Background

Data on the impact of biologics and immunomodulators on coronavirus disease 2019 (COVID-19)–related outcomes remain scarce.

Objective

We sought to determine whether patients taking tumor necrosis factor inhibitors (TNFis) or methotrexate are at increased risk of COVID-19–related outcomes.

Methods

In this large comparative cohort study, real-time searches and analyses were performed on adult patients who were diagnosed with COVID-19 and were treated with TNFis or methotrexate compared with those who were not treated. The likelihood of hospitalization and mortality were compared between groups with and without propensity score matching for confounding factors.

Results

More than 53 million (53,511,836) unique patient records were analyzed, of which 32,076 (0.06%) had a COVID-19–related diagnosis documented starting after January 20, 2020. Two hundred fourteen patients with COVID-19 were identified with recent TNFi or methotrexate exposure compared with 31,862 patients with COVID-19 without TNFi or methotrexate exposure. After propensity matching, the likelihood of hospitalization and mortality were not significantly different between the treatment and nontreatment groups (risk ratio = 0.91 [95% confidence interval, 0.68-1.22], P = .5260 and risk ratio = 0.87 [95% confidence interval, 0.42-1.78], P = .6958, respectively).

Limitations

All TNFis may not behave similarly.

Conclusion

Our study suggests that patients with recent TNFi or methotrexate exposure do not have increased hospitalization or mortality compared with patients with COVID-19 without recent TNFi or methotrexate exposure.

中文翻译：

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CoVid-19 在服用肿瘤坏死因子抑制剂和/或甲氨蝶呤的患者中的临床结果：一项多中心研究网络研究。

背景

关于生物制剂和免疫调节剂对 2019 年冠状病毒病 (COVID-19) 相关结果的影响的数据仍然很少。

客观的

我们试图确定服用肿瘤坏死因子抑制剂 (TNFis) 或甲氨蝶呤的患者出现 COVID-19 相关结局的风险是否增加。

方法

在这项大型比较队列研究中，对诊断为 COVID-19 并接受 TNFis 或甲氨蝶呤治疗的成年患者与未接受治疗的患者进行了实时搜索和分析。在有和没有混杂因素的倾向得分匹配的情况下，比较两组的住院和死亡率的可能性。

结果

分析了超过 5300 万 (53,511,836) 份独特的患者记录，其中 32,076 份 (0.06%) 记录了 2020 年 1 月 20 日之后开始的 COVID-19 相关诊断。214 名 COVID-19 患者被确定为最近患有 TNFi 或与未暴露 TNFi 或甲氨蝶呤的 31,862 名 COVID-19 患者相比，暴露了甲氨蝶呤。倾向匹配后，住院和死亡率的可能性在治疗组和非治疗组之间没有显着差异（风险比 = 0.91 [95% 置信区间，0.68-1.22]，P = .5260 和风险比 = 0.87 [95%置信 区间, 0.42-1.78], P  = .6958)。

限制

并非所有 TNFis 的行为都相似。

结论

我们的研究表明，与近期未暴露于 TNFi 或甲氨蝶呤的 COVID-19 患者相比，近期暴露于 TNFi 或甲氨蝶呤的患者住院率或死亡率并未增加。