COVID-19 Infection in Rheumatologic Patients on Treatment with Targeted Therapies

Background/Purpose: SARS COV 2 pandemic has been an issue which has challenged the health care systems around the world Rheumatology has been involved in two ways: in the one hand, due to the use, in its treatment, of specific agents usually indicated in rheumatologic conditions and, on the other hand, the fear that our patients could be at higher risk due to the use of immunosuppressive agents The main objective of our study was to analyze the incidence of COVID infection in rheumatologic patients on treatment with targeted therapies (TT) (b and stDMARD) and to compare the incidence of such infection in the general population Methods: All patients with rheumatologic inflammatory conditions and COVID infection (confirmed by PCR of nasopharyngeal swab or serology) followed at three university referral centers from Basque Country (Spain) were identifi ed Patients on treatment with TT were selected Characteristics of rheumatologic condition, type of TT and outcome of the infection were registered Infection rates with the different TT were calculated and compared with the general population Results: Among 97 rheumatologic patients with COVID-19 infection 19 (12 with TNFi, 2 with anti-IL6 and 1 with abatacept, rituximab, ustekinumab, anakinra and baricitinib) were on treatment with TT at the COVID-19 infection diagnosis Although, no significant differences were observed with those not taking TT with regards to severe disease outcome (hospital admission or death), the admission rate was 31 8% (greater than that commonly reported in general population ≈ 20%) and the mortality rate 13 8%, higher than that observed in our region (7 8%) In comparison with the general population of our region, the total infection rate for patients on TT was 4% vs 0 9% Specifically, in those taking TNFi the infection rate was of 3 5% and in those taking anti-IL6 of 3 1% Conclusion: Rheumatologic patients taking TT present higher rates of COVID infection than those seem in the general population (under the same criteria for infection definition) The admission rates observed in these patients suggest also a more severe course of the infection