author Professor Sinad Langan, Wellcome Senior Clinical Fellow and Professor of Clinical Epidemiology at LSHTM, said: “During the height of the pandemic in the UK in 2020, many people suffer from Inflammatory diseases that affect the intestines, joints and skin are advised to stay at home and cover up because doctors do not know how COVID-19 will affect them, or the impact of medications such as therapeutics. What will immunomodulation used to treat IMID look like?

“Our study provides the most accurate assessment of the risk of severe COVID-19 before vaccination in people with IMID and with the drugs used to treat them. We hope to analyze This analysis will help inform evidence-based policy as we continue to live with COVID-19.”

The team also investigated the effects of several medications, identifying about 200,000 people who were taking drugs that modulate the immune system.

The study found no increased risk of death or hospitalization from COVID-19 overall for patients receiving most targeted immunomodulatory drugs (commonly known as biologics) compared with with standard systemic drugs (that act on the broader immune system) used to treat this group of conditions.

For example, there was no increase in severe COVID-19 cases (death, hospitalization, or death, or hospitalization) in people using most of the targeted immunomodulatory therapies examined. including TNF blockers such as adalimumab versus more commonly used standard immunosuppressants such as methotrexate.

Professor Catherine Smith, consultant dermatologist at St John’s Institute of Dermatology at Guy’s and St Thomas’ NHS Foundation Trust, said: “We know that certain factors, such as age, increase a person’s risk of severe COVID-19 infection.

But so far we don’t know if the risk of severe COVID-19 is increased with ongoing health conditions related to problems with the immune system such as arthritis, Crohn’s disease, and psoriasis. or not.

Our research provides important information that will help guide policymakers in securing prevention strategies such as vaccination and early intervention treatments.

“Overall, our findings regarding drugs that modulate the immune system are reassuring. It’s important that people continue to take their medications as prescribed and discuss treatment decisions. with their doctor and get vaccinated as recommended.”

The OpenSAFELY Platform accesses an unprecedented scale of data accessed through the Trusted Research Environment to protect an individual’s privacy.

It provides a complete dataset of all raw, single event-level clinical events for all individuals at 40% of all GP practices in the UK, including all All tests, treatments, diagnostics, and demographic and clinical information are linked to various hospital data sources including, for the first time, a comprehensive drug data set by provided by hospitals.

This study was made possible through OpenSAFELY links to a new data source with information on “high cost” drugs. Because of the way these specialty drugs are prescribed, such as through programs through home care companies, this means they are often not on the GP record.

The study marks the first time that researchers have been able to analyze this class of drugs in this way and highlights why access to these data is so important to the study.

Co-author Dr Nick Kennedy, Consultant Gastroenterologist and Clinical Senior Lecturer at the University of Exeter, said: “Our study is an example of high-quality, collaborative research that has demonstrated took place during the pandemic using OpenSafely’s innovative research platform.

For patients with inflammatory bowel disease, the overall message is reassuring, although there is some increased risk of hospitalization in people with COVID-19.

“Our study also shows that the targeted drugs we commonly use to treat Crohn’s and colitis are not associated with an increased risk of poor outcomes.”

Source: Medindia

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