Article ; Online: Association Between Chronic Use of Immunosuppresive Drugs and Clinical Outcomes From Coronavirus Disease 2019 (COVID-19) Hospitalization: A Retrospective Cohort Study in a Large US Health System.
Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
2021 Volume 73, Issue 11, Page(s) e4124–e4130
Abstract: ... better clinical outcomes among adults hospitalized with COVID-19 in one US health system. ... and 29 August 2020 with confirmed or suspected COVID-19 in a large academic health system ... the severity of coronavirus disease 2019 (COVID-19), with plausible mechanisms for both.: Methods ...
| Abstract | Background: It is unclear whether chronic use of immunosuppressive drugs worsens or improves the severity of coronavirus disease 2019 (COVID-19), with plausible mechanisms for both. Methods: Retrospective cohort study in 2121 consecutive adults with acute inpatient hospital admission between 4 March and 29 August 2020 with confirmed or suspected COVID-19 in a large academic health system, with adjustment for confounding with propensity score-derived stabilized inverse probability of treatment weights. Chronic immunosuppression was defined as prescriptions for immunosuppressive drugs current at the time of admission. Outcomes included mechanical ventilation, in-hospital mortality, and length of stay. Results: There were 2121 patients admitted with laboratory-confirmed (1967, 93%) or suspected (154, 7%) COVID-19 during the study period, with a median age of 55 years (interquartile range, 40-67). Of these, 108 (5%) were classified as immunosuppressed before COVID-19, primarily with prednisone (>7.5 mg/day), tacrolimus, or mycophenolate mofetil. Among the entire cohort, 311 (15%) received mechanical ventilation; the median (interquartile range) length of stay was 5.2 (2.5-10.6) days, and 1927 (91%) survived to discharge. After adjustment, there were no significant differences in the risk of mechanical ventilation (hazard ratio [HR], .79; 95% confidence interval [CI], .46-1.35), in-hospital mortality (HR, .66; 95% CI, .28-1.55), or length of stay (HR, 1.16; 95% CI, .92-1.47) among individuals with immunosuppression and counterparts. Conclusions: Chronic use of immunosuppressive drugs was neither associated with worse nor better clinical outcomes among adults hospitalized with COVID-19 in one US health system. |
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| MeSH term(s) | Adult ; COVID-19 ; Cohort Studies ; Hospital Mortality ; Hospitalization ; Humans ; Middle Aged ; Pharmaceutical Preparations ; Respiration, Artificial ; Retrospective Studies ; SARS-CoV-2 | ||||||||||
| Chemical Substances | Pharmaceutical Preparations | ||||||||||
| Language | English | ||||||||||
| Publishing date | 2021-01-06 | ||||||||||
| Publishing country | United States | ||||||||||
| Document type | Journal Article ; Research Support, N.I.H., Extramural | ||||||||||
| ZDB-ID | 1099781-7 | ||||||||||
| ISSN | 1537-6591 ; 1058-4838 | ||||||||||
| ISSN (online) | 1537-6591 | ||||||||||
| ISSN | 1058-4838 | ||||||||||
| DOI | 10.1093/cid/ciaa1488 | ||||||||||
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| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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