Prescribed immunosuppressants may not increase risk of COVID-19 infection, claims study

A group of researchers at the American healthcare company, Henry Ford Health System claim that people who are on immunosuppressants for common skin and rheumatic conditions including rheumatoid arthritis and psoriasis are not at an increased risk of getting COVID-19 and should continue to take the medications. The study published in the Journal of the American Academy of Dermatology concluded that there is no evidence that using a single immunosuppressant can put you at risk for severe COVID-19. In fact, it may help reduce your chances of hospitalisation if you do get the disease. As per a news release by the healthcare company, the dermatologists at Henry Ford treat a huge population of Michigan’s skin inflammatory disease patients including those with psoriasis, lupus and eczema. The use of immunosuppressants in the treatment of these diseases is what had prompted the researchers to conduct this trial. The study For the study, the researchers did a retrospective cohort analysis of patients at the Henry Ford Healthcare System who tested positive for COVID-19 between 1 February and 18 April, 2020. About 213 patients with immune-mediated inflammatory diseases (IMID) were included in the study. Out of these about 36.2 percent tested positive for COVID-19. The scientists noted the following things in the study:

• The 36.2 percent patients who had tested positive for COVID-19 did not show any higher risk of hospitalisation or need for ventilation. 
• Those who were taking prescribed TNF alpha inhibitors had a lower chance of hospitalisation. TNF alpha inhibitors are immunosuppressive drugs that are used to suppress inflammation.  
• Those who were on single drug treatment did not have a high risk of getting COVID-19 or developing a severe condition. However, those on multiple-drug therapy were at a higher risk of getting hospitalised.

Previous evidence Those who are taking immunosuppressive drugs were intuitively included under the high-risk category for COVID-19 along with people with weak immunity, the elderly and those with chronic conditions. However, in the absence of clinical evidence, scientists have since been dubious about this recommendation. Immunosuppressant drugs are given to patients who’ve undergone an organ transplant or those with autoimmune diseases. Normally, patients on these drugs are prone to infections, especially upper respiratory tract infections like common cold and cough. However, previous case studies and studies conducted on small groups of people on immunosuppressants have pointed out no different course of COVID-19 in these patients than an otherwise healthy patient. In fact, studies indicate that immunosuppressants were not a problem in the SARS and MERS (two related coronavirus outbreaks in the 21st century) outbreaks either. As a result, a lot of organisations including the American Gastroenterological Association, British Society of Gastroenterology, British Society of Rheumatology and American Academy of Dermatology have suggested patients to continue using immunosuppressants (if they are prescribed one) while taking the appropriate precautions for COVID-19. “If you require an immunosuppressant medication for your condition to be well controlled, you should not be afraid to continue that medication during the pandemic," Veenstra, lead author of the study and a dermatologist at Henry Ford, said in a news release. He added, “Physicians who prescribe these medications should feel comfortable either continuing or resuming their patients on these medications…They can counsel their patients that there’s data to support the safety profile of these medications during the COVID-19 pandemic."

For more information, read our article on What it means to be immunocompromised. Health articles in Firstpost are written by myUpchar.com, India’s first and biggest resource for verified medical information. At myUpchar, researchers and journalists work with doctors to bring you information on all things health.