Does Biological Therapy Protect against Severe COVID-19?
Authors: Mazzucchelli Ramon , González Raquel Almodovar , Villarías Natalia Crespi , García Zamora Elena , Pérez Fernández Elia , Quirós Donate Javier , Pérez Encinas Monserrat , Sanmartín Fenollera Patricia , Velasco María , López Serrano Pilar , Lázaro Perez Calle Jose , Rodríguez Conrado Fernández , López-Estebaranz José Luis , Zarco Pedro 
Published: June 2020

AbstractObjectiveTo estimate COVID-19 infection incidence rate with severe affectation (requiring hospitalization) in patients with biological treatment due to rheumatoid arthritis (RA), psoriatic arthritis (PsA), spondyloarthritis (SpA), psoriasis (Ps), and inflammatory bowel disease (IBD) and compare it with incidence rate in the general population.MethodsRetrospective observational study based on information provided by two administrative databases. One of these two databases contains information on all patients seen in our hospital and diagnosed with COVID-19 infection between March 4th 2020 and April 26th 2020. The other database contains data from patients seen at Rheumatology, Dermatology and Digestive Departments in our hospital who are currently receiving biological therapy. We calculated the crude and age and sex adjusted incidence in both groups. To compare both groups we calculated the Incidence Rate Ratio.ResultsThere was a total of 2,182 patients with COVID-19 requiring hospitalization. Four patients out of a total of 797 patients receiving biological therapy had contracted COVID-19 and required hospital care. Crude incidence rate of COVID-19 requiring hospital care among the general population was 1.41%, and it was 0.50% among the group receiving biological therapy. Rates adjusted by age and sex in the biological group was 0.45% (CI95% 0.11-4.13). The IRR of the group receiving biological therapy compared to the general population was 0.39 (CI95% 0.14-1, p=0.049).ConclusionFindings suggest that prior use of biological therapy does not associate with severe manifestations of COVID-19, and it is likely to have a protective effect against them when compared to the general population.Key MessagesWhat is already known about this subject?Covid-19 susceptibility in patients with immune-mediated disorders and receiving treatment with biological therapy is unknown.What does this study add?Severe manifestation incidence rate in patients with immune-mediated disorders receiving biological therapy treatment is not increased when compared to the general population.Biological therapies might protect patients from presenting severe COVID-19 manifestations.How might this impact on clinical practice?These data could be used for current recommendations regarding management of patients receiving biological therapies.Mini AbstractThe objective of this study is to analyze the incidence rate of severe COVID-19 requiring hospital care for patients receiving biological therapy and to compare it to the general population. Patients treated with biological therapy have crude and adjusted incidence rates under those of the general population.Statement of Human and Animal RightsThis article does not contain any studies involving human participants or animals that were performed by the authors. For this type of study, formal consent was therefore not required.