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Decrease of infectious complications in outpatients with autoimmune diseases from 2019 to 2020 under the COVID-19
Yumiko Oka1, Takao Kodera1, Miki Takeshita1
1Department of Hematology and Rheumatology, Tohoku Medical and Pharmaceutical University Hospital, Sendai, Miyagi, Japan.
Insights
The COVID-19 pandemic led to fewer infections, like pneumonia and influenza, in autoimmune disease patients. Increased mask use and hand sanitizer adoption likely contributed to this decline.
Area of Science:
- Rheumatology
- Infectious Diseases
- Public Health
Background:
- Autoimmune diseases require careful management of infection risks.
- The COVID-19 pandemic prompted significant public health measures and lifestyle changes.
Purpose of the Study:
- To investigate the impact of the COVID-19 pandemic on infectious complications in outpatients with autoimmune diseases.
Main Methods:
- A retrospective, record-linked cohort study and lifestyle questionnaire were used.
- Data were collected from outpatients in 2019 and 2020.
Main Results:
- Infections, including pneumonia and influenza, significantly decreased in 2020 compared to 2019.
- Increased use of immunomodulating agents was observed in 2020.
- Patients reported increased mask use (75%) and hand sanitizer use (81%) during the pandemic.
Conclusions:
- The COVID-19 pandemic was associated with a reduction in certain infectious complications among autoimmune disease outpatients.
- Public health interventions and patient behavioral changes may have played a role in this decrease.
Objectives:
To examine how the novel coronavirus disease (COVID-19) has changed infectious complications in outpatients with autoimmune diseases.
Methods:
We performed a retrospective, record-linked cohort study and questionnaire about lifestyle changes in patients who visited our department in 2019 and 2020.
Results:
We surveyed 1316 outpatients in 2019 and 1284 in 2020. The most common underlying diseases were rheumatoid arthritis (842 vs. 814) and systemic lupus erythematosus (SLE) (126 vs. 127). No significant difference in median age (66 vs. 67 years), respiratory comorbidities (30.4% vs. 32.0%), or corticosteroid use (42.2% vs. 44.3%) was found between the years. Immunomodulating agents were used more in 2020 (33.1% vs. 39.7%, p < .001). Total number of infections (28.0/100 vs. 19.4/100 person-years), pneumonia (3.6 vs. 1.6), influenza (2.1 vs. 0.1), and nonviral dermatological infections (3.8 vs. 2.1) were significantly lower in 2020. No significant difference was found for herpes zoster (2.2 vs. 1.8), urinary tract infections (3.3 vs. 3.8), or gastrointestinal infections (2.9 vs. 3.0). According to the questionnaire, 75% of the respondents became more conscious about wearing masks and 81% began to use hand sanitizer during the pandemic.
Conclusion:
Under the COVID-19 pandemic, some infectious complications have decreased in outpatients with autoimmune diseases.
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