CO0003 TREATMENT WITH BIOLOGICAL THERAPIES AND RISK OF BEING ADMITTED TO THE HOSPITAL FOR COVID19 INFECTION
Authors: C. Gonzalez, L. A. Menchén Viso, O. Baniandrés Rodríguez, A. Herranz Alonso, C. Lobo Rodríguez, J. C. Nieto, I. Monteagudo Sáez, I. Marín Jiménez, A. López, A. López, A. Ais Larisgoitia, E. Chamorro de Vega, P. Morales de Los Ríos, M. J. Lizcano, J. M. Alvaro Gracia, S. García de San José
Journal: Annals of the Rheumatic Diseases (2020)

Objectives: To analyze the risk of admission for COVID19 infection and outcome of patients treated with bDMARD or tsDMARD from our biologic therapy center, to compare with all patients admitted for COVID-19 infection in our hospital. Methods: Records of the patients from our center admitted for COVID-19 infection between March 8 and May 8, 2020 were analyzed retrospectively. Age, gender, and outcome of all patients admitted for COVID19 infection to our hospital on the same dates were collected. Chi-square, Student’s t and Man-Whitney U tests were used for comparisons when appropriate. Results: 1,668 patients with inflammatory diseases treated with bDMARD or tsDMARD were included. Median age 53.0 years (range 17-91), 52.4% women. Diagnoses and DMARD distribution are shown in tables 1 and 2. 19/1668 (1.1%; 6.8 patient-years) were admitted for severe COVID19 infection. Mortality ratio: 4/19 (21.1%). Median age of the admitted patients was higher: 61.0y (SD 14.2) vs 53.0y (SD 15.0); p &lt;0.009. Median age of deceased patients was also higher 69.5y (SD 20.3) vs 53.0y (SD 15.0); p: NS. Female gender had a worse prognosis trend: 52.4% of all group, 68.4% of those hospitalized, 75.0% of those who died. Females had a higher median age than men: 55.0y (SD 14.9) vs. 50.0y (SD 14.9); p &lt;0.001. When comparing patients treated with DMARD admitted for COVID19 infection with all patients hospitalized for the same reason (4,601patients), no differences were found neither in age (61.0y [SD 14.2] vs 58.3y [SD 18.1]; NS) nor gender (female: 68.4% vs 54.7%; NS). However, DMARD group seemed to have higher mortality: 4/19 (21.1%) vs 551/4601 (12.0%); p: NS, at a younger age: 69.5y (SD 20.3) vs 82.4 (SD 11.4); p: NS. Rheumatoid arthritis patients were admitted more frequently: (9/392 (2.3%) vs 10/1276 (0.8%); p &lt;0.025. And were older: median 62y (SD 13.5) vs 50.0y (SD 14.4); p &lt;0.001. Patients treated with anti-TNF suffered less admissions: 6/1055 (0.6%) vs 13/613 (2.1%); p&lt;0.001 and were younger: median 51.0y (SD 15.0) vs 55.0y (SD 14.7); p &lt;0.001. Anti-TNF were less used in patients with rheumatoid arthritis 188/392 (48.0%) vs 867/1276 (67.9%); p&lt;0.001. Disease N (%) Admitted deaths Rheumatoid arthritis Spondylarthritis Psoriatic arthritis JIA CTD Vasculitis IBD Psoriasis Others 392 (23.5%) 277 (16.6%) 124 (7.4%) 30 (1.8%) 31 (1.9%) 20 (1.2%) 582 (34.9%) 202 (12.1%) 10 (0.6%) 9/392 (2.3%) 2/277 (0.7%) 1/124 (0.8%) 0/30 (0.0%) 1/31 (3.2%) 0/20 (0.0%) 4/578 (0.7%) 2/202 (1.0%) 0/10 (0.0%) 1 1 0 0 1 0 1 0 0 TOTAL 1,668 (100%) 19/1668 (1.1%) 4/19 (21.1%) JIA: Juvenile Idiopathic Arthritis; CTD: Connective Tissue Disease; IBD: Inflammatory Bowel Disease Treatment N (%) Admitted deaths Anti-TNF Anti-CD20 Anti-IL6 CTLA4-Ig Anti-IL17 Anti-IL12/23 Anti-integrin JAK inhibitor PDE4 inhibitor Anti-IL23 1055 (63.2%) 79 (4.7%) 96 (5.8%) 44 (2.6%) 92 (5.5%) 143 (8.6%) 79 (4.7%) 34 (2.0%) 32 (1.9%) 14 (0.8%) 6/1055 (0.6%) 3/79 (3.8%) 3/96 (3.1%) 3/44 (6.8%) 2/92 (2,2%) 1/143 (0.7%) 0/79 (0.0%) 1/34 (2.9%) 0/32 (0.0%) 0/14 (0.0%) 2 1 0 1 0 0 0 0 0 0 TOTAL 1,668 (100%) 19/1668 (1.1%) 4/19 (21.1%) Conclusion: It seems reasonable that patients with inflammatory diseases treated with bDMARD or tsDMARD continue their treatment during the COVID19 epidemic. The different rates of hospitalization based on the diagnosis or DMARD may be due to comorbidity, confounding by indication and other bias. The study is not powerful enough to study these confounders. Disclosure of Interests: Carlos Gonzalez Consultant of: Gilead, Janssen, Novartis, Speakers bureau: Abbvie, Celgene, Gilead, Janssen, Novartis, Pfizer, Roche, Luis Alberto Menchén Viso Grant/research support from: Abbvie, Janssen, MSD, Takeda, Consultant of: Abbvie, Janssen, Takeda, MSD, Medtronic, Tillotts, Pfizer, Dr. Falk Pharma, Speakers bureau: Abbvie, Janssen, Takeda, MSD, General Electric, Tillotts, Pfizer, Ferring, General Electric, Fresenius, Ofelia Baniandrés Rodríguez: None declared, Ana Herranz Alonso: None declared, Carmen Lobo Rodríguez: None declared, Juan Carlos Nieto Speakers bureau: Pfizer, Abbvie, MSD, Novartis, Janssen, Lilly, Nordic Pharma, BMS, Gebro, FAES Farma, Roche, Sanofi, Indalecio Monteagudo Sáez: None declared, Ignacio Marín Jiménez: None declared, Amparo López: None declared, Ana López: None declared, Arantza Ais Larisgoitia: None declared, Esther Chamorro de Vega: None declared, Paloma Morales de los Ríos: None declared, Maria Jesus Lizcano: None declared, Jose Maria Alvaro Gracia: None declared, Sonia García de San José: None declared