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

  • 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. FemaleObjectives: 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.show moreshow less

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Author:Rebecca Hasseli, Frank Hanses, Melanie Stecher, Christof Specker, Tobias Weise, Stefan Borgmann, Martina Hasselberger, Bernd Hertenstein, Martin Hower, Bimba F. Hoyer, Carolin Koll, Andreas Krause, Marie von Lilienfeld-Toal, Hanns-Martin Lorenz, Uta Merle, Susana M. Nunes de Miranda, Mathias W. Pletz, Anne C. Regierer, Jutta G. Richter, Siegbert Rieg, Christoph Roemmele, Maria M. Ruethrich, Tim Schmeiser, Hendrik Schulze-Koops, Anja Strangfeld, Maria J. G. T. Vehreschild, Florian Voit, Reinhard E. Voll, Jörg Janne Vehreschild, Ulf Müller-Ladner, Alexander Pfeil
URN:urn:nbn:de:bvb:384-opus4-1125301
Frontdoor URLhttps://opus.bibliothek.uni-augsburg.de/opus4/112530
ISSN:2296-858XOPAC
Parent Title (English):Frontiers in Medicine
Publisher:Frontiers Media SA
Type:Article
Language:English
Year of first Publication:2024
Publishing Institution:Universität Augsburg
Release Date:2024/04/16
Tag:General Medicine
Volume:11
First Page:1332716
DOI:https://doi.org/10.3389/fmed.2024.1332716
Institutes:Medizinische Fakultät
Medizinische Fakultät / Universitätsklinikum
Medizinische Fakultät / Lehrstuhl für Innere Medizin mit Schwerpunkt Gastroenterologie
Dewey Decimal Classification:6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit
Licence (German):CC-BY 4.0: Creative Commons: Namensnennung (mit Print on Demand)