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Systematic review with meta-analysis: COVID-19 outcomes in patients receiving anti-TNF treatments

Georgios Kokkotis1, Konstantina Kitsou2, Ioannis Xynogalas3

  • 1GI Unit, 3rd Department of Internal Medicine, National and Kapodistrian University of Athens, Athens, Greece.

Alimentary Pharmacology & Therapeutics
|December 9, 2021
PubMed
Abstract

Insights

Tumour necrosis factor-alpha (TNF-α) inhibitors may reduce the risk of hospitalization and severe COVID-19 outcomes. This meta-analysis confirms a lower probability of hospitalization and severe disease in COVID-19 patients treated with anti-TNF agents.

Area of Science:

  • Immunology
  • Infectious Diseases
  • Rheumatology

Background:

  • Growing evidence suggests benefits of TNF-α inhibitors for COVID-19 outcomes, but findings are inconsistent.
  • This study systematically reviews and meta-analyzes existing data on anti-TNF treatments in COVID-19 patients.

Approach:

  • Conducted a systematic search of PubMed and Scopus databases for studies published by September 2021.
  • Included 84 studies in the review and 35 in the meta-analysis, assessing bias with the Newcastle Ottawa Scale.
  • Calculated pooled effect measures using a random-effects model.

Key Points:

  • Anti-TNF treatment was associated with reduced hospitalization probability (OR=0.53) and severe COVID-19 (OR=0.63) compared to non-anti-TNF treatments.
  • No significant difference in hospitalization risk for COVID-19 was observed in non-COVID-19 populations receiving anti-TNF therapy.
  • Adjustments were made for validated predictors of adverse disease outcomes.

Conclusions:

  • TNF-α inhibitors are linked to a decreased likelihood of hospitalization and severe COVID-19.
  • These findings suggest a potential protective role of anti-TNF agents in managing COVID-19 in patients with inflammatory diseases.

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