Programa de Pós-Graduação em Ciências Médicas, Faculdade de Medicina, Universidade de Brasília, Brasília, Brazil.
Hospital Universitário de Brasília, Universidade de Brasília, Brasília, Brazil.
PLoS Negl Trop Dis. 2021 Jul 28;15(7):e0009635. doi: 10.1371/journal.pntd.0009635. eCollection 2021 Jul.
Protective effects of Bacillus Calmette-Guérin (BCG) vaccination and clofazimine and dapsone treatment against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection have been reported. Patients at risk for leprosy represent an interesting model for assessing the effects of these therapies on the occurrence and severity of coronavirus disease 2019 (COVID-19). We assessed the influence of leprosy-related variables in the occurrence and severity of COVID-19.
METHODOLOGY/PRINCIPAL FINDINGS: We performed a 14-month prospective real-world cohort study in which the main risk factor was 2 previous vaccinations with BCG and the main outcome was COVID-19 detection by reverse transcription polymerase chain reaction (RT-PCR). A Cox proportional hazards model was used. Among the 406 included patients, 113 were diagnosed with leprosy. During follow-up, 69 (16.99%) patients contracted COVID-19. Survival analysis showed that leprosy was associated with COVID-19 (p<0.001), but multivariate analysis showed that only COVID-19-positive household contacts (hazard ratio (HR) = 8.04; 95% CI = 4.93-13.11) and diabetes mellitus (HR = 2.06; 95% CI = 1.04-4.06) were significant risk factors for COVID-19.
CONCLUSIONS/SIGNIFICANCE: Leprosy patients are vulnerable to COVID-19 because they have more frequent contact with SARS-CoV-2-infected patients, possibly due to social and economic limitations. Our model showed that the use of corticosteroids, thalidomide, pentoxifylline, clofazimine, or dapsone or BCG vaccination did not affect the occurrence or severity of COVID-19.
卡介苗（BCG）疫苗接种和氯法齐明与氨苯砜治疗对严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）感染的保护作用已有报道。麻风病患者是评估这些治疗方法对 2019 年冠状病毒病（COVID-19）发生和严重程度影响的一个有趣模型。我们评估了麻风病相关变量对 COVID-19 发生和严重程度的影响。
方法/主要发现：我们进行了一项为期 14 个月的前瞻性真实世界队列研究，主要风险因素是 2 次 BCG 疫苗接种，主要结局是通过逆转录聚合酶链反应（RT-PCR）检测 COVID-19。采用 Cox 比例风险模型。在纳入的 406 例患者中，有 113 例被诊断为麻风病。随访期间，69 例（16.99%）患者确诊 COVID-19。生存分析显示麻风病与 COVID-19 相关（p<0.001），但多变量分析显示，只有 COVID-19 阳性的家庭接触者（风险比（HR）=8.04；95%CI=4.93-13.11）和糖尿病（HR=2.06；95%CI=1.04-4.06）是 COVID-19 的显著危险因素。
结论/意义：麻风病患者易感染 COVID-19，因为他们与 SARS-CoV-2 感染患者接触更频繁，这可能是由于社会和经济方面的限制。我们的模型显示，使用皮质类固醇、沙利度胺、己酮可可碱、氯法齐明或氨苯砜或卡介苗接种并不影响 COVID-19 的发生或严重程度。
