Frontiers in Medicine (Mar 2024)
The protective effect of tumor necrosis factor-alpha inhibitors in COVID-19 in patients with inflammatory rheumatic diseases compared to the general population—A comparison of two German registries
- Rebecca Hasseli,
- Rebecca Hasseli,
- Frank Hanses,
- Melanie Stecher,
- Christof Specker,
- Tobias Weise,
- Stefan Borgmann,
- Martina Hasselberger,
- Bernd Hertenstein,
- Martin Hower,
- Bimba F. Hoyer,
- Carolin Koll,
- Andreas Krause,
- Marie von Lilienfeld-Toal,
- Hanns-Martin Lorenz,
- Uta Merle,
- Susana M. Nunes de Miranda,
- Mathias W. Pletz,
- Anne C. Regierer,
- Jutta G. Richter,
- Jutta G. Richter,
- Siegbert Rieg,
- Christoph Roemmele,
- Maria M. Ruethrich,
- Tim Schmeiser,
- Hendrik Schulze-Koops,
- Anja Strangfeld,
- Maria J.G.T. Vehreschild,
- Florian Voit,
- Reinhard E. Voll,
- Jörg Janne Vehreschild,
- Jörg Janne Vehreschild,
- Ulf Müller-Ladner,
- Alexander Pfeil
Affiliations
- Rebecca Hasseli
- Section of Rheumatology and Clinical Immunology, Department of Internal Medicine D, University Hospital Münster, Münster, Germany
- Rebecca Hasseli
- Department of Rheumatology and Clinical Immunology, Justus-Liebig University Giessen, Giessen, Germany
- Frank Hanses
- Emergency Department and Department for Infectious Diseases and Infection Control, University Hospital Regensburg, Regensburg, Germany
- Melanie Stecher
- Department I of Internal Medicine, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
- Christof Specker
- Department of Rheumatology and Clinical Immunology, KEM Kliniken Essen-Mitte, Essen, Germany
- Tobias Weise
- Biocontrol Jena, Jena, Germany
- Stefan Borgmann
- Department of Infectious Diseases and Infection Control, Ingolstadt Hospital, Ingolstadt, Germany
- Martina Hasselberger
- Klinikum Passau, Passau, Germany
- Bernd Hertenstein
- Klinikum Bremen-Mitte, Bremen, Germany
- Martin Hower
- 0Department of Pneumology, Infectious Diseases, Internal Medicine and Intensive Care, Klinikum Dortmund GmbH, Dortmund, Germany
- Bimba F. Hoyer
- 1Department for Rheumatology and Clinical Immunology, University of Schleswig-Holstein, Kiel, Germany
- Carolin Koll
- Department I of Internal Medicine, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
- Andreas Krause
- 2Department of Rheumatology, Clinical Immunology and Osteology, Immanuel Hospital Berlin, Berlin, Germany
- Marie von Lilienfeld-Toal
- 3Department of Hematology and Medical Oncology, University Hospital Jena, Jena, Germany
- Hanns-Martin Lorenz
- 4Department of Internal Medicine V, University of Heidelberg, Heidelberg, Germany
- Uta Merle
- 5Department of Gastroenterology and Infectious Diseases, Heidelberg University Hospital, Heidelberg, Germany
- Susana M. Nunes de Miranda
- 6Department of Medicine II, University of Freiburg, Freiburg, Germany
- Mathias W. Pletz
- 7Institute for Infectious Diseases and Infection Control, Jena University Hospital, Jena, Germany
- Anne C. Regierer
- 8Epidemiology Unit, German Rheumatism Research Center Berlin, Berlin, Germany
- Jutta G. Richter
- 9Department of Rheumatology, University Hospital Düsseldorf, Medical Faculty of Heinrich-Heine-University, Düsseldorf, Germany
- Jutta G. Richter
- 0Hiller Research Center, University Hospital Düsseldorf, Medical Faculty of Heinrich-Heine-University, Düsseldorf, Germany
- Siegbert Rieg
- 1Division of Infectious Diseases, Department of Medicine II, University of Freiburg, Freiburg, Germany
- Christoph Roemmele
- 2Department of Gastroenterology, Faculty of Medicine, University of Augsburg, Augsburg, Germany
- Maria M. Ruethrich
- 3Department of Hematology and Medical Oncology, University Hospital Jena, Jena, Germany
- Tim Schmeiser
- 3Private Practice, Cologne, Germany
- Hendrik Schulze-Koops
- 4Division of Rheumatology and Clinical Immunology, Department of Internal Medicine IV, University of Munich, Munich, Germany
- Anja Strangfeld
- 8Epidemiology Unit, German Rheumatism Research Center Berlin, Berlin, Germany
- Maria J.G.T. Vehreschild
- 5Department of Internal Medicine, Infectious Diseases, University Hospital Frankfurt, Goethe University Frankfurt, Frankfurt am Main, Germany
- Florian Voit
- 6Department of Internal Medicine II, School of Medicine, University Hospital Rechts Der Isar, Technical University of Munich, Munich, Germany
- Reinhard E. Voll
- 7Department of Rheumatology and Clinical Immunology, Faculty of Medicine, Medical Center-University of Freiburg, University of Freiburg, Freiburg, Germany
- Jörg Janne Vehreschild
- Department I of Internal Medicine, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
- Jörg Janne Vehreschild
- 8Department II of Internal Medicine, Hematology/Oncology, Goethe University, Frankfurt, Germany
- Ulf Müller-Ladner
- Department of Rheumatology and Clinical Immunology, Justus-Liebig University Giessen, Giessen, Germany
- Alexander Pfeil
- 9Department of Internal Medicine III, University Hospital Jena, Jena, Germany
- DOI
- https://doi.org/10.3389/fmed.2024.1332716
- Journal volume & issue
-
Vol. 11
Abstract
ObjectivesTo investigate, whether inflammatory rheumatic diseases (IRD) inpatients are at higher risk to develop a severe course of SARS-CoV-2 infections compared to the general population, data from the German COVID-19 registry for IRD patients and data from the Lean European Survey on SARS-CoV-2 (LEOSS) infected patients covering inpatients from the general population with SARS-CoV-2 infections were compared.Methods4310 (LEOSS registry) and 1139 cases (IRD registry) were collected in general. Data were matched for age and gender. From both registries, 732 matched inpatients (LEOSS registry: n = 366 and IRD registry: n = 366) were included for analyses in total.ResultsRegarding the COVID-19 associated lethality, no significant difference between both registries was observed. Age > 65°years, chronic obstructive pulmonary disease, diabetes mellitus, rheumatoid arthritis, spondyloarthritis and the use of rituximab were associated with more severe courses of COVID-19. Female gender and the use of tumor necrosis factor-alpha inhibitors (TNF-I) were associated with a better outcome of COVID-19.ConclusionInflammatory rheumatic diseases (IRD) patients have the same risk factors for severe COVID-19 regarding comorbidities compared to the general population without any immune-mediated disease or immunomodulation. The use of rituximab was associated with an increased risk for severe COVID-19. On the other hand, the use of TNF-I was associated with less severe COVID-19 compared to the general population, which might indicate a protective effect of TNF-I against severe COVID-19 disease.
Keywords
- inflammatory rheumatic diseases
- COVID-19
- general population
- tumor necrosis factor-alpha inhibitors
- severe disease
