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Arthritis

15 September 2020

Covid-19 ills no greater for those with lupus, rheumatoid arthritis

Lupus patients on steroids can rest assured that they are at no greater risk of having to be admitted to hospital from Covid-19 than other lupus or arthritis patients.

  • People with inflammatory forms of arthritis aren't more likely to be hospitalised as a result of Covid-19 
  • Many with autoimmune diseases, however, take immunosuppressant drugs 
  • A new study has found, though, that immunosuppressant therapy doesn't increase one's risk of being hospitalised due to Covid-19


People with lupus aren't at increased risk of hospitalisation from Covid-19 due to steroidal medications they take to reduce immune system activity, a new study finds.

And a related study found that people with inflammatory forms of arthritis – such as rheumatoid arthritis – aren't more likely to be hospitalised with Covid-19 than people without arthritis.

Both studies were led by researchers at NYU Grossman School of Medicine, in New York City.

Autoimmune diseases

The findings "should reassure most patients, especially those on immunosuppressant therapy, that they are at no greater risk of having to be admitted to hospital from Covid-19 than other lupus or arthritis patients," Dr Ruth Fernandez-Ruiz, co-author of the studies, said in an NYU Langone news release.

"People with lupus or inflammatory arthritis have the same risk factors for getting seriously ill from Covid-19 as people without these disorders," said Fernandez-Ruiz, a postdoctoral fellow in rheumatology.

Lupus and conditions like rheumatoid arthritis, psoriatic arthritis and spondyloarthritis are autoimmune diseases in which the immune system mistakenly attacks a person's own tissues. This causes inflammation in the joints, skin, kidneys and other parts of the body.

The researchers found that lupus patients taking immune-suppressing medications – such as mycophenolate mofetil (CellCept) and azathioprine (Imuran) – had no greater risk of hospitalisation (15 out of 24) than lupus patients not using the medications (nine of 17).

Dangers of glucocorticoids

In addition, the Covid-19 hospitalisation rate for people with inflammatory arthritis (26%) was similar to that of New York City residents overall (25%).

Another finding was that patients taking biologic drugs for arthritis, such as adalimumab (Humira) and etanercept (Enbrel), or the antiviral hydroxychloroquine, had no greater or lower risk of Covid-19 hospitalisation than those not taking the drugs.

But patients who took steroids called glucocorticoids, even in mild doses, had a 10 times higher risk of Covid-19 hospitalisation than those who didn't take steroids. Although the finding is statistically significant, the study's small size may overestimate the actual risk, the researchers noted.

The studies were recently published online in the journal Arthritis and Rheumatology.

Image credit: Getty

 

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Arthritis expert

Professor Asgar Ali Kalla completed his MBChB (Bachelor of Medicine and Bachelor of Surgery) degree in 1975 at the University of Cape Town and his FRCP in 2003 in London. Professor Ali Kalla is the Isaac Albow Chair of Rheumatology at the University of Cape Town and also the Head of Division of Rheumatology at Groote Schuur Hospital. He has participated in a number of clinical trials for rheumatology and is active in community outreach. Prof Ali Kalla is an expert in Arthritis for Health24.

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