Some immunosuppressants do not increase Covid-19 risk: Scientists

Therapeutics which suppress the immune system in those with inflammatory diseases like psoriasis and rheumatoid arthritis "are not associated with a significantly greater risk" for contracting Covid-19, according to a study which says these patients should continue taking their medicine as prescribed.

Dermatology researchers from the Henry Ford Health System in the US, which treats a large number of patients with inflammatory diseases like psoriasis, eczema and lupus, said most of these patients are not at any greater risk for Covid-19 than the general population, despite their weakened immune system.

While patients who are immunosuppressed are predisposed to upper respiratory infections like the common cold, which may cause coughing, a runny nose and a sore throat, the scientists said this patient population has not been reported to be at higher risk for Covid-19 to date.

According to the researchers, the study, published in the Journal of the American Academy of Dermatology, is one of the first to analyse the association between immunosuppressive medications for skin diseases and the risk of Covid-19 infection and outcomes.

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"If you require an immune suppressant medication for your condition to be well controlled, you should not be afraid to continue that medication during the pandemic," said Jesse Veenstra, a Henry Ford dermatologist and the study's lead author.

The researchers noted that until now, very little was known about managing patients on these medications in the pandemic, and whether they may be at increased risk for infection with Covid-19, or related complications because of their weakened immune system.

In the current study, they conducted a retrospective analysis of 213 patients who were taking immunosuppressive medication for an immune-mediated inflammatory disease.

They tested the patients who had been receiving immunosuppressive medication for at least one month prior to being tested for Covid-19 between February 1 and April 18.

The study found that 36 per cent of the 213 patients tested Covid-19 positive, and had no greater odds of being hospitalised or placed on a ventilator than the general population.

The scientists said they did not find any evidence of an immunosuppressive medication increasing a patient's odds for testing positive or developing serious disease.

Patients prescribed a TNF alpha inhibitor, which are protein therapeutics part of a class of immunosuppressive agents, had significantly lower odds for hospitalisation, the study noted.

On the contrary, Veenstra said, patients who were on multidrug therapy regimens were at greater odds of being hospitalised than those taking a single medication.

He added that more research is needed to fully explain this finding.

Citing the limitations of the research, the scientists noted that being a single-center study, the findings may not be easily generalised to other communities.

They added that only patients who tested for Covid-19 were analysed in the study.

However, the researchers believe the findings suggest that multiple medications further suppress a patient's immune system, thus rendering them more susceptible to Covid-19.

"Traditionally, you think of these medications putting you at higher risk for infection," Veenstra said.

"With Covid-19, this is a new type of pathogen, and no one really knows how these medications affect your immune system's ability to deal with the infection," he added.