免疫抑制剂或免疫调节剂对严重COVID-19结果的影响:基于人口的队列研究
Shelby Marozoff1, Jeremiah Tan2, Na Lu1
1Arthritis Research Canada, Vancouver, British Columbia, Canada.
烯酸和葡萄糖皮质类药物增加了COVID-19的严重风险,包括住院和ICU入院. 葡萄糖皮质醇使用也增加了死亡风险. 这些发现凸显了免疫抑制剂的患者情况的多样性.
科学领域:
- 免疫学 免疫学 免疫学
- 传染性疾病 传染性疾病
- 药理学 药理学是指药理学的学科.
背景情况:
- COVID-19带来了严重的风险,特别是对于免疫力低下的人来说.
- 了解免疫抑制和免疫调节剂 (IIA) 对COVID-19结果的影响至关重要.
研究的目的:
- 为了估计IIA暴露和严重的COVID-19结果之间的关联.
- 确定增加严重COVID-19风险的特定IIA.
主要方法:
- 加拿大不列颠哥伦比亚省的一项基于人口的队列研究分析了18岁以上的SARS-CoV-2阳性个体.
- 在测试后3个月内使用IIA被分类,包括传统的DMARD,免疫抑制剂 (例如MMF),生物制剂 (例如TNFi) 和葡萄皮质皮质激素.
- 严重的结局包括住院,ICU入院和60天内死亡,分析使用后勤回归与倾向得分重叠权重.
主要成果:
- 菌酸莫菲提尔 (MMF),所有免疫抑制剂和葡萄糖皮质类药物与显著更高的住院和ICU入院风险有关.
- 葡萄糖皮质激素的使用是唯一与60天死亡率增加显著相关的IIA.
- 对于其他具有严重COVID-19结果的IIAs,没有发现统计学上显著的关联.
结论:
- 目前使用MMF和葡萄糖皮质类药物与严重的COVID-19结局的增加有关.
- 这些发现强调了COVID-19患者不同IIA相关的多样性风险.
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