#MSCOVID-19. Learning from other autoimmune conditions


This post is about arthritis. What relevance has it to MS. Well it is another condition with disease modifying treatments (DMT) only they call them DMARDS (Disease-modifying anti-rheumatic drugs) . Some of the drugs are similar to MS drugs, and some seem to cause MS like lesions…which perhaps gives us insight into what is the problem with MS.

Objective:Patients living with systemic autoimmune rheumatic diseases (SARDs) continue to be concerned about risks of severe COVID‐19 outcomes.

Methods: Using a large multi‐center electronic health record network, we conducted a comparative cohort study of patients with SARDs diagnosed with COVID‐19 (identified by diagnostic code or positive molecular test) versus non‐SARD comparators with COVID‐19, matched by age, sex, race/ethnicity, and body mass index (primary model) and comorbidities and health care utilization (extended model). Thirty‐day outcomes were assessed, including hospitalization, intensive care unit (ICU) admission, mechanical ventilation…..and death.

Results: We initially identified 2,379 SARD patients with COVID‐19 (mean age 58 years, 79% female) and 142,750 comparators (mean age 47 years, 54% female). In the primary matched model (2,379 SARD patients and 2,379 matched non‐SARD comparators with COVID‐19), SARD patients had significantly higher risks of hospitalization (RR 1.14, 95% CI: 1.03 to 1.26), ICU admission (RR 1.32, 95% CI: 1.03 to 1.68), but did not have significantly higher risks of mechanical ventilation or death.

Conclusions: SARD patients with COVID‐19 may be at higher risk of hospitalization, ICU admission,….versus matched comparators. These risks may be largely mediated by comorbidities.

Thrombotic effects were an issue for people with COVID-19 and is not surprising given that blood clots are caused by the SARS-CoV-2 virus. Within the SARDs cohort, there were significantly higher risks of the composite outcome among patients on glucocorticoids compared with non-users (relative risk, 1.74; 95% CI, 1.28- 2.38), while conventional synthetic DMARDs and biologic/targeted synthetic DMARDs were not associated with higher risks of outcome.

So risks of treatment were not associated with a worse outcome

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