COVID-19 and patients with immune-mediated inflammatory diseases undergoing pharmacological treatments: a rapid living systematic review

Autor: Aline Pereira da Rocha, Álvaro Nagib Atallah, Ana Carolina Pereira Nunes Pinto, César Ramos Rocha-Filho, Keilla Martins Milby, Vinicius Tassoni Civile, Nelson Carvas Junior, Felipe Sebastião de Assis Reis, Laura Jantsch Ferla, Gabriel Sodré Ramalho, Giulia Fernandes Moça Trevisani, Maria Eduarda dos Santos Puga, Virgínia Fernandes Moça Trevisani
Jazyk: angličtina
Rok vydání: 2020
Předmět:
Zdroj: São Paulo Medical Journal, Vol 138, Iss 6, Pp 515-520 (2020)
Druh dokumentu: article
ISSN: 1806-9460
1516-3180
DOI: 10.1590/1516-3180.2020.0421.r2.10092020
Popis: 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 AND SETTING: 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.
Databáze: Directory of Open Access Journals
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