• Dhiren Mahiban

Study finds certain immunosuppressing treatments do not increase risk for Covid-19

According to dermatologists at the Henry Ford Health System in Detroit, patients on immunosuppressive therapies for common skin and rheumatic diseases such as psoriasis and rheumatoid arthritis are not at an increased risk for contracting Covid-19 and should continue taking their medicine as prescribed.

Dr. Jesse Veenstra, a dermatologist at Henry Ford Health System and lead author of the study ‘Antecedent immunosuppressive therapy for immune-mediated inflammatory diseases in the setting of a Covid-19 outbreak’ said patients on immunosuppressive therapies are not at any greater risk for Covid-19 than the general population, despite their weakened immune system.

“If [a patient] requires an immune suppressant medication for [their] condition to be well controlled, [they] should not be afraid to continue that medication during the pandemic,” Dr. Veenstra said in a Sept. 14, 2020 press release.

The study, published online ahead of print the Journal of the American Academy of Dermatology (Jul 28, 2020), is one of the first to investigate the association between immunosuppressive medications for skin diseases and the risk of Covid-19 infection and outcomes.

Previously, little was known about managing patients on these medications in the pandemic and whether they may be at an increased risk for Covid-19 infection or related complications as a result of their weakened immune system.

The researchers conducted a retrospective analysis of 213 patients who had been prescribed immunosuppressive medication for an immune-mediated inflammatory disease. The patients were tested for Covid-19 between Feb. 1 and Apr. 18, 2020 and had been receiving immunosuppressive medication for at least one month prior to being tested for Covid-19.

The study’s investigators found that of the 213 patients, 36% tested positive for Covid-19 and did not have increased odds of being hospitalized or placed on a ventilator when compared to the general population. Further, they found no evidence that any particular immunosuppressive therapy increased a patient’s odds of testing positive for Covid-19 or developing serious disease.

Additionally, researchers discovered race was a predictor for Covid-19 status with African-Americans having greater odds of testing positive. Also, patients prescribed a TNF alpha inhibitor had significantly lower odds for hospitalization.

Dr. Veenstra said patients who were on multi-drug therapy regimens were at greater odds of being hospitalized than those taking a single medication. He adds more research is needed to fully explain the finding, but that it may suggest multiple medications further suppress a patient's immune system, rendering them more susceptible to Covid-19.

Patients who are immunosuppressed are predisposed to upper respiratory infections such as the common cold, which may cause coughing, a runny nose and a sore throat, said Dr. Veenstra. However, this patient population has not been reported to be at higher risk for COVID-19.

Older adults and people with underlying medical conditions such as cancer, COPD (chronic obstructive pulmonary disease) and diabetes are considered high risk for contracting the coronavirus, Dr. Veenstra added.

“Physicians who prescribe these medications should feel comfortable either continuing or resuming their patients on these medications,” said Dr. Veenstra. “They can counsel their patients that there is data to support the safety profile of these medications during the COVID-19 pandemic.”

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