COVID-19 and patients with immune-mediated inflammatory diseases undergoing pharmacological treatments: a rapid living systematic review.
Sao Paulo Med J
; 138(6): 515-520, 2020.
Article
in English
| MEDLINE | ID: covidwho-1127826
ABSTRACT
BACKGROUND:
Patients with immune-mediated inflammatory diseases (IMID) are at increased risk of infection.OBJECTIVE:
To assess whether patients undergoing pharmacological treatment for IMID present higher risk of worse outcomes when diagnosed with COVID-19. DESIGN ANDSETTING:
Rapid systematic review conducted in the medical school of the Federal University of São Paulo (SP), Brazil.METHODS:
We searched CENTRAL, MEDLINE, EMBASE, LILACS, SCOPUS, Web of Science, L·OVE, ClinicalTrials.gov and WHO-ICTRP for studies evaluating patients diagnosed with COVID-19 who were undergoing pharmacological treatment for IMID. Two authors selected studies, extracted data and assessed risk of bias and certainty of evidence, following the Cochrane recommendations.RESULTS:
We identified 1,498 references, from which one cohort study was included. This compared patients with and without rheumatic diseases (RD) who all had been diagnosed with COVID-19. Those with RD seemed to have higher chances of hospitalization and mortality, but no statistical difference was detected between the groups hospitalization odds ratio (OR) 1.17; 95% confidence interval (CI) 0.6 to 2.29; mortality rate OR 1.53; 95% CI 0.33 to 7.11 (very low certainty of evidence). Patients with RD were three times more likely to require admission to intensive care units (ICUs), with invasive mechanical ventilation (IMV), than those without RD OR 3.72; 95% CI 1.35 to 10.26 (for both outcomes; very low certainty of evidence).CONCLUSION:
Patients undergoing pharmacological treatment for IMID seem to present higher chances of requiring admission to ICUs, with IMV. Additional high-quality studies are needed to analyze the effects of different treatments for IMID.
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Arthritis, Rheumatoid
/
COVID-19
Type of study:
Cohort study
/
Experimental Studies
/
Observational study
/
Prognostic study
/
Randomized controlled trials
/
Reviews
/
Systematic review/Meta Analysis
Limits:
Humans
Country/Region as subject:
South America
/
Brazil
Language:
English
Journal:
Sao Paulo Med J
Journal subject:
Medicine
Year:
2020
Document Type:
Article
Affiliation country:
1516-3180.2020.0421.r2.10092020
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