Related Experiment Video
Updated: Nov 17, 2025
Author Spotlight: Advancing Immune Monitoring in Critical Care Patients Using Whole Blood Assays
Published on: September 20, 2024
Coronavirus disease 2019, immune-mediated inflammatory diseases and immunosuppressive therapies - A Danish
Mohamed Attauabi1, Jakob Benedict Seidelin2, Oluf Krautwald Felding3
1Gastrounit, Medical Section, Hvidovre University Hospital, Hvidovre, Denmark; Copenhagen Center for Inflammatory Bowel Disease in Children, Adolescents and Adults, University of Copenhagen, Hvidovre Hospital, Denmark; Department of Gastroenterology and Hepatology, Herlev Hospital, University of Copenhagen, Denmark.
Insights
Patients with immune-mediated inflammatory diseases (IMIDs) had fewer COVID-19 cases but more severe outcomes. Systemic steroids worsened COVID-19 severity, while biologics reduced risk. Suspending immunosuppressants increased hospitalization risk.
Area of Science:
- Immunology
- Epidemiology
- Infectious Diseases
Background:
- Limited data exist on COVID-19 outcomes in patients with immune-mediated inflammatory diseases (IMIDs).
- Understanding the impact of immunosuppressants on COVID-19 course in IMID patients is crucial.
Purpose of the Study:
- To investigate the association between COVID-19 and immunosuppressants in patients with rheumatological, dermatological, gastrointestinal, and neurological IMIDs.
- To determine the impact of different immunosuppressant therapies on COVID-19 severity and outcomes.
Main Methods:
- A Danish population-based cohort study was conducted from January 28th, 2020, to September 15th, 2020.
- Included residents tested for SARS-CoV-2 via RT-PCR, analyzing COVID-19 development, hospitalization, and mortality.
- Compared outcomes between IMID patients and the general population.
Main Results:
- COVID-19 was less common in IMID patients (1.60%) versus the general population (1.85%).
- IMID patients faced higher risks of COVID-19 hospitalization (31.1%) and mortality (9.8%), particularly those over 65 or with comorbidities.
- Systemic steroids correlated with severe COVID-19 (OR=3.56), while biologic therapies showed a reduced risk (OR=0.47). Suspending immunosuppressants increased hospitalization risk (OR=3.59).
Conclusions:
- IMID patients experience lower COVID-19 incidence but more severe disease.
- Systemic steroid use and immunosuppressant suspension are linked to worse COVID-19 outcomes.
- Careful consideration of immunosuppressant management is vital during the COVID-19 pandemic for IMID patients.
Background:
Limited data exist regarding the disease course of coronavirus disease 2019 (COVID-19) and its relationship with immunosuppressants among patients with immune-mediated inflammatory diseases (IMIDs). Therefore, this study aims to investigate the association between COVID-19, frequent rheumatological, dermatological, gastrointestinal, and neurological IMIDs and immunosuppressants.
Methods:
We conducted a Danish population-based cohort study including all residents living within Capital Region of Denmark and Region Zealand from January 28th, 2020 until September 15th, 2020 with the only eligibility criterion being a test for SARS-CoV-2 via reverse transcription-polymerase chain-reaction. Main outcomes included development of COVID-19, COVID-19-related hospitalization and mortality.
Results:
COVID-19 was less common among patients with IMIDs than the background population (n = 328/20,513 (1.60%) and n = 10,792/583,788(1.85%), p < 0.01, respectively). However, those with IMIDs had a significantly higher risk of COVID-19-related hospitalization (31.1% and 18.6%, p < 0.01, respectively) and mortality (9.8% and 4.3%, p < 0.01, respectively), which were associated with patients older than 65 years, and presence of comorbidities. Furthermore, systemic steroids were independently associated with a severe course of COVID-19 (Odds ratio (OR) = 3.56 (95%CI 1.83-7.10), p < 0.01), while biologic therapies were associated with a reduced risk hereof (OR = 0.47 (95%CI 0.22-0.95), p = 0.04). Patients suspending immunosuppressants due to COVID-19 had an increased risk of subsequent hospitalization (OR = 3.59 (95%CI 1.31-10.78), p = 0.02).
Conclusion:
This study found a lower occurrence, but a more severe disease course, of COVID-19 among patients with IMIDs, which was associated with the use of systemic steroids for IMIDs and suspension of other immunosuppressants. This study emphasizes the importance of weighing risks before suspending immunosuppressants during COVID-19.
More Related Videos
05:31Noninvasive Sampling of Mucosal Lining Fluid for the Quantification of In Vivo Upper Airway Immune-mediator Levels
Published on: August 7, 2017
07:36Contact-Free Co-Culture Model for the Study of Innate Immune Cell Activation During Respiratory Virus Infection
Published on: February 28, 2021
Related Concept Videos
01:29Drugs for Treatment of Crohn's Disease in IBD Using Immunomodulatory Agents
01:25Immunodeficiency Diseases
There are three main causes of immunodeficiency...
01:29Autoimmune Disorders
Concept and Mechanism of Autoimmune Diseases
The immune...
01:22Rheumatic Heart Disease II: Clinical Manifestations and Diagnostic Studies
01:27Psychoneuroimmunology: Cardiovascular Disease
A key area of focus in PNI is the relationship between stress and coronary...
01:29Immune Response Against Viral Pathogens
NK Cells
NK cells are a crucial part of our innate immune system, acting as the first line of defense against viral infections. These cells can recognize and kill infected cells without prior exposure to the virus, effectively slowing down the spread of infection. Additionally, NK cells produce proinflammatory...