Scientists from the London School of Hygiene & Tropical Medicine found that people with certain inflammatory immune conditions affecting the joints, bowel and skin, such as rheumatoid arthritis, may have a higher death risk if they got COVID-19 before vaccination.
The research is published in The Lancet Rheumatology and was conducted by Sinéad Langan et al.
In the study, the team analyzed 17 million patient GP records in England during the first phase of the pandemic from March-September 2020.
More than one million patients in the analysis had immune-mediated inflammatory diseases (IMIDs).
These included inflammatory bowel diseases such as Crohn’s disease and ulcerative colitis, conditions affecting the joints such as rheumatoid arthritis, and skin conditions including psoriasis.
The team found that people with inflammatory diseases affecting the bowel, joints and skin had a 23% increased risk of COVID-19-related death and 23% increased risk of COVID-related hospitalization.
People with inflammatory joint disease appeared to be at the greatest risk compared to those with gut or skin disease.
This study provides the most accurate assessment of the risk of severe COVID-19 before vaccination in people with IMIDs and with the drugs used for their treatment.
The researchers hope this analysis will help to inform evidence-based policy as we continue to live with COVID-19.
The team also examined the impact of certain medications, identifying around 200,000 people who were on immune-modifying drugs.
They found there was no overall increased risk of COVID-19 death or hospitalization for patients on most targeted immune-modifying drugs (often referred to as biologics) compared to standard systems (that work on the wider immune system) given to treat this group of conditions.
This study provides important information that will help guide policymakers to ensure prevention strategies such as vaccination, and early intervention treatments such as anti-virals, are targeted towards those most at risk.
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