From the Department of Rheumatology, Umraniye Training and Research Hospital, Umraniye, Istanbul, Turkey.
From the Department of Internal Medicine, Umraniye Training and Research Hospital, Umraniye, Istanbul, Turkey.
Ann Saudi Med. 2022 May-Jun;42(3):155-164. doi: 10.5144/0256-4947.2022.155. Epub 2022 Jun 2.
Anti-cytokine treatments are used in the treatment of severe COVID-19. Other studies have shown statistical significance with TNF inhibitors but not with other biological/targeted synthetic disease-modifying anti-rheumatic drugs (b/tsDMARD).
Compare the rate of severe acute respiratory syndrome coronavirus-2 (SARS-COV-2) infection and the course and incidence of COVID-19 infection in patients who received b/tsDMARD with control patients.
Analytical cross-sectional SETTINGS: Tertiary care hospital PATIENTS AND METHODS: All patients who applied to the rheumatology outpatient clinic between June 2020-March 2021 and received b/tsDMARD were included in the study. All patients with rheumatoid arthritis, psoriatic arthritis and spondyloarthritis who applied to the rheumatology outpatient clinic in the three months before March 2021 and did not receive b/tsDMARD were included as the control group. History of COVID-19 infection and treatments were recorded. Multivariate analysis was performed to assess factors associated with use of tumor necrosis factor (TNF) inhibitors and differences between specific biologic drugs.
Rate of COVID-19 disease among patients using biological/targeted synthetic therapy and non-biological/targeted synthetic therapy. COVID-19 clinical outcomes (hospitalization, intensive care admission, mechanical ventilation and death).
533 in total; 341 received b/tsDMARD, 212 in the control group that did not receive b/tsDMARD.
One hundred patients (18%) had been infected with SARS-COV-2. The difference in SARS-COV-2 infection between b/tsDMARD and the control was statistically significant (13, 2% vs. 25, 9%, respectively) (<.001). The hospital stays were longer in the controls (<.001). Multinomial regression analysis revealed that COVID-19 negative patients were more likely to use tumor necrosis factor (TNF) inhibitors (OR: 2, 911; 95% CI: 1.727-4.908; <.001) compared to COVID-19 positive participants. Multinomial logistic regression analysis indicated that hospitalized patients were more likely to use TNF inhibitors (OR: 11, 006; 95% CI: 3.447-35.138; <.001) and there was no significant difference between b/tsDMARDs other than TNF inhibitors in frequency of hospitalization.
Patients who were medicated with b/tsDMARD were less likely to be infected with COVID-19 and be hospitalized due to the infection. We have found that this effect was particularly dependent on the use of TNF inhibitors.
Conducted in a single center and unable to provide a homogeneous study population.
None.
抗细胞因子治疗用于治疗严重的 COVID-19。其他研究表明 TNF 抑制剂具有统计学意义，但其他生物/靶向合成的疾病修正抗风湿药物（b/tsDMARD）则不然。
比较接受 b/tsDMARD 治疗和对照组患者的严重急性呼吸综合征冠状病毒 2（SARS-COV-2）感染率以及 COVID-19 感染的病程和发生率。
分析性横断面研究
三级保健医院
纳入 2020 年 6 月至 2021 年 3 月间在风湿病门诊就诊并接受 b/tsDMARD 治疗的所有患者。纳入 2021 年 3 月前三个月内在风湿病门诊就诊且未接受 b/tsDMARD 治疗的所有类风湿关节炎、银屑病关节炎和脊柱关节炎患者作为对照组。记录 COVID-19 感染史和治疗情况。采用多变量分析评估与使用肿瘤坏死因子（TNF）抑制剂相关的因素以及特定生物药物之间的差异。
使用生物/靶向合成治疗和非生物/靶向合成治疗的患者 COVID-19 疾病发生率。COVID-19 临床结局（住院、重症监护病房入院、机械通气和死亡）。
总共 533 例；341 例接受 b/tsDMARD，212 例未接受 b/tsDMARD 的对照组。
100 例患者（18%）感染 SARS-COV-2。b/tsDMARD 和对照组之间 SARS-COV-2 感染的差异具有统计学意义（分别为 13.2%和 25.9%，<.001）。对照组的住院时间更长（<.001）。多项回归分析显示，COVID-19 阴性患者更有可能使用肿瘤坏死因子（TNF）抑制剂（比值比：2.001；95%置信区间：1.727-4.908；<.001）。多项逻辑回归分析表明，住院患者更有可能使用 TNF 抑制剂（比值比：11.006；95%置信区间：3.447-35.138；<.001），而 TNF 抑制剂以外的 b/tsDMARD 之间住院频率无显著差异。
接受 b/tsDMARD 治疗的患者感染 COVID-19 的可能性较低，且因感染而住院的可能性也较低。我们发现这种效果特别依赖于 TNF 抑制剂的使用。
在单中心进行，无法提供同质的研究人群。
无。
