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MeSH Disease

Human Phenotype

Transmission

Seroprevalence

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    Association between autoimmune diseases MESHD and COVID-19 as assessed in both a test-negative case-control and population case-control design

    Authors: Rossella Murtas; Anita Andreano; Federico Gervasi; Davide Guido; David Consolazio; Sara Tunesi; Laura Andreoni; Maria Teresa Greco; Maria Elena Gattoni; Monica Sandrini; Antonio Riussi; Antonio Giampiero Russo

    doi:10.21203/rs.3.rs-58948/v1 Date: 2020-08-13 Source: ResearchSquare

    Background: COVID-19 epidemic has paralleled with the so called infodemic, where countless pieces of information have been disseminated on putative risk factors for COVID-19. Among those, emerged the notion that people suffering from autoimmune diseases MESHD ( AIDs MESHD) have a higher risk of SARS-CoV-2 infection MESHD. Methods: The cohort included all COVID-19 cases residents in the Agency for Health Protection (AHP) of Milan that, from the beginning of the outbreak, developed a web-based platform that traced TRANS positive and negative cases as well as related contacts. AIDs MESHD subjects were defined ad having one the following autoimmune disease MESHD: rheumatoid arthritis HP rheumatoid arthritis MESHD, systemic lupus erythematosus HP systemic lupus erythematosus MESHD, systemic sclerosis MESHD, Sjogren disease, ankylosing spondylitis MESHD, myasthenia gravis MESHD, Hashimoto's disease MESHD, acquired autoimmune hemolytic anemia HP autoimmune hemolytic anemia MESHD, and psoriatic arthritis MESHD arthritis HP. To investigate whether AID subjects are at increased risk of SARS-CoV-2 infection MESHD, and whether they have worse prognosis than AIDs MESHD-free subjects once infected, we performed a combined analysis of a test-negative design case-control study, a case-control with test-positive as cases, and one with test-negative as cases (CC-NEG). Results: During the outbreak, the Milan AHP endured, up to April 27th 2020, 20,364 test-positive and 34,697 test-negative subjects. We found no association between AIDs MESHD and being positive to COVID-19, but a statistically significant association between AIDs MESHD and being negative to COVID-19 in the CC-NEG. If, as likely, test-negative subjects underwent testing because of respiratory infection MESHD symptoms, these results imply that autoimmune diseases MESHD may be a risk factor for respiratory infections MESHD in general (including COVID-19), but they are not a specific risk factor for COVID-19. Furthermore, when infected by SARS-CoV-2, AIDs MESHD subjects did not have a worse prognosis compared to non- AIDs MESHD subjects. Results highlighted a potential unbalance in the testing campaign, which may be correlated to the characteristics of the tested person, leading specific frail population to be particularly tested.Conclusions: Lack of availability of sound scientific knowledge inevitably lead unreliable news to spread over the population, preventing people to disentangle them form reliable information. Even if additional studies are needed to replicate and strengthen our results, these findings represent initial evidence to derive recommendations based on actual data for subjects with autoimmune diseases MESHD.

    Does Biological Therapy Protect against Severe COVID-19?

    Authors: Ramon Mazzucchelli; Raquel Almodovar-Gonzalez; Natalia Crespi-Villarias; Elena Garcia-Zamora; Elia Perez-Fernandez; Javier Quiros-Donate; Monserrat Perez-Encinas; Patricia Sanmartin-Fenollera; Maria Velasco-Arribas; Pilar Lopez-Serrano; Jose lazaro Perez-Calle; Conrado Fernandez-Rodriguez; Jose Luis Lopez-Estebaranz; Pedro Zarco-Montejo

    doi:10.1101/2020.06.21.20136788 Date: 2020-06-24 Source: medRxiv

    Objective. To estimate COVID-19 infection MESHD incidence rate with severe affectation MESHD (requiring hospitalization) in patients with biological treatment due to rheumatoid arthritis HP rheumatoid arthritis MESHD ( RA MESHD), psoriatic arthritis MESHD arthritis HP ( PsA MESHD), spondyloarthritis MESHD ( SpA MESHD), psoriasis MESHD ( Ps MESHD), and inflammatory bowel disease MESHD ( IBD MESHD) and compare it with incidence rate in the general population. Methods: Retrospective observational study based on information provided by two administrative databases. One of these two databases contains information on all patients seen in our hospital and diagnosed with COVID-19 infection between March 4th 2020 and April 26th 2020. The other database contains data from patients seen at Rheumatology, Dermatology and Digestive Departments in our hospital who are currently receiving biological therapy. We calculated the crude and age TRANS and sex adjusted incidence in both groups. To compare both groups we calculated the Incidence Rate Ratio. Results: There was a total of 2,182 patients with COVID-19 requiring hospitalization. Four patients out of a total of 797 patients receiving biological therapy had contracted COVID-19 and required hospital care. Crude incidence rate of COVID-19 requiring hospital care among the general population was 1.41%, and it was 0.50% among the group receiving biological therapy. Rates adjusted by age TRANS and sex in the biological group was 0.45% (CI95% 0.11-4.13). The IRR of the group receiving biological therapy compared to the general population was 0.39 (CI95% 0.14-1, p=0.049). Conclusion: Findings suggest that prior use of biological therapy does not associate with severe manifestations of COVID-19, and it is likely to have a protective effect against them when compared to the general population.

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MeSH Disease
Human Phenotype
Transmission
Seroprevalence


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