Incidence and outcome of covid-19 in AIRD patients on concomitant treatment with tofacitinib-results from KRA covid cohort (KRACC) subset

ABSTRACT

Background: We assessed the risk factors and outcome of COVID-19 in patients with autoimmune rheumatic diseases (AIRD) who contracted infection while on background treatment with tofacitinib. Method(s) This is a non-interventional, cross-sectional, questionnaire based telephonic study which included consecutive AIRD patients on tofacitinib co-treatment. Data related to the AIRD subset, disease modifying anti rheumatic drugs (DMARDs) including glucocorticoids and comorbidities, was collected from 7 rheumatology centers across Karnataka during the second wave of COVID-19 pandemic. The information about COVID-19 occurrence and COVID-19 vaccination was recorded. Result(s) During the study period (June-July 2021), 335 AIRD patients (80.6% female) on treatment with tofacitinib were included. The mean duration of tofacitinib use was 3.4 +/- 3.1 months. Thirty-six (10.75%) patients developed COVID-19. Diabetes mellitus P = 0.04 (OR 2.60 [1.13-5.99]) was identified as a risk factors for COVID-19 in our cohort. Almost half of our cohort was COVID-19 vaccinated with at least one dose, with resultant decline in incidence of COVID-19 (OR 0.15 [0.06-0.39]) among the vaccinated. Recovery among COVID-19 infection group was 91.2%. Conclusion(s) The AIRD patients on co-treatment with tofacitinib had a higher incidence of COVID-19 than the general population during the same time period. Diabetes mellitus was identified as an independent risk factor in our cohort. COVID-19 vaccinated patients contracted COVID-19 at a significantly lesser rate than the non-vaccinated patients.