Hospitalization for COVID-19 in patients treated with selected immunosuppressant and immunomodulating agents, compared to the general population : A Danish cohort study

© 2020 British Pharmacological Society..

AIMS: In the Danish population, we examined whether patients treated with thiopurines, methotrexate, systemic corticosteroids, anti-tumour necrosis factor (TNF)-α agents, anti-interleukin therapeutic agents, selective immunosuppressive agents and cyclosporine/tacrolimus had an increased risk of hospitalization for COVID- 19, compared to the background population.

METHODS: A nationwide cohort study including all people alive in Denmark on 1 March 2020. Exposed patients constituted those exposed to thiopurines (n = 5484), methotrexate (n = 17 977), systemic corticosteroids (n = 55 868), anti-TNF-α agents (n = 17 857), anti-interleukin therapeutic agents (n = 3744), selective immunosuppressive agents (n = 3026) and cyclosporine/tacrolimus (n = 1143) in a period of 12 months prior to 1 March 2020 (estimated time of outbreak in Denmark). We estimated the adjusted risk of hospitalization for COVID-19 for patients treated with the above-mentioned categories of medications, compared to the rest of the population.

RESULTS: The adjusted odds ratios of hospitalization in patients treated with corticosteroids and cyclosporine/tacrolimus were 1.64 (95% confidence interval [CI] 1.35 to 2.00) and 4.75 (95% CI 1.96 to 11.49), respectively. The risks of hospitalization in patients treated with thiopurines, methotrexate, and anti-TNF-α agents, were 1.93 (95% CI 0.91 to 4.08), 0.74 (95% CI 0.43 to 1.28), 1.00 (95% CI 0.52 to 1.94), respectively. The number of outcomes in patients treated with anti-interleukin therapeutic agents and selective immunosuppressive agents was too small for analysis.

CONCLUSION: Patients treated with systemic corticosteroids and cyclosporine/tacrolimus had a significantly increased risk of being hospitalized for COVID-19. Our study does not uncover whether the increased risk is related to the drug itself, the underlying condition for which the patient is treated or other factors.

Media Type:

Electronic Article

Year of Publication:

2021

Contained In:

British journal of clinical pharmacology - Vol. 87, No. 4 (2021), p. 2111-2120

Language:

English

Contributors:

Nørgård, Bente Mertz
Nielsen, Jan
Knudsen, Torben
Nielsen, Rasmus Gaardskaer
Larsen, Michael Due
Jølving, Line Riis
Kjeldsen, Jens

Links:

Volltext

Keywords:

*Hospitalization
*Immunocompromised Host
Adolescent
Adult
Aged
Aged, 80 and over
Biologics
COVID-19
Case-Control Studies
Clinical epidemiology
Denmark
Female
Hospitalization
Humans
Immunologic Factors
Immunosuppressive
Immunosuppressive Agents
Journal Article
Male
Middle Aged
Pharmacoepidemiology
Registries
Research Support, Non-U.S. Gov't
Risk Assessment
Risk Factors
Thiopurines
Time Factors
Young Adult

Notes:

Date Completed 31.03.2021

Date Revised 31.03.2021

published: Print-Electronic

Citation Status MEDLINE

Copyright: From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

Physical Description:

Online-Ressource

doi:

10.1111/bcp.14622

PMID:

33098713

PPN (Catalogue-ID):

NLM317653326