Infectious Disease

COVID-19 tests 20% higher in patients with immune-mediated inflammatory diseases

September 27, 2021

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Eder reports that he is the Canadian Head of Research at Equity in Care of Rheumatic Diseases. Please refer to the study for all relevant financial information from the other authors.

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Patients with immune-mediated inflammatory diseases are tested for COVID-19 at a 20% higher rate than the general population, according to data published in Arthritis Care & Research.

Despite this higher test rate, the risk of SARS-CoV-2 infection was not significantly higher in most patients with IMIDs compared to their non-IMID counterparts.

Patients with immune-mediated inflammatory diseases are, according to Eder L et al. tested for COVID-19 at a 20% higher rate than patients without immune-mediated inflammatory diseases. Arthritis Care Res. 2021; doi: 10.1002 / acr.24781.

“Despite several studies on the risk of COVID-19 infection and its complications with IMIDs, the evidence from population-based studies is limited.” Lihi Eder, MD, PhD, of the University of Toronto Women’s College Research Institute and colleagues. “Observational studies have been reported that rely on self-reported infection status, hospital admissions, and targeted testing in selected populations, but are prone to selection bias. Reported COVID-19 infection rates are functions of sociodemographic factors and comorbidities that affect people’s propensity to undergo a SARS-CoV-2 test.

“Previous studies that have limited their analysis to hospital patients, people tested for active infection, or people who have volunteered to participate are most prone to collider bias because of the relationships between all variables that relate to the outcome, are biased compared to the general population. “They added. “Since it is difficult to identify all of these potential confounders in order to mitigate this collider bias, accurate estimates of COVID-19 risk in IMIDs are best made from studies with unselected population-based data and a careful adjustment of the factors that make up the SARSCov -2 test, won. “

Lihi Eder

To examine the incidence and related factors of COVID-19 testing and infection in patients with IMIDs versus patients without IMIDs, Eder and colleagues conducted a population-based, concerted cohort study of adults 20 years and older through Ontario, Canada, January 2020 to December 2020. In total, the study included 493,499 patients with rheumatoid arthritis, psoriasis, psoriatic arthritis, ankylosing spondylitis, systemic autoimmune rheumatic diseases, multiple sclerosis, iritis, inflammatory bowel disease, polymyalgia rheumatica and vasculitis46, as well as 2,466,999 from the general population.

Researchers obtained data on the Ontario Health Insurance Plan, a public, single-paying health system that covers hospital admissions, medical benefits, and COVID-19 testing for all Ontario residents. Each enrolled patient with an IMID was compared to five people without IMIDs based on sociodemographic factors. The researchers then estimated the frequency of COVID-19 tests and infections in the two groups. They also used multivariable logistic regressions to determine the likelihood of SARS-CoV-2 infection.

According to the researchers, patients with IMIDs were 27.4% more likely to have had at least one COVID-19 test than patients without IMIDs, versus 22.7%. However, the proportion of people who tested positive for COVID-19 was 0.9% in both groups. Overall, patients with IMIDs showed a 20% higher chance of being tested for COVID-19 (OR = 1.2; 95% CI, 1.19-1.21).

In the meantime, the likelihood of SARS-CoV-2 infection varied between the IMIDs groups. However, they were not significantly increased in most patients compared to the general population. For example, the likelihood of SARS-CoV-2 infection was lower in patients with IBD and multiple sclerosis and slightly higher in patients with RA and iritis.

“Despite the fact that patients with IMIDs were tested for SARS-COV2 more often than the reference populations, their risk of infection was similar to that of controls,” Eder told Healio Rheumatology. “It should be emphasized that this study did not assess the risk of hospitalization for COVID-19, which our group and others rated as higher in patients with IMIDs.”

“We also found that risk factors for infection are similar to those of the general population and include urban living, lower socio-economic factors, multimorbidity and living in long-term care,” added Eder. “Overall, the study provides insights into the epidemiology of COVID-19 in patients with IMIDs before vaccination was introduced.”

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COVID-19 and rheumatology

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