The protective effect of tumor necrosis factor-alpha inhibitors in COVID-19 in patients with inflammatory rheumatic diseases compared to the general population : a comparison of two German registries

Affiliation
Section of Rheumatology and Clinical Immunology, Department of Internal Medicine D, University Hospital Münster ,Münster ,Germany
Hasseli, Rebecca;
Affiliation
Emergency Department and Department for Infectious Diseases and Infection Control, University Hospital Regensburg ,Regensburg ,Germany
Hanses, Frank;
Affiliation
Department I of Internal Medicine, University of Cologne, Faculty of Medicine and University Hospital Cologne ,Cologne ,Germany
Stecher, Melanie;
Affiliation
Department of Rheumatology and Clinical Immunology, KEM Kliniken Essen-Mitte ,Essen ,Germany
Specker, Christof;
GND
1249820227
Affiliation
Biocontrol Jena ,Jena ,Germany
Weise, Tobias;
Affiliation
Department of Infectious Diseases and Infection Control, Ingolstadt Hospital ,Ingolstadt ,Germany
Borgmann, Stefan;
Affiliation
Klinikum Passau ,Passau ,Germany
Hasselberger, Martina;
Affiliation
Klinikum Bremen-Mitte ,Bremen ,Germany
Hertenstein, Bernd;
Affiliation
Department of Pneumology, Infectious Diseases, Internal Medicine and Intensive Care, Klinikum Dortmund GmbH ,Dortmund ,Germany
Hower, Martin;
Affiliation
Department for Rheumatology and Clinical Immunology, University of Schleswig-Holstein ,Kiel ,Germany
Hoyer, Bimba F.;
Affiliation
Department I of Internal Medicine, University of Cologne, Faculty of Medicine and University Hospital Cologne ,Cologne ,Germany
Koll, Carolin;
Affiliation
Department of Rheumatology, Clinical Immunology and Osteology, Immanuel Hospital Berlin ,Berlin ,Germany
Krause, Andreas;
GND
1283030233
Affiliation
Department of Hematology and Medical Oncology, University Hospital Jena ,Jena ,Germany
von Lilienfeld-Toal, Marie;
Affiliation
Department of Internal Medicine V, University of Heidelberg ,Heidelberg ,Germany
Lorenz, Hanns-Martin;
Affiliation
Department of Gastroenterology and Infectious Diseases, Heidelberg University Hospital ,Heidelberg ,Germany
Merle, Uta;
Affiliation
Department of Medicine II, University of Freiburg ,Freiburg ,Germany
Nunes de Miranda, Susana M.;
GND
123964334
Affiliation
Institute for Infectious Diseases and Infection Control, Jena University Hospital ,Jena ,Germany
Pletz, Mathias W.;
Affiliation
Epidemiology Unit, German Rheumatism Research Center Berlin ,Berlin ,Germany
Regierer, Anne C.;
Affiliation
Department of Rheumatology, University Hospital Düsseldorf, Medical Faculty of Heinrich-Heine-University ,Düsseldorf ,Germany
Richter, Jutta G.;
Affiliation
Division of Infectious Diseases, Department of Medicine II, University of Freiburg ,Freiburg ,Germany
Rieg, Siegbert;
Affiliation
Department of Gastroenterology, Faculty of Medicine, University of Augsburg ,Augsburg ,Germany
Roemmele, Christoph;
GND
1203565593
Affiliation
Department of Hematology and Medical Oncology, University Hospital Jena ,Jena ,Germany
Ruethrich, Maria M.;
Affiliation
Private Practice ,Cologne ,Germany
Schmeiser, Tim;
Affiliation
Division of Rheumatology and Clinical Immunology, Department of Internal Medicine IV, University of Munich ,Munich ,Germany
Schulze-Koops, Hendrik;
Affiliation
Epidemiology Unit, German Rheumatism Research Center Berlin ,Berlin ,Germany
Strangfeld, Anja;
Affiliation
Department of Internal Medicine, Infectious Diseases, University Hospital Frankfurt, Goethe University Frankfurt ,Frankfurt am Main ,Germany
Vehreschild, Maria J.G.T.;
Affiliation
Department of Internal Medicine II, School of Medicine, University Hospital Rechts Der Isar, Technical University of Munich ,Munich ,Germany
Voit, Florian;
Affiliation
Department of Rheumatology and Clinical Immunology, Faculty of Medicine, Medical Center-University of Freiburg, University of Freiburg ,Freiburg ,Germany
Voll, Reinhard E.;
Affiliation
Department I of Internal Medicine, University of Cologne, Faculty of Medicine and University Hospital Cologne ,Cologne ,Germany
Vehreschild, Jörg Janne;
Affiliation
Department of Rheumatology and Clinical Immunology, Justus-Liebig University Giessen ,Giessen ,Germany
Müller-Ladner, Ulf;
GND
132401290
Affiliation
Department of Internal Medicine III, University Hospital Jena ,Jena ,Germany
Pfeil, Alexander

Objectives To investigate, whether inflammatory rheumatic diseases (IRD) inpatients are at higher risk to develop a severe course of SARS-CoV-2 infections compared to the general population, data from the German COVID-19 registry for IRD patients and data from the Lean European Survey on SARS-CoV-2 (LEOSS) infected patients covering inpatients from the general population with SARS-CoV-2 infections were compared. Methods 4310 (LEOSS registry) and 1139 cases (IRD registry) were collected in general. Data were matched for age and gender. From both registries, 732 matched inpatients (LEOSS registry: n = 366 and IRD registry: n = 366) were included for analyses in total. Results Regarding the COVID-19 associated lethality, no significant difference between both registries was observed. Age > 65°years, chronic obstructive pulmonary disease, diabetes mellitus, rheumatoid arthritis, spondyloarthritis and the use of rituximab were associated with more severe courses of COVID-19. Female gender and the use of tumor necrosis factor-alpha inhibitors (TNF-I) were associated with a better outcome of COVID-19. Conclusion Inflammatory rheumatic diseases (IRD) patients have the same risk factors for severe COVID-19 regarding comorbidities compared to the general population without any immune-mediated disease or immunomodulation. The use of rituximab was associated with an increased risk for severe COVID-19. On the other hand, the use of TNF-I was associated with less severe COVID-19 compared to the general population, which might indicate a protective effect of TNF-I against severe COVID-19 disease.

Cite

Citation style:
Could not load citation form.

Rights

License Holder: Copyright © 2024 Hasseli, Hanses, Stecher, Specker, Weise, Borgmann, Hasselberger, Hertenstein, Hower, Hoyer, Koll, Krause, von Lilienfeld-Toal, Lorenz, Merle, Nunes de Miranda, Pletz, Regierer, Richter, Rieg, Roemmele, Ruethrich, Schmeiser, Schulze-Koops, Strangfeld, Vehreschild, Voit, Voll, Vehreschild, Müller-Ladner and Pfeil.

Use and reproduction: